Quebec has become the last bastion of health-care co-operatives in Canada.
The province has 77 of Canada’s 117 health co-ops, although most are locally based home-care agencies.
Saskatchewan has fallen from a high of 25 co-op medical clinics formed during the 1962 doctors’ strike to the four remaining in Wynyard, Prince Albert, Saskatoon and Regina.
More than 125,000 people use the services of those four clinics, Anne Doucette, president of the Saskatchewan Community Health Co-operative Federation, told an international conference held in Saskatoon Oct. 30.
She said almost every province has developed clinics that use the Saskatchewan model – tailoring services to the patients to better manage chronic diseases, a focus on health promotion and disease prevention and effective use of the staff, including doctors on salary and nurse practitioners who take on some of the roles of doctors.
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The co-op model also includes an elected board that works with community and university partners.
Doucette called it health with a social conscience.
However, few of the new health clinics are developed on the co-operative model.
“I think governments aren’t keen on co-operatives because they’re not in charge,” Doucette said.
Saskatchewan’s health ministry provides each clinic with a lump sum of money, and “it’s our board and staff that decide what to spend it on.”
In a later interview, she said rural depopulation has taken its toll. As young people leave small communities and take their energy with them, the aging seniors left behind find it harder to maintain volunteer activities, including health co-ops.
Doucette said her federation has been speaking to residents in Tisdale, Maple Creek and Regina Beach about the co-op model for community health clinics. As well, she said there has been interest from Enterprise Saskatchewan, the advisory board that the provincial government set up to assist the economy.
Jose Carlos Guisado del Toro, who heads the Espriu Foundation, which runs two hospitals, several medical clinics and a health insurance company on a nonprofit basis near Barcelona, said the co-op model is thriving in Spain, where 85 percent of the population uses the services of medical co-ops.
Guisado del Toro said co-ops do well with the money the government gives them because they have learned to be efficient.
Ricardo Lopez, who works for an Argentine co-op, said 20 million Argentines, or half of the population, have no health service, which led to the development of health co-ops in the past 10 years that now serve two million people.
An aging society led Japanese medical co-ops to start what are called han groups, said Nobumasa Kitajima of the Japanese Health Co-operative Association. About three million Japanese are organized into groups of 10 to 20 people who meet monthly for support. The han groups hold clinics to check blood pressure, talk about nutrition and encourage exercise.
