Newfoundland and Labrador: A Health System Profile

By Stephen Bornstein, John Abbott, Victor Maddalena, Aimee Letto, Melissa Sullivan, and Pablo Navarro

© 2021

There is not, and has never been, a single Canadian health system. Newfoundland and Labrador: A Health System Profile provides a detailed and critical analysis of how Canada’s single-payer healthcare system has been implemented in the country’s youngest province. As part of a series on the health systems of Canada’s provinces and territories, this book provides historical background on how the health system of Newfoundland and Labrador has developed since the early twentieth century with an emphasis on the period since it became part of the Canadian federation in 1949.

Examining the way the province’s health services have been, and currently are, organized, funded, and delivered, the authors focus on the challenges involved in providing effective health care in a setting characterized by a large, decentralized territory, a small population much of which is widely distributed in a large number of rural communities and small towns, and comparatively limited fiscal capacity and health human resources. Drawing on maps, figures, and data tables, this book documents the hesitant and limited ways in which Newfoundland and Labrador has sought to deal with the challenges and difficulties that the system has experienced in responding to recent changes in demography, economics and medical technology.

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Product Details

  • Series: Provincial and Territorial Health System Profiles
  • World Rights
  • Page Count: 208 pages
  • Illustrations: 7
  • Dimensions: 6.0in x 1.0in x 9.0in
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Quick Overview

Combining a historical account with a current analysis, Newfoundland and Labrador: A Health System Profile is the first comprehensive study of the province’s health institutions, policies, and outcomes.

Newfoundland and Labrador: A Health System Profile

By Stephen Bornstein, John Abbott, Victor Maddalena, Aimee Letto, Melissa Sullivan, and Pablo Navarro

© 2021

There is not, and has never been, a single Canadian health system. Newfoundland and Labrador: A Health System Profile provides a detailed and critical analysis of how Canada’s single-payer healthcare system has been implemented in the country’s youngest province. As part of a series on the health systems of Canada’s provinces and territories, this book provides historical background on how the health system of Newfoundland and Labrador has developed since the early twentieth century with an emphasis on the period since it became part of the Canadian federation in 1949.

Examining the way the province’s health services have been, and currently are, organized, funded, and delivered, the authors focus on the challenges involved in providing effective health care in a setting characterized by a large, decentralized territory, a small population much of which is widely distributed in a large number of rural communities and small towns, and comparatively limited fiscal capacity and health human resources. Drawing on maps, figures, and data tables, this book documents the hesitant and limited ways in which Newfoundland and Labrador has sought to deal with the challenges and difficulties that the system has experienced in responding to recent changes in demography, economics and medical technology.

Continue Reading Read Less

Product Details

  • Series: Provincial and Territorial Health System Profiles
  • World Rights
  • Page Count: 208 pages
  • Illustrations: 7
  • Dimensions: 6.0in x 1.0in x 9.0in
  • Author Information

    Stephen Bornstein is professor of Community Health and Humanities and of Political Science and Director of the Newfoundland and Labrador Centre for Applied Health Research at Memorial University of Newfoundland.


    John Abbott is Chief Executive Officer of the NL Division of the Canadian Mental Health Association, former deputy minister of NL's health and community services department, and the last CEO of the Health Council of Canada.


    Victor Maddalena is an associate professor in the Division of Community Health and Humanities and Faculty of Medicine at Memorial University of Newfoundland.


    Aimee Letto is a lawyer from St. John’s, Newfoundland and Labrador whose work focuses on health law and public health policy.


    Melissa Sullivan is an Applied Health Services Research Consultant.


    Pablo Navarro is a research officer and project coordinator at the Newfoundland & Labrador Centre for Applied Health Research at the Memorial University of Newfoundland.
  • Table of contents

    Series Editor’s Foreword

    List of Acronyms

    1. Introduction and overview 
    1.1 Geography and socio-demography 
    1.2 Political context 
    1.3 Economic context 
    1.4 Health status of the population 
    1.5 Summary 

    2. Organization and regulation 
    2.1 History 
    2.2 Current organization of the provincial health system 
    2.3 Health system planning 
    2.4 Coverage and benefits 
    2.5 Regulation 
    2.6 Patients 
    2.7 Summary 

    3. Health spending and financing 
    3.1 Expenditures and trends 
    3.2 Public revenue 
    3.3 Private revenue 
    3.4 Public financial flows 
    3.5 Summary 

    4. Physical infrastructure 
    4.1 Hospitals and rehabilitation facilities 
    4.2 Long-term care facilities and personal care homes 
    4.3 Medical and diagnostic facilities 
    4.4 Public health services 
    4.5 Information and communications technology infrastructure 
    4.6 Research and evaluation infrastructure 
    4.7 Summary 

    5. Health human resources 
    5.1 Main workforce challenges 
    5.2 Physicians 
    5.3 Nurses 
    5.4 Other health professionals 
    5.5 Health workforce planning, education and training 
    5.6 Summary 

    6. Services and Programs 
    6.1 Public and population health services 
    6.2 Primary Care 
    6.3 Acute care 
    6.4 Long-term care 
    6.5 Public Prescription Drug Program 
    6.6 Workers’ compensation programs 
    6.7 Rehabilitation care 
    6.8 Mental health care 
    6.9 Dental health care 
    6.10 Complementary and alternative medicine 
    6.11 Targeted services 
    6.12 Palliative care 
    6.13 Summary 

    7. Reforms 
    7.1 Regional health system restructuring 
    7.2 Some incremental changes 
    7.3 Future prospects 
    7.4 Analysis 

    8. Assessment of the health system 
    8.1 Stated objectives of the health system 
    8.2 Financial protection and equity in financing 
    8.3 Equity of access 
    8.4 Outcomes 
    8.5 User experience and satisfaction 
    8.6 Efficiency 
    8.7 Transparency and accountability 
    8.8 Summary 

    9. Conclusion 

    References

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