Now most Canadian health organizations are in the national capital JIM GARNER
With the move to Ottawa of the Canadian Hospital Association, nearly all the major national health care organizations have arrived in the national capital, the chief holdout from this move being the College of Family Physicians of Canada. Some of the other specialist societies continue to prefer locations outside the national capital too, possibly because they do not see their functions as being especially political. The steady drift of organizations to locations next the seat of government is a negation of McLuhanism. According to this thesis the movement of information had become more important than the movement of goods, and the seamless electronic web of telecommunication would render obsolete the need for physical togetherness. The move to Ottawa by so many organizations is a reflection of the growing influence of government in health care, of course. This in turn has led to a steady growth in the lobbying function of these organizations, to the point* that many heads of staff (secretary general, executive secretary etc) say frankly that lobbying is the most important thing they do. Indeed I know of one executive secretary who says lobbying is virtually the only thing his organization does. Officials at CMA House don't usually refer to themselves as lobbyists, which is a word that strictly means dealing with legislators. But when we remember that CMA policies are determined by the membership at General Council meetings and that exactly half of the 70 formal resolutions at General Council this year specifically referred to some action that would influence government decisions, we have to conclude that the association's day-to-day activities include a large component of - shall we say? - government-influencing. The political process, mind you, is carried on at various levels. It is an illusion that a government's policies in a democracy are determined solely by elected persons. The influencing that is carried on by most organizations in
Ottawa consists of talking to bureaucrats at the two or three highest levels and persuading them that such-andsuch a policy would be beneficial. If the bureaucrats are convinced and the proposal does not have any vote-losing potential, the minister will usually accept the recommendation from his officials. Again, some ministers are more able than others. The present health minister has an excellent grasp of his department's administrative details (and has held his office longer than most of his
senior officials) so can be pretty firm about what he accepts or rejects. Some ministers are known to be so hopeless off the public platform that they rubber-stamp everything put up to them. Provincially, the seats of power have not yet exercised the same attraction. CMA's provincial divisions have tended to locate in the largest city of each province, which is not always the capital. Thus we have the BCMA in Vancouver, the QMA in Montreal and the NBMS in Saint John. The Canadian Hospital Association's previous location in Toronto is an example of what the economists call commercial inertia, and its move to Ottawa industrial momentum (two phrases that strangely enough often mean the same, but not in this case). The CHA located in Toronto because it began life as a department of CMA and became an independent body 25 years ago. So naturally it set up its own offices in the same city as mother CMA. That's commercial inertia. The move to Ottawa was directed by a desire to be near, not only the national government but the many other health care organizations located in this city - and that's industrial momentum.
The CHA thus becomes a neighbour of national organizations representing physicians, dentists, public health workers, psychiatrists, nurses and pharmacists, among others. No doubt the Canadian Council on Hospital Accreditation will be thinking about whether to move, now that all the organizations that hold seats on the council are in Ottawa. The CHA declined to locate in the so-called health sciences complex that is being built up in the south end of Ottawa. At present this consists of three hospitals - one military, one pediatric, one general - and a veteran' s home. Another hospital and some teaching faculties are due to move into the area. It was here that the National Capital Commission in 1968 provided land to the CMA for its new headquarters, and the presence of the CMA later influenced the Canadian Dental Association, which built next door. The location of CMA House is rather inconvenient for reportorial purposes. The two most important buildings in this city for a news section are those housing the Department of National Health and Welfare and Parliament. We're 8 km from the one and 5 km from the other. On the other hand, the staff likes to be able to avoid downtown traffic and watch groundhogs and bunnies during the lunch hour. The CHA has located near Parliament and the National Press Club, just across the road from lona Campagnola's office and the Ottawa Journal. Being near to the centres of information does, intangibly, make it easier to know what's going on, albeit there are persons in this building who have a remarkable grasp of the inward churnings of the government machine. The arrival of the CHA is welcome because it almost completes the family circle of allied health organizations. This should be quite a factor in improving professional input into the many mutual problems that face the health care team.E
CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117 503
With the move to Ottawa of the Canadian Hospital Association, nearly all the major national health care organizations have arrived in the national capital, the chief holdout from this move being the College of Family Physicians of Canada. Some of the other specialist societies continue to prefer locations outside the national capital too, possibly because they do not see their functions as being especially political. The steady drift of organizations to locations next the seat of government is a negation of McLuhanism. According to this thesis the movement of information had become more important than the movement of goods, and the seamless electronic web of telecommunication would render obsolete the need for physical togetherness. The move to Ottawa by so many organizations is a reflection of the growing influence of government in health care, of course. This in turn has led to a steady growth in the lobbying function of these organizations, to the point* that many heads of staff (secretary general, executive secretary etc) say frankly that lobbying is the most important thing they do. Indeed I know of one executive secretary who says lobbying is virtually the only thing his organization does. Officials at CMA House don't usually refer to themselves as lobbyists, which is a word that strictly means dealing with legislators. But when we remember that CMA policies are determined by the membership at General Council meetings and that exactly half of the 70 formal resolutions at General Council this year specifically referred to some action that would influence government decisions, we have to conclude that the association's day-to-day activities include a large component of - shall we say? - government-influencing. The political process, mind you, is carried on at various levels. It is an illusion that a government's policies in a democracy are determined solely by elected persons. The influencing that is carried on by most organizations in
Ottawa consists of talking to bureaucrats at the two or three highest levels and persuading them that such-andsuch a policy would be beneficial. If the bureaucrats are convinced and the proposal does not have any vote-losing potential, the minister will usually accept the recommendation from his officials. Again, some ministers are more able than others. The present health minister has an excellent grasp of his department's administrative details (and has held his office longer than most of his
senior officials) so can be pretty firm about what he accepts or rejects. Some ministers are known to be so hopeless off the public platform that they rubber-stamp everything put up to them. Provincially, the seats of power have not yet exercised the same attraction. CMA's provincial divisions have tended to locate in the largest city of each province, which is not always the capital. Thus we have the BCMA in Vancouver, the QMA in Montreal and the NBMS in Saint John. The Canadian Hospital Association's previous location in Toronto is an example of what the economists call commercial inertia, and its move to Ottawa industrial momentum (two phrases that strangely enough often mean the same, but not in this case). The CHA located in Toronto because it began life as a department of CMA and became an independent body 25 years ago. So naturally it set up its own offices in the same city as mother CMA. That's commercial inertia. The move to Ottawa was directed by a desire to be near, not only the national government but the many other health care organizations located in this city - and that's industrial momentum.
The CHA thus becomes a neighbour of national organizations representing physicians, dentists, public health workers, psychiatrists, nurses and pharmacists, among others. No doubt the Canadian Council on Hospital Accreditation will be thinking about whether to move, now that all the organizations that hold seats on the council are in Ottawa. The CHA declined to locate in the so-called health sciences complex that is being built up in the south end of Ottawa. At present this consists of three hospitals - one military, one pediatric, one general - and a veteran' s home. Another hospital and some teaching faculties are due to move into the area. It was here that the National Capital Commission in 1968 provided land to the CMA for its new headquarters, and the presence of the CMA later influenced the Canadian Dental Association, which built next door. The location of CMA House is rather inconvenient for reportorial purposes. The two most important buildings in this city for a news section are those housing the Department of National Health and Welfare and Parliament. We're 8 km from the one and 5 km from the other. On the other hand, the staff likes to be able to avoid downtown traffic and watch groundhogs and bunnies during the lunch hour. The CHA has located near Parliament and the National Press Club, just across the road from lona Campagnola's office and the Ottawa Journal. Being near to the centres of information does, intangibly, make it easier to know what's going on, albeit there are persons in this building who have a remarkable grasp of the inward churnings of the government machine. The arrival of the CHA is welcome because it almost completes the family circle of allied health organizations. This should be quite a factor in improving professional input into the many mutual problems that face the health care team.E
CMA JOURNAL/SEPTEMBER 3, 1977/VOL. 117 503
