title: Bringing Canadian healthcare closer to home: the initial stages of change for senior managers within the province of British Columbia.
abstract: This paper explores some recent healthcare reforms within the Canadian healthcare sector. As in most countries across the world, healthcare managers in Canada have been faced with the dilemma of how to achieve a balance between equity of provision and expenditure control. This study explores the external and internal pressures for change at the provincial and national levels within Canada. More significantly, it focuses on how the early stages of these changes have resulted in altered work roles and relationships for healthcare managers. A case study of British Columbia is described, where radical changes occurred in the healthcare sector in the mid-1990s. Interviews conducted with a sample of senior healthcare managers in the province illustrate how the restructuring of healthcare impacted upon management roles, structures and communication. The qualitative interview data is intended to provide an important addition to the body of largely quantitative, statistical data that is collected on international health systems on a regular basis. How the findings of the case study can contribute to learning and practice within the health services management arena is discussed.
authors.affiliation: Open University Business School, Milton Keynes, UK.
authors.forename: D
authors.initials: D
authors.lastname: Preston
mesh_terms: D001291:Attitude of Health Personnel; D001955:British Columbia; D003142:Communication; D003363:Cost Control; D018166:Health Care Reform / Q000458:organization & administration*; D006270:Health Facility Administrators; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D009313:National Health Programs / Q000458:organization & administration*; D019982:Organizational Case Studies; D009936:Organizational Innovation; D011787:Quality of Health Care; D012040:Regional Health Planning / Q000458:organization & administration*