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UBC Theses and Dissertations

The development and implementation of health manpower planning in Canada with special reference to British Columbia Manning, Wendy Gaye

Abstract

The purpose of this study is threefold: a) to review current health manpower planning methodologies b) to describe in context, the growth and changes in medical manpower planning in Canada with special reference to British Columbia. The manpower issues in five other health professional areas will also be explored. c) to critique the Canadian and British Columbian manpower planning processes using current models and recommend on changes to the system which would increase effectiveness. The Canadian health care system sets the stage for a study of the development of health manpower structures and efforts in Canada. The role of the third party payment system is investigated as the primary reason for government's increased interest in the control of physician manpower and health care labour costs in general. Problems in defining health and jurisdictional overlaps are outlined. Planning models and their relation to health manpower planning are described. Government's interest to replace the entrepreneurial planning methods which preceded health insurance with rational planning methods is discussed. The major rational planning methods and their limitations are reviewed. These include physician-population ratios, manpower needs, economic demand and service target methods. Formal federal and provincial structures established to address manpower issues are analyzed as are the buffer and lobby groups established to moderate their efforts. As physician manpower planning is the pattern setter for all other health manpower planning, issues in this area are examined in considerable detail. This discussion is followed by a consideration of planning in five other health professional areas: nursing, pharmacy, dentistry, rehabilitation and dietetics. This discussion shows how these groups have all concerned themselves with their own individual situations and not with interprofessional areas. Individual professional priorities are also discussed. Insensitivity to the health care system generally and a lack of understanding of rational planning in relation to other planning modes seem to be the. reason for unsuccessful attempts in health manpower planning. It is recommended these failings be addressed if this planning activity is to continue.

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