❙❙❙❙dispatches ❙❙❙❙Pulse

❙❙❙❙heart and soul ❙❙❙❙on the net NNEWSEWS Anne McLellan: new direction from a new minister?

Within days of being made federal health tract and keep the best scientists, clini- minister last January, Anne McLellan was cians and students. I think one of the off and running. On CTV’s Question Pe- most exciting achievements of this gov- riod, the new minister broke a Liberal ernment is the increase in biomedical re- taboo by raising the possibility that com- search dollars and the creation of the panies could build and run private hospi- Canadian Institutes of Health Research.” tals that might be allowed to operate In his 5 years as minister, Rock was within the Canadian health care system. known for his close relationship with “Does corporate structure necessarily groups like the CMA, and McLellan matter in terms of a hospital, as long as may take that approach too. “Doctors when I take my health card they are in the forefront of understanding the take that card and my stay in that hospital complexities of these issues,” she says. and the treatment therein is covered by a Her switch to health from justice was publicly funded, publicly administered unexpected. Until Industry Minister health care plan?” ’s abrupt resignation in Janu- McLellan could not have signalled ary, observers predicted only a minor more clearly that there was a new hand cabinet shuffle. However, with Tobin on the tiller. But does she represent a gone the prime minister had to make change of style, or of substance? “Look,” more dramatic changes, and McLellan, a Canapress the minister told CMAJ, “approach is 9-year cabinet veteran, was suddenly in McLellan: “If Premier Klein chose to vi- really important here. The Canadian play. She was eating dinner in her Ed- olate the principles of the Canada federation works best when govern- monton riding when she was told to Health Act, I would take him on.” ments work collaboratively. I was one of catch the red-eye to so that she the federal negotiators for the Social could be sworn into her new job next day. Health Act, I would take him on. Ab- Union Accord in September 2000.” The Alliance Party’s Dr. Keith Mar- solutely.” As minister of justice, McLel- According to McLellan, that success- tin was pleased with the appointment. lan has already shown that she likes be- ful agreement between the provinces “She has given encouraging indications ing the iron fist in a velvet glove — she and Ottawa is a model for how she that she is open-minded about the fun- championed gun control despite the would like health care reform to pro- damental structural changes that must outrage of the Alberta-heavy gun lobby. ceed. “ have told us to stop occur,” the BC MP says, “and she can What is McLellan’s own experience bickering and fix health care. So that’s devote time to the portfolio because she of Canada’s health care system? The 51- what we have to do — sit down and fix is not running for the leadership.” year-old minister laughs as she admits it.” And unlike predecessor , Health care analyst Michael Decter that her “wonderful family doctor” re- McLellan appears to embrace flexibility: lauds her openness: “Maybe we are see- cently told her she must lose 20 pounds “I don’t think the Canada Health Act ing the emergence of a pragmatic centre and exercise more — advice that is diffi- should be etched in stone.” on the health issue, which we have cult to follow in a high-stress job charac- In early February she took on an is- never had.” terized by erratic hours and mealtimes. sue that has dogged federal-provincial However, for all McLellan’s new ap- “It is so important,” she reflects, “for all relations for years, announcing that she proach it is still unclear whether a shift in of us to understand what we can do to wants Ottawa and the provinces to de- federal policy will follow this shift in tone. stay well and help sustain the system.” velop quickly a dispute-resolution pro- Until Roy Romanow issues his report in But she also recognises that medicare is cedure to settle disagreements about the November, McLellan is unlikely to make key to the well-being of Canadians. “My Canada Health Act (CHA). any structural changes. This means that father was 55 when he had his first heart McLellan, the former associate dean she must stay on top of the debate as sev- attack, and before he died at age 65 he had of law at the , says eral provinces, especially Alberta, take the surgery 2 or 3 times. We could never have the goal for every minister must be “re- lead in reforms that may stretch the 5 afforded to pay out of our own pockets for newal of the system,” but she distin- principles of the CHA. the care he needed and received. guishes between pressing challenges and In her CTV interview, she made it “Canadians, including Albertans, long-term objectives. “Coming from a clear that the new-found federal flexibil- want to know that health care like that university background, I understand the ity has its limits. “If Premier Klein chose will be there when they need it.” — importance of research if we want to at- to violate the principles of the Canada Charlotte Gray, Ottawa

CMAJ • MAR. 5, 2002; 166 (5) 639

© 2002 Canadian Medical Association or its licensors