BGCOLOR="#38C757" TEXT="#070707" VLINK="#7D7E82"> <H1>Will Nurses Call the Shots?</H1>

A Look at the Delivery of Health Care Twenty Years from Now.

(Norah Brochu, former director, Nursing and Health Policy, Canadian Nurses Association.)

Too much of our health care is delivered by physicians. Better use of nurses, radiology technologists, social workers and other professionals (but especially nurses) will lower the cost of health care with no loss of quality.

There are 270,000 registered nurses in Canada. They have skills and experience in every corner of primary, secondary, and tertiary health care, as well as in health promotion and disease prevention.

Full use of the skills of nurses and other professionals has, to date, been impeded by outmoded legislation, discriminatory payment policies and physician opposition.

This book describes impediments to change and how these impediments can be overcome. It especially looks at how specialist nurses could provide many of the services currently provided by specialist physicians.

Will Nurses Call the Shots expands on the human resources chapter in Spending Smarter and Spending Less (1994).Spending Smarter is a comprehensive health care policy book which examines the options available to governments and regions as they seek to control health care spending and protect public access to health care.

Excerpts

" The book is built around two hypotheses. The first is that expensive professionals (especially specialist physicians) are very regularly used to provide services which could be adequately provided at a lower cost by other providers. The second hypothesis is that expanded roles for less expensive providers, especially nurses, are no longer experimental." "Most(health care) services can be competently provided by more than one type of professional. Unfortunately, Canada (all provinces) has developed patterns of law and of payment which have prevented full utilization of the skills of almost every professional except physicians. If nurses are creative and aggressive they may be the major beneficiaries of the changes which will occur. If they are slow and timid, they may lose major areas of health care to both existing professionals and to new professionals who will emerge."

"The current manner in which health care professionls are utilized is unfair and uneconomical. Current arrangements cannot deliver the greatest possible volume of necessary health care with the health care dollars which are available, and they perpetuate professional discrimination.

"The preferred future includes cooperative, continuing, broad and saleable progress towards delivery of care by the professionals who can deliver acceptable quality of care at the lowest cost."

"The battleground is not qualifications, not public benefit and not the cost-effectiveness of health care; it is money."

"Transfers of function have been quickly introduced by physicians when these transfers served the objectives of physicians. Such transfers should now be introduced when they serve the public interest." About the Author

Dr. Ralph Sutherland grew up in Northern British Columbia and graduated from the University of Alberta in medicine in 1952. He practiced in Alberta and Saskatchewan before obtaining his graduate degree in health care administration at the University of Toronto. He was director of the Saskatchewan medicare program, taught health care administraton and public policy at the University of Ottawa for 25 years and was a senior policy adviser of the Ontario Ministry of Health. He has been on the municipal councils of the City of Ottawa and the Regional Municipality of Ottawa- Carleton. He has been on numerous hospital and other boards and committees, and was a member of the District Health Council of Kingston and district. He has been a Fellow with the Association of University Programs in Health Administration in Washington, D.C. and has served on the Board of Accreditation of Canadian Schools of Social Work. He has been consultant to various governments, boards and agencies, consulting editor with the Canadian Medical Association Journal and a visiting professor at McGill University.

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Address order to: Ralph Sutherland, Box 129, Plevna, Ont. K0H 2M0
Phone 1-613-479-2325 Fax 1-613-729-0309
Email jbennett@istar.ca

Make cheques payable to Ralph Sutherland Also available from:

Canadian Nurses Association
Canadian Public Health Association See the RNAO's list of nurses' interest groups: Registered Nurses Association of Ontario