A well-written, logical and internally consistent report, compiled by the Saskatchewan Commission on Directions in Health Care, was released in April 1990 after twenty-one months of study and an expenditure of $1.6 million. The Commission was chaired by Dr. R.G. Murray, former dean of Medicine (1973-82). Walter Podiluk, former director of the Saskatoon Separate School System, stepped down from his position as provincial Deputy Minister of Health to become deputy chair and executive director. The other five commissioners were: Morris A. Anderson, former president of Luther College, Regina; Berva Farr, RN and executive director of a senior citizens home in Regina; Maureen L. Kurtz, a former public health nurse, Tisdale; Bishop Blaise Morand, a Roman Catholic leader from Prince Albert; and Ernie Moen, a Cabri farmer. Dr. Sylvia Fedoruk, a former physicist for the Saskatchewan Cancer Clinics, resigned from the committee when she was appointed Saskatchewan's Lieutenant-Governor.
This report, the first attempt to make a comprehensive plan for Saskatchewan health services since the Sigerist Report of 1944, described the Saskatchewan health care system as “open-ended, constantly expanding and lacking sufficient controls,” with insufficient emphasis on health promotion and preventive medicine.
The report recommended an increased effort to achieve a more unique Saskatchewan character, with a sense of ownership, a focus on health, professional teamwork, effectiveness, adaptability, affordability, and consultation. Among the 262 recommendations was a suggestion to divide the province into fifteen comprehensive health services divisions, with fifteen councils to replace the 127 hospital boards, 133 nursing home boards, 108 ambulance boards, and forty-five home care boards. It was proposed that fifty-seven one-doctor hospitals in villages and towns be turned into medical services centres, some staffed by a registered nurse, and that medical doctors be clustered into groups of at least three. A provincial health promotion fund of $10 million per year, as well as a health analysis and development commission targeting 1% of the health budget for research, were also mooted. To balance these new expenditures, the commission proposed tighter controls on medical practice, more home care, and fewer hospital admissions. Nurses should be given greater responsibility and paid more. Pediatrics and obstetrics would be moved to University Hospital.
In 1993, NDP Health Minister Louise Simard announced the closure of fifty-two rural hospitals; but this resulted in thirty health regions until 2003, when their number was reduced to ten. The amalgamation of pediatrics and obstetrics at Royal University Hospital, with closure of those units at the other two Saskatoon hospitals, took place in 1995; the last childbirth in the St. Paul's Hospital obstetric unit was on June 25, 1995.
C. Stuart Houston