Newfoundland and Labrador: A Health System Profile

by Stephen Bornstein, John Abbott, Victor Maddalena, Aimee Letto, Melissa Sullivan

Overview

There is not, and has never been, a single Canadian health system. Part of a series on the health systems of Canada’s provinces and territories, Newfoundland and Labrador: A Health System Profile provides a critical analysis of how the single-payer health care system has been implemented in the country’s youngest province.

Examining the way the province’s health services 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 collected data, 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.

Product Details

ISBN-13:	9781487525859
Publisher:	University of Toronto Press
Publication date:	10/20/2021
Series:	Provincial and Territorial Health System
Pages:	208
Product dimensions:	6.10(w) x 9.10(h) x 0.50(d)
Age Range:	18 Years

About the Author

Stephen Bornstein is a professor in the Division of Community Health and Humanities and the Department of Political Science and the director of the Newfoundland and Labrador Centre for Applied Health Research at Memorial University of Newfoundland.
John Abbott is the chief executive officer of the Newfoundland-Labrador 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

What People are Saying About This

Tom Noseworthy

"Newfoundland and Labrador: A Health System Profile is comprehensive, well-written, and informative, with a distinct political science lens. The authors offer a descriptive and analytic assessment and avoid unwarranted judgment. It depicts a health system that is falling short of achieving health outcomes, that appears to have consistently resisted change, and one that is not meeting health goals achieved elsewhere."

Editorial Reviews

" Newfoundland and Labrador: A Health System Profile is comprehensive, well-written, and informative, with a distinct political science lens. The authors offer a descriptive and analytic assessment and avoid unwarranted judgment. It depicts a health system that is falling short of achieving health outcomes, that appears to have consistently resisted change, and one that is not meeting health goals achieved elsewhere."

—Tom Noseworthy, Professor Emeritus of Community Health Sciences,, University of Calgary

From the Publisher