The crisis of regionalization.
Currently in Canada, there is no consensus concerning the efficacy of regionalization, a reversal of the strong commitment in favour only a decade earlier. Instead, provincial governments are either dismantling regional health authorities in favour of highly centralized structures under the control of ministries of health or actively considering more centralized approaches. There is a general feeling among political leaders that regionalization has failed to achieve its original objectives. However, by not including physicians and primary care within regionalized governance, provincial governments have never given regionalization a real chance. Moreover, given the fact that the status quo prior to regionalization was far from an ideal state and would be almost impossible to return to in any event, some provincial governments should consider implementing a more full-blooded version of regionalization before abandoning the approach.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. greg.marchildon@utoronto.ca.
Gregory P
GP
Marchildon