Date of Award
Did governments in different countries regulate common concerns about patient safety differently? If so how and why did they do this? This thesis undertakes a historical comparison of the regulation of patient safety in Britain and Canada between 1980 and 2005. These jurisdictions began the period with very similar regulatory frameworks, but by 2005 there were distinct differences in each jurisdiction‘s regulatory response to patient safety. Britain was very actively regulating all aspects of service provision within its health system in the name of patient safety, whereas Canada‘s regulatory direction showed adherence to the 1980s model with only scattered incremental developments. This thesis assesses the broader sociopolitical context and the structure of the health systems in each jurisdiction and concludes there are differences in the logics of these systems that established a foundation for future regulatory divergence. It is argued that between 1980 and 2005 there were two factors that influenced regulatory directionality in each jurisdiction: changing political norms associated with the development of neoliberalism and the New Public Management; and events or scandals associated with the provision of health services. The differing levels of penetration of both the changing political norms into governance cultures and of scandals into the public and political consciousness are critical to explaining regulatory differences between jurisdictions. The thesis concludes that what and how governments chose to regulate is a function of the perceived need for action and the dominant social and political norms within that society. Context is everything in the formulation of regulatory approaches to address pressing social problems.
Fiona McDonald, Patient Safety Law: Regulatory Change in Britain and Canada (JSD Dissertation, Dalhousie University, Schulich School of Law, 2010) [unpublished].