O'Neill M
School of Nursing, Laval University, Quebec City, Quebec, Canada.
Int J Health Serv. 1992;22(2):287-301. doi: 10.2190/AKBE-UN31-6QEF-VG15.
Since the beginning of the 1970s, the province of Quebec has undergone a major reform of its health and social services system. Following this reform, the state has become a major protagonist, and the participation of the population is a built-in element in the system, guaranteed by law. Now, about 20 years later, there is a major effort to reorganize health services, in the wake of a "dewelfarization" mood that has reached Canada and Quebec. This article reviews the successes and pitfalls of public participation in Quebec's health system, presents the way in which participation is dealt with in current reform proposals, and draws lessons for people in many countries who have recently been encouraged to jump onto the bandwagon of participation as a strategy to promote the health of populations.
自20世纪70年代初以来，魁北克省对其卫生和社会服务体系进行了重大改革。此次改革之后，政府成为了主要推动者，民众的参与成为该体系的一个内在要素，并受到法律保障。如今，大约20年后，在一种波及加拿大和魁北克的“去福利化”思潮影响下，人们正在大力重组卫生服务。本文回顾了魁北克卫生系统中公众参与的成功之处与存在的问题，介绍了当前改革提案中处理参与问题的方式，并为最近受到鼓励而加入参与热潮以促进民众健康的许多国家的人们提供经验教训。
