The Story of the Manitoba Centre for Health Policy
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THE STORY OF THE MANITOBA CENTRE FOR HEALTH POLICY March 2010 Manitoba Centre for Health Policy Department of Community Health Sciences Faculty of Medicine, University of Manitoba Gail Marchessault, PhD, PHEc, R.D. Qualitative Researcher, Manitoba Centre for Health Policy Assistant Professor, Department of Community Health Sciences Faculty of Medicine, University of Manitoba ACKNOWLEDGEMENTS I am appreciative of the advice, assistance and support that I received in the 200 days that I worked on this project and a manuscript for Healthcare Policy. I thank the following people: Patricia Martens, Mark Smith, Alan Katz, Paulette Collins, and Carole Ouelette (the executive team) for concept and guidance; Ruth Bond for photos and diligent recording of many events in the Centre’s life; Pat Nicol for photos, documents, and dates; Marina Yogendran for photos and for watering my orchids when I was away; Th eresa Daniuk for scanning photos and her detective work in fi nding documents and people; Janine Harasymchuk and Jack Rach for photos of Centre events; Angela Bailly for editorial assistance; Jundong Song for rescuing me when NVivo crashed; Shannon Lussier and Mya Kraft for tracking down documents relating to the founding directors; Ollie Schroeder and Tina Marchessault for transcribing audio–records; Kirsten Giroux and Sophie Buternowsky who did fi nancial arrangements; Kathy Bell for checking departmental fi les and reviewing Council meetings for MCHP–related reports; current staff who provided comments and feedback on the Surveymonkey questions, research highlights, and timeline. I received wonderful support from staff —too numerous to be named individually. I especially thank the people who agreed to an interview and for their review of transcripts and summaries. I thank Louis Barré, Charlyn Black, Tom Carson, Norman Frohlich, Paul Henteleff , Alan Katz, Deborah Malazdrewicz, Patricia Martens, Frank Maynard, Cam Mustard, Fraser Mustard, Arnold Naimark, Pat Nicol, Donald Orchard, Carole Ouelette, Brian Postl, Les Roos, Noralou Roos, Evelyn Shapiro, John Wade and eight anonymous participants. I acknowledge the fi nancial support of the Lupina Foundation. Although obvious, it needs to be said. Insights stem from all this support while any and all shortcomings within this report are solely my own. ii TABLE OF CONTENTS Acknowledgements .......................................................................... II Chapter 1: Introduction .................................................................... 1 A Quick Look at Methods ..........................................................................................2 Project Overview ........................................................................................................3 Chapter 2: Talking with the Founding Directors, Drs. Leslie Roos and Noralou Roos ..................................................................... 7 Chapter 3: Telling the Story ..............................................................15 3.1 Dr. Paul Henteleff ............................................................................................15 3.2 Dr. Fraser Mustard ...........................................................................................20 3.3 Dr. Arnold Naimark .........................................................................................23 3.4 Dr. John Wade .................................................................................................26 3.5 Dr. Brian Postl .................................................................................................30 3.6 Donald Orchard ...............................................................................................35 3.7 Frank Maynard .................................................................................................41 3.8 Tom Carson .....................................................................................................44 3.9 Dr. Norman Frohlich .......................................................................................49 3.10 Dr. Cam Mustard .............................................................................................53 3.11 Dr. Charlyn Black ............................................................................................58 3.12 Louis Barré ......................................................................................................62 3.13 Deborah Malazdrewicz .....................................................................................67 3.14 Dr. Patricia Martens .........................................................................................73 Chapter 4: The Board of Directors: Initial and Most Recent .......... 82 Chapter 5: Who’s Been Around Since the Beginning (or Before)? For 10 years? For 15 Years? .......................................................84 Chapter 6: Comments from Current MCHPers ............................... 85 6.1 What were the major challenges that MCHP has faced? .....................................85 6.2 What factors do you see as important in the Centre’s success?.............................91 6.3 What do you see as the key events in MCHP’s existence? ...................................99 iii Chapter 7: Looking Back: Research Highlights ............................. 102 7.1 Th e First Ten Years .............................................................................................102 7.2 Unexpected or Intriguing Findings from the Second Ten Years ...........................103 Chapter 8: Timeline ........................................................................... 107 8.1 Health Insurance in Manitoba ..........................................................................107 8.2 Pre–Centre Events ............................................................................................107 8.3 Establishment of the Centre .............................................................................107 8.4 First Ten Years, MCHPE ..................................................................................109 8.5 Second Ten Years, MCHP ................................................................................110 8.6 A Timeline for Data–Related Events ................................................................113 8.7 A Timeline for Leadership at the Centre ...........................................................114 8.8 University and Political Leaders ........................................................................115 Chapter 9: MCHP Photo Gallery ...................................................... 119 Chapter 10: Biography of the Founding Directors, Drs. Leslie Roos and Noralou Roos ......................................... 156 Chapter 11: Summing Up .................................................................161 Appendix 1: Research Participant Information and Consent Form .........................................................................................166 Appendix 2: The Manitoba Centre for Health Policy: A Case Study Interview Guide ............................................................ 170 Appendix 3: Surveymonkey Questions: A Report on the Manitoba Centre for Health Policy .......................................... 172 iv The Story of the Manitoba Centre for Health Policy 1 CHAPTER 1: INTRODUCTION Dr. Patricia Martens, the current director of the Manitoba Centre for Health Policy, invited me to tell MCHP’s story through the eyes of the people involved in creating and sustaining it. She said personalities drive the Centre and make it what it is today—20 years after its formal establishment by two of those personalities, Drs. Noralou and Les Roos, the founding directors. Today, MCHP is internationally renowned for its use of administrative data in health research and its expertise in knowledge translation. Th e Manitoba Centre for Health Policy is a research unit in the Department of Community Health Sciences in the University of Manitoba’s Faculty of Medicine. Research scientists and their collaborators at the Centre study health services, population and public health, and the social determinants of health using data based on the entire population of Manitoba. With approximately half of their funding coming from the Manitoba government, much of the research is oriented towards answering questions of interest to policy makers. Th e Centre has had this dual mission from its fi rst contract with the Department of Health. It now has formal associations with fi ve government departments and 11 regional health authorities to address research questions aimed at improving the health of Manitoba’s citizens. Over the 20 years that MCHP has existed, its success in research endeavours has attracted national and international attention. In 2007, MCHP received visitors from Statistics Canada, Alberta, Ontario, Malaysia, and Australia to learn more about the Centre’s operational model (Martens, 2008; Manitoba Centre for Health Policy and Evaluation, 2008; Manitoba Centre for Health Policy and Evaluation, 2007b). Additionally, the year prior Dr. Martens received speaking invitations from nine of 10 provinces, and Drs. Noralou and Les Roos spent their sabbatical in Australia working with groups in Sidney, Adelaide, Melbourne, and New Zealand (Manitoba Centre for Health Policy and Evaluation, 2007a). Articles written by the Centre investigators explaining their use of administrative databases have been cited as often as 400 times (Lewis, Martens, & Barre, 2009). Th is interest in MCHP’s work and