We Can Fashion the Future, But What Fashion Will We Choose?

Abstract

This response is to the article "Fashioning the Future" by Verna Splane in the Fall 1984 issue of Nursing Papers.* I have been asked to comment briefly on the article, and nursing's involvement in events sequential to the Canada Health Act (CHA). In the article Splane has brilliantly portrayed the development of the health care system in a social, political, and economic framework, identifying nursing's role in shaping the health care system up to the CHA. She has established that nursing did not have a key role. For the most part nurses provided "input" into events as they happened from 1934 to 1984. She indicates that the role of the nursing profession in this period has yet to be described, but it did progress from a representational reactive role to a proactive one, seeking to ensure influence on policy decisions on national health and advancing from a limited nursing viewpoint to a health system perspective (Splane, 1984). The CHA activity, led by the Canadian Nurses Association (CNA) and entered into enthusiastically by provincial associations and their members, established nursing's potential for proaction. To what extent has that potential been exploited in the period following the CHA? How has nursing acted to inhibit further erosion of the health care system? How has it responded to the issues in the wake of the CHA, especially in regard to the recommendation of the Honourable Madame Begin, the then Minister of Health and Welfare, Canada, "To use the nurse as the point of first contact and the doctor as the final point of referral" (1982, p.3-4).