1. CoopZone 2012 03 30 Vanessa Hammond: Chair vanessa.co-op@shaw.ca Ian MacPherson Emeritus Professor of History University of Victoria ianmacphers@gmail.com

2. Agenda Health co-ops internationally Health co-ops in Canada Achievements of Health co-ops in Canada Some issues in starting and sustaining health co-ops including the challenges facing health co-ops in Canada Why we formed HCCFC and the International Forum

3. Health co-ops internationally the conventional and the social markets the declining roles of religious organisations the power of class, ethnic, community, and workplace associations the emergence of the health professions the traditions of social/community co-operatives the welfare state the varieties of health co-ops Canadian beginnings towards a definition

4. One Definition A health co-operative is organized in keeping with the values and principles of the international Co-operative Alliance (http://www.ica.coop/coop/principles.html). It can be concerned with any or all kinds of health service delivery and with any or all of the determinants of good health. It typically is concerned with team-based health services, preventive medicine, and increasing member responsibility for individual and community wellness. It is controlled by its members, be they consumer/users, workers/practitioners, institutions or multiple stakeholders. Ian MacPherson, March 2012

5. Health co-ops in Canada Now over 70 across the country, we are still finding more every month Identified everywhere except Newfoundland and Labrador, the Yukon, Nunavut and the North-West Territories. Providing care to over one million Canadians

6. Home care Training and employment support for people facing multiple barriers to employment Support for at-risk families Wellness education Integrative, primary health care Primary medical care Community outreach Etc. Health Care Co-ops provide:

7. Achievements of Health co-ops in Canada Health promotion Integrative, primary health care Home care, consistency Self-help including training and employment for people with multiple barriers Reducing drop-out rates Shared facilities and services On-line services Pharmacy, ambulance, paramedics, lab, imaging

8. Some issues in starting and sustaining health co-ops including the challenges facing health co-ops in Canada organizational issues structural issues policy issues operational issues

9. Organizational Issues Explaining the need Appreciating the possibilities Identifying the volunteers Funding the learning curve Strengthening/creating links with practitioners, members, communities Appreciating the co-op differences/advantages Finding space Locating funds

10. Structural Issues Learning roles Accommodating professional interests and training Managing the delivery of health services Learning how to work with other co-ops

11. Policy Issues Working within fee-for-service Operating within government systems Living within professional boundaries Gaining access to support from governments

12. Operational Issues Mingling of professions Finding “engageable” practitioners Development of activities Ensuring income flow Managing diversity of services Ensuring good member/client care Sustaining member/community interest Developing appropriate technology

13. But…. Gratification from  Doing something of immediate value  Doing something of long-term value  Meeting many concerned and involved people (some of the best!)  Understanding better those around you  Meeting personal/family needs  Being healthier

14. Our challenges: Access to medical professionals Equal access to RFPs Research support Start-up and development funding Creating a higher profile etc Some specific challenges widely reported to the HCCFC and experienced by the VCHC

15. Why and how we formed the HCCFC Need for sector-wide contacts and learning by health co-op and the Canadian Co-operative Association (CCA) Health co-ops from across Canada met in July 2012 supported by The Co-operators Incorporated and operating with CCA support from the financially through CDI and with the help of Mark Goldblatt Co-operating with the Quebec Health Care and Home Care Federation and internationally

16. Purpose: To promote and support Health Care Co-operatives across Canada Members in Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta, BC. Discussions in Newfoundland and Labrador, New Brunswick, PEI, Yukon. Allowance: directors from every province and 3 “at large” HCCFC

17. Identify all health care co-ops in Canada except for Quebec (already covered by the Quebec Federation, FCSDSQ) and obtain up-to-date contact information Facilitate networking and learning through a website with brief “bio” of each co-op, a Question and Answer section, and a guestbook Initial 2012 priorities

18. Then … We became aware of Co-op Summit, Oct 8-11 th 2012 Quebec City With the International Health Organizations Committee and the FCSDSQ, we are planning the International Health Care Co-operatives Forum Oct 12 th

19. Morning presentations “health co-ops build a better world” from Japan, USA, Brazil etc. Afternoon workshops with colleagues from the co-ops around the world: – Health promotion – Aging population – Serving people with disabilities – Cost-effectiveness, care-effectiveness – Member engagement/citizen participation So, come to Quebec Oct 12 th !