The discourse of health reform has emphasized the need to increase public participation in decision-making as a way to enhance accountability. Despite recent gains in public participation in health care — primarily through citizen governance of regional health authorities — a clearly articulated accountability framework remains elusive in the Canadian context. If citizen participation is to be effective and meaningful, governing boards and politicians need to adopt an accountability framework that clearly delineates roles and responsibilities.
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References
1.
FykeKJ. Caring for medicare: Sustaining a quality system. Regina, SK: Government of Saskatchewan; 2001.
2.
KirbyML. The health of Canadians — The federal role. Volume 1–4: Issues and options, volume 6: Recommendations. Ottawa, ON: Standing Committee on Social Affairs, Science and Technology. Government of Canada; 2002.
3.
MazankowskiD. A framework for reform. Edmonton, AB: Premier's Advisory Council on Health; 2001.
4.
RomanowR. Commission on the future of health care in Canada — Final report; November 28, 2002. Available from: http://www.heathcarecommission.ca
5.
AbelsonJEylesJ. Public participation and citizen governance in the Canadian health system. Discussion paper submitted to the Commission on the Future of Health Care in Canada. Cat. No. CP32-79/7-2002E-IN; July 2002.
6.
EylesJ. The role of the citizen in health care decision-making. McMaster University Centre for Health Economics and Policy Analysis. Policy Commentary C93–1; June 1993.
7.
FooksCMasloveL. Rhetoric, fallacy or dream? Examining the accountability of Canadian health care to citizens. Health Care Accountability Papers No. 1. Canadian Policy Research Network; March 2004. Available from: www.cpm.ca.
8.
PivikJR. Practical strategies for facilitating meaningful citizen involvement in health planning. Discussion Paper 23. Commission on the Future of Health Care in Canada; September 2002.
9.
AbelsonJGauvinF-P. Engaging citizens: One route to health care accountability. Health Care Accountability Papers No. 2. Canadian Policy Research Network; April 2004. Available from: www.cpm.ca.
10.
FloodCMArchibaldT. Hamstrung and hogtied: Cascading constraints on citizen governors in medicare. Health Care Accountability Papers No. 6. Canadian Policy Research Network; June 2005. Available from: www.cpm.ca.
11.
HurleyJLomasJBhatiaV. When tinkering is not enough: Provincial reform to manage health care resources. Can Pub Admin1994; 37(3): 490–514.
12.
MhatreSLDeberRB. From equal access to health care to equitable access to health: A review of Canadian provincial health commissions and reports. Int J Health Serv1992; 22(4): 645–668.
13.
EvansRBarerMMarmorT, editors. Why are some people healthy and others not? The determinants of health of populations. New York: Aldine de Gruyter; 1994.
14.
SpasoffRA. Epidemiologic methods for health policy. New York: Oxford University Press; 1999.
15.
AlexanderJA. Hospital governance: Problems and prospects for health services research. J Health Adm Educ1991; 9(4): 395–442.
16.
GillM. Governance do's and don'ts: Lessons from case studies on twenty Canadian non-profits — Final report. Ottawa, ON: Institute on Governance; April 2001.
17.
HouleCO. Governing boards: Their nature and nurture. San Francisco, CA: Jossey-Bass Publishers; 1989.
18.
KovnerA. Improving hospital board effectiveness: An update. Front Health Serv Manage1990; 6(3): 3.
19.
PlumtreTGrahamJ. Governance in the new millenium: Challenges for Canada. Ottawa, ON: Institute on Governance; January 2000.
20.
ChynaJT. The consumer revolution: An age of changing expectations. Healthc Exec2000; 15(1): 7–10.
21.
OttenAL. The influence of mass media on health policy. Health Aff (Millwood)1992; 11(4): 111–118.
22.
StanburyWT. A skeptic's guide to the claims of so-called public interest groups. Can Pub Admin1995; 36(4): 580–605.
23.
BaderBS. Putting all the pieces together. Trustee2000; 53(3): 6–10.
24.
CarverJ. Boards that make a difference: A new design for leadership in nonprofit and public organizations (2nd ed.) San Francisco, CA: Jossey-Bass; 1997.
25.
GrahamJAmosBPlumtreT. Principles for good governance in the 21st century. Policy Brief No.15. Ottawa, ON: Institute on Governance; August 2003.
26.
SassoP. Searching for trust in the not-for-profit boardroom: Looking beyond the duty of obedience to ensure accountability. UCLA Law Review2003; 50: 1485–1546.
LewisSJKouriDEstabrooksCADickinsonHDutchakJJWilliamsI. Devolution to democratic health authorities in Saskatchewan: An interim report. CMAJ2001; 164(3): 343–347.
29.
DawsonCRathwellTPatersonCButlerLCobbettSPennockM. Determining the impact of the population health approach by community health boards in Nova Scotia. Halifax, NS: Dalhousie University; 2004.
30.
AhearnKDonohueMMangaP. The role of consumers in health care decision making. Healthc Manage Forum1997; 10: 25–27.
31.
TaylorDWWrightSRuggieroK. Discrimination: An invisible evil. In: DriedgerLHalliSS, editors. Race and racism: Canada's challenge. McGill/Queen's University Press; 2000.
32.
RobertsCCConnorsEJ. Major challenges facing governing boards of healthcare delivery organizations. Journal Healthc Manage1998; 43(4): 297–301.
33.
FrankishCJKwanBRatnerPAHigginsJWLarsenC. Community participation in health system decision-making: Community report of a survey of health authorities in British Columbia, January-May 1998. Institute of Health Promotion Research, University of British Columbia; November 1998.
34.
AlexanderJAWeinerBJBogueRJ. Changes in the structure, composition, and activity of hospital governing boards, 1989–1997: Evidence from two national surveys. Milbank Quarterly2001; 79(2): 253–279.
35.
MaddalenaVJ. Attending to the health needs of African Nova Scotians: Exploring the role of district health authorities. Doctoral dissertation. Halifax, NS: Dalhousie University; 2005.
36.
Ontario Ministry of Health and Long Term Care.Local health integration networks: Building a true system. Bulletin No. 11, May 2, 2005.
37.
BrownWA. Inclusive governance practices in non-profit organizations and implications for practice. Non-Profit Management and Leadership2002; 12(4): 369–385.
38.
CarverJCarverM. Making diversity meaningful in the boardroom. San Francisco, CA: Jossey-Bass; 1997.
39.
GuterbockTMLondonB. Race, political orientation, and participation: An empirical test of four competing theories. Am Soc Rev1983; 48: 439–453.