Is it really the tail that wags the dog?

Healthc Pap. 2008;8(2):26-32; discussion 64-7. doi: 10.12927/hcpap.2008.19705.


Brian Hutchison views the numerous initiatives on primary healthcare in provinces and territories as indications that transformative changes are finally under way in Canada. Changes are indeed occurring. New primary healthcare models are being introduced. One could question whether they are the most promising models and whether they have the characteristics to become performing ones. These initiatives are being taken precisely at the time when the performance of the Canadian healthcare system is at the bottom. But performance was a lot better long before these changes were being introduced. Something else is at play in shaping the Canadian healthcare system, which involves but goes beyond primary healthcare: a tilting healthcare system. Unless a rebalance in favour of primary healthcare is accomplished, it is unlikely that the introduction of new PHC models alone could make the difference.

Publication types

  • Comment

MeSH terms

  • Canada
  • Health Care Reform / economics
  • Health Care Reform / organization & administration*
  • Health Policy
  • Health Services Accessibility / organization & administration
  • Humans
  • Primary Health Care / economics
  • Primary Health Care / organization & administration*
  • Societies, Medical
  • State Medicine / economics
  • State Medicine / organization & administration*