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The Saskatchewan Children's Dental Plan: Is It Time for Renewal?, in an Oral Examination Held on January 18, 2010

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The Saskatchewan Children's Dental Plan: Is It Time for Renewal?, in an Oral Examination Held on January 18, 2010 THE SASKATCHEWAN CHILDREN’S DENTAL PLAN: IS IT TIME FOR RENEWAL? A Thesis Submitted to the Faculty of Graduate Studies and Research in Partial Fulfillment of the Requirements for the Degree of Master of Arts in Social Studies University of Regina by Garry Ewart Regina, Saskatchewan 2010 Copyright, 2010: G. Ewart UNIVERSITY OF REGINA FACULTY OF GRADUATE STUDIES AND RESEARCH SUPERVISORY AND EXAMINING COMMITTEE Garry Ashworth Ewart, candidate for the degree of Master of Arts in Social Studies, has presented a thesis titled, The Saskatchewan Children's Dental Plan: Is it Time for Renewal?, in an oral examination held on January 18, 2010. The following committee members have found the thesis acceptable in form and content, and that the candidate demonstrated satisfactory knowledge of the subject material. External Examiner: Dr. Gregory Marchildon, Johnson Shoyama Graduate School of Public Policy Supervisor: Dr. Murray Knuttila, Adjunct Professor, Department of Sociology and Social Studies Committee Member: Dr. Wendee Kubik, Department of Women's and Gender Studies Committee Member: Dr. John F. Conway, Department of Sociology and Social Studies Chair of Defense: Dr. James Mulvale, Faculty of Social Work Abstract The topic of this thesis is the implementation of the Saskatchewan Children's Dental Plan (SDP) in the 1970s, and the decision to scale back and eventually privatize the program in the 1980s. The SDP provided free dental services to children through school-based clinics, and to adolescents at private practice dentist offices. All children were allowed to have routine dental services free of charge if their parents consented to have them treated through the government program. When the Progressive Conservative government of Grant Devine came into power the SDP was privatized and eventually eliminated. Through interviews with several figures involved in the SDP and a variety of print sources, this thesis examines the history of why the Plan failed and whether there were flaws that could have been overcome to save this program. The elimination of this program led to many problems for those families unable to afford proper dental care for their children. Studies suggest there is a link between poor dental health and some serious health problems. The evidence is that when children grow up with poor dental care, they grow into adults with severe dental problems that could lead to other severe illnesses. Based on such evidence a program like the SDP would improve the health outcomes of all citizens, and also reduce overall health care expenditures. This thesis assesses whether this type of program, or some variation of it, would be useful in improving the health outcomes of children and adults in Saskatchewan. The implementation and cancellation of this innovative program has failed to receive the attention and consideration that it deserves. This thesis fills that gap. i Acknowledgements I would like to extend my sincere appreciation to Dr. Murray Knuttila for his guidance, direction, encouragement, and for steering me towards this topic. I would also like to acknowledge the other members of my Supervisory Committee, Dr. John Conway and Dr. Wendee Kubik, for their guidance and support. I would like to acknowledge the Faculty of Graduate Studies and Research and the Department of Sociology and Social Studies at the University of Regina for the opportunity to write this thesis and for the Teaching Assistantship positions, which offered me the financial ability to pursue my studies. A special thank you is extended to my interview subjects who offered a large amount of information that I would not have been able to acquire otherwise. It was an honour to speak with all of my interview subjects regarding this monumental plan. I would also like to thank Stacey Sallenback, Secretary for the Department of Sociology and Social Studies, for all of the support that she offered me when I did not know whom to turn to for information. Also, the employees at the Saskatchewan Archives Board, University Library and Interlibrary Loans office, and Regina Central Library for all of their assistance over the many, many days that I spent looking through information and printing out countless documents. My thanks are extended to my wife (Lorri) who helped me with my research at the Saskatchewan Archives Board and editing my writing, my son (David) who has never known me as anything other than a university student, my step-children (Stephan and Jeannie), and especially my parents (Dave and Bertie) who offered much emotional and financial support over this rather lengthy time period. ii Post-Defense Acknowledgement I would like to offer my thanks to Dr. Gregory Marchildon, the external examiner for my defense, for trying to make my thesis the best that it could be. I would also like to thank Dr. James Mulvale for chairing the defense. iii Dedication I would like to dedicate my thesis to my nana (Lorna Wave) who believed in my ability to accomplish more than I believed I could. While she may have passed away many years ago, her special way of encouraging me has lingered on throughout the years. During her lifetime, she suffered with not being able to continue her education beyond grade 10 because of financial barriers and a debilitating illness, which took her life far too early. Her suffering and her beautiful spirit have inspired me in many ways throughout my lifetime and I would like to use this moment to offer thanks for all of her encouragement. iv Table of Contents Abstract…………………………………………………………………………………….i Acknowledgements………………………………………………………………..………ii Post-Defence Acknowledgement……………………….………………………………..iii Dedication………………………………………………………………………………...iv Table of Contents………………………………………………………………………….v List of Appendices………………………………..…………………….…..…………….vi List of Acronyms..…………………………………………………………………….....vii Important Figures……………………………………………………………………….viii Introduction…………………….………………………………………………………….1 Chapter 1 Methodology.…………………………………………………………………...…4 Chapter 2 Historical Context………………….…………………………………………….11 Chapter 3 The History that Brought About a Need for the SDP……………………………22 Chapter 4 The Relatively Humble Beginning of the SDP………………………………......30 Chapter 5 The Saskatchewan Children’s Dental Plan 1974-1987…………………………..56 Chapter 6 What Led to the Demise of the SDP……………………………………………..77 Chapter 7 Conclusion……….……………………………………………………………..120 References..……………...……………………………………………………………...135 Appendix A: Ethics Board Approval Letter………………………...………………….149 Appendix B: Interview Consent Form………………………………………………….150 Appendix C: List of Questions for Interview Subjects…………………………………151 v List of Appendices Appendix A: Ethics Board Approval Letter……………………………………………149 Appendix B: Interview Consent Form………………………………………………….150 Appendix C: List of Questions for Interview Subjects…………………………………151 vi List of Acronyms CCF - Co-operative Commonwealth Federation CDA - Canadian Dental Association CDP - Children’s Dental Plan (after privatization in 1987) CDSS - College of Dental Surgeons of Saskatchewan Dental Therapist - Dental Nurse was originally used but it was later decided the term Dental Therapist was more appropriate1. DPH - Department of Public Health KWNS - Keynesian Welfare National State NDP - New Democratic Party NSDT - National School of Dental Therapy PCs or Tories - Progressive Conservative Party SCHR - Swift Current Health Region SDP or ‘the Plan’ - Saskatchewan Children’s Dental Plan SDTA - Saskatchewan Dental Therapists Association WIAAS - Wascana Institute of Applied Arts and Sciences 1 Dental Nurse was the term that was used in the New Zealand Dental Plan, which the SDP was modeled after. The selection of the term Dental Nurse, and subsequent change of the term later in ‘the Plan,’ will be further explained in the history section of this paper. vii Important Figures Adams, N. D. - Director of the Research and Planning Branch, Department of Health from 1971-1979. He was Deputy Minister of Health from 1991-1997. Ambrose, Dr. E. R. - Dean of the Faculty of Dentistry at McGill University. Anguish, D. K. - Opposition NDP MLA for the constituency of The Battlefords from 1986 to 1991. Atkinson, P. - Served as NDP health critic; she represented the constituency of Saskatoon Nutana from 1986 to 1991 and after 1991 became a Cabinet Minister in the NDP Government. Beatty, G. H. - Secretary of the Treasury Board. Bergstrom, L. - Deputy Minister of Education from 1965 to 1972. Blakeney, A. - NDP Premier of Saskatchewan from 1971 to 1982. He represented the constituency of Regina Centre/ Regina Elphinstone. Borowko, M. - President of the SDTA. Brett, Dr. R. O. - Council of the CDSS. Brockelbank, J. - Opposition NDP MLA for the constituency of Saskatoon Westmount from 1982 to 1991. Byers, B. - President of the SGEU. Caswell, G. - PC MLA for the constituency of Saskatoon Westmount from 1982 to 1986. Curry, Dr. T. M. - Director for the Division of Dental Health in the DPH from 1968 to 1974, at which time he left the position and Dr. Lewis took over the new position of Executive Director of the SDP in the DPH. In my interview with Dr. G.H. Peacock, he suggested Dr. Curry played a major role in the establishment of the SDP. Mr. Barker agreed, calling Dr. Curry “the ‘father’ of the SDP”2. Derrick, M. B. - Associate Deputy Minister of Health from 1968 to 1975. Devine, G. - PC Premier of Saskatchewan from 1982 to 1991. Mr. Devine represented the constituency of Estevan. 2 Paul Frederick Barker, The Formulation and Implementation of the Saskatchewan Dental Plan, Diss,
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