Managing a health system through an economic downturn: a masterclass

A masterclass to draw on experience from Canada in the early to mid 1990s to inform strategy in the NHS during a period of financial challenge.


Start date: 17/05/2011 | 10:00

End date: 17/05/2011 | 16:30

For more information on this conference contact:

020 7631 8450

A partnership between the Canadian Health Services Research Foundation and the Nuffield Trust, this masterclass drew on experience from Canada in the early to mid 1990s, when policy-makers were confronted with a deep recession, with the aim of informing strategies for managing the National Health Service (NHS) through its current financial challenges.

The masterclass was led by senior health leaders involved in provincial decision-making at the time in Canada, offering a real-life perspective on how decisions regarding the decommissioning and closure of hospitals were made and justified and how they engaged physician associations, the public and other stakeholders. 

We recorded video interviews with the keynote speakers from the event including: 

  • Maureen O’Neil, Canadian Health Services Research Foundation; 
  • Mark Rochon, Toronto Rehabilitation Institute; 
  • Louise Simard, Former Minister of Health, Saskatchwan; and 
  • Professor Terrence Sullivan, University of Toronto.  To watch the video interviews, and access other highlights from the masterclass, use the arrow buttons on each block in the right-hand column to scroll through the interviews and slideshow content.

Reflecting on their experience the speakers explain that it was crucial for politicians and policy-makers to be honest with the public about the scale of cuts needed at the same time as setting out and communicating a clear and compelling vision for reform. In one province, politicians took the lead in engaging directly with doctors, nurses and the wider community across a wide area. In another, politicians devolved decision making to a commission, which was given power to make binding decisions. In both cases, it was important for elected politicians to take responsibility for difficult and unpopular decisions.

The masterclass was chaired by Maureen O’Neil, President of the Canadian Health Services Research Foundation and Dr Jennifer Dixon, Chief Executive of the Health Foundation.