Collaboration and Democracy in Health Care


They go by many names and most sectors have them – joint committees, collaborative tables and other industry-specific names.  These are the places where industry groups with competing interests decide to put aside their differences and come together for a common purpose – starting with dialogue and spawning initiatives for improvement in which all parties see value for their constituencies.

Most people have never heard of these groups, but we should be paying attention because in an era where electoral democracy has become vulnerable to the vagaries of influence and deception (witness our neighbor to the south), these tables bring an incremental approach to change that makes the world better for all of us.

For example, the General Practice Services Committee ( brings together the Ministry of Health, family physicians from the Doctors of BC, and all the health authorities in the province. Together, they hammer out new ways to improve the first point of contact in the healthcare system, support physicians to have more satisfying and efficient practices, and improve access to the care for patients. 

The GPSC is well-funded and has grown to include a significant team of people at the local and provincial level who have built expertise in collaborative system change.  One unintended and positive consequence of this is that skilled people from the non-profit world who come with experience in community engagement and a hunger for system change, have transitioned into helping our healthcare system improve.  Another consequence is the movement of non-physicians across the boundaries of physician, health authority and Ministry workplaces, leaving us with a strong network of people who see the system from a variety of perspectives.  

This talented group of people have – by virtue of their occupying roles across the system – built relationships that can move challenging initiatives forward by virtue of their understanding of multiple systems. 

I see these developments as a means of building convergence from diversity and improving key systems on which healthy democracies depend.  How do you see the growth of these collaborative groups?