Community Clinics

Saskatchewan's community clinics were born amid turmoil and controversy in July 1962. Most of the province's doctors withdrew services on July 1, and Saskatchewan was plunged into a bitter 23-day strike. The CCF government had introduced North America's first public, tax-financed health insurance system, and the medical profession was opposed.

As the strike loomed, however, some doctors and consumers organized to provide health care during the crisis. In Saskatoon, doctors Margaret Mahood and Joan Whitney-Moore began to see patients on July 3 in a threadbare room in an office building. Dr. Samuel Wolfe, an internationally known physician and researcher, and a professor of medicine at the University of Saskatchewan, resigned his academic post to work at the clinic and was later to become its first medical director. Similar community health associations were organized in twenty-five centres, including Regina, Moose Jaw, Nipawin, Biggar and Wynyard. In Prince Albert, Dr. Orville Hjertaas was a pioneer and enduring presence in the community health clinic. The strike ended with the signing of the Saskatoon Agreement on July 23. Under terms of that agreement, doctors were to be paid on a fee-for-service basis. That created immediate difficulties for the co-operative clinics, which would have preferred global budgets, encouraging a different relationship between medical professionals and their consumer boards.

There were continuing strained relations between doctors who had opposed medicare and those who supported it, particularly those who chose to work in the clinics. A number of physicians new to the province, including Dr. Reynold Gold of the Saskatoon clinic, were denied hospital privileges for months.

Despite these and other difficulties, community clinics have provided health services for forty years, and continue to exist in five Saskatchewan centres. They offer a comprehensive range of services to 85,000 people in settings where medical professionals work in formal co-operation with citizen boards.

This type of practice has frequently been lauded by governments, but less often supported financially. With the endorsement of primary health care in 2003 by two prestigious government reports (the so-called Romanow Report, and the Senate report popularly known as the Kirby Report), community health centres or their equivalent may come into their own at last.

Dennis Gruending