Health Services Planning Commission, 1944-50

The Health Services Planning Commission (HSPC) was created in November 1944 to serve as a central health planning and advisory body to the new Co-operative Commonwealth Federation (CCF) government of T.C. Douglas. The CCF had come to power in 1944 with the intention of creating a comprehensive system of socialized health services in Saskatchewan. Under the leadership of Douglas and the HSPC, the new government was to realize much of its goal in its first term in office from 1944 to 1948.

The Commission had been one of the “recommendations for immediate action” made by Dr. Henry E. Sigerist, professor of Medical History at Johns Hopkins University and recognized expert in public health and “socialized medicine,” whom Douglas had recruited to conduct a review of health conditions in the province and to make recommendations that would serve as an outline for the government for future reform.

By 1944, Saskatchewan had already seen several innovations in health care such as municipal doctor and union hospital schemes, which collectively allowed a large number of people access to pre-paid hospital and medical care. These ideas, and others, had evolved over time as a result of local initiative, not of a central government plan. The Department of Public Health had focused primarily on public health activities and not on planning a comprehensive public health, medical and hospital scheme for the province.

A small Commission allowed for a concerted effort to transform the system. Douglas staffed the Commission with reform-minded individuals instead of relying on the more traditional Department of Public Health. The Commission was, in some ways, a continuation of Sigerist’s work, with the initial three members—C.C. Gibson, an experienced hospital administrator, T.H. McLeod, economic advisor to the government, and Dr. M.C. Sheps, secretary and member—each having served in some capacity with Sigerist’s survey. Selection of a permanent chairperson for the Commission did not occur until 1946, when Dr. F.D. Mott, former Assistant Surgeon General for the United States, assumed the role. But the Commission did not wait for a chairperson to begin; the reforms came quickly and the list was impressive.

The Commission proved instrumental in launching a series of initiatives including a program of medical and hospital care for residents receiving various forms of social assistance (January 1945); division of the province into health regions to deliver public health and preventative services (launched in 1945); plans for these same health regions to provide hospital and medical services (by July 1, 1946, Weyburn, Health Region No. 3, had a full hospitalization scheme, and Swift Current, Health Region No. 1, had complete medical and hospital care); development of a model contract (including full medical and preventive care) and financial support for municipal doctor plans (1945); a system of grants to support hospital construction (March 1945); construction of a new medical school and a university hospital (begun in 1946); efforts to attract and retain needed health care professionals; the launch of the Air Ambulance Service (1946); and, of course, the implementation of Saskatchewan Hospital Services Plan on January 1, 1947, providing the first provincewide, universal, pre-paid hospital insurance plan in Canada.

By 1948 the HSPC was increasingly occupied with administration of its many reforms. At the same time, the CCF determined to slow the pace of social reform and concentrate on economic matters. The need for a compact planning body focused on health reform had diminished, and on April 1, 1950, the operational programs of the HSPC were moved to a reorganized Department of Public Health. The Commission reverted to its original role as a planning and advisory body, and continued to exist until 1963—but in a much diminished capacity, and without the influence or importance it held from 1944 to 1948.

The HSPC had its detractors, in particular the organized medical community who would have preferred an “independent commission,” and its plans were sometimes modified or postponed (for example, plans for local health centres based on salaried physician practices were not implemented); but between 1944 and 1948, the HSPC had provided the government with advice and programs needed to eliminate many of the hardships evident in 1944 and to set the stage for the next major reform, medicare, which would come more than a decade later.

Duane Mombourquette