ABSTRACT
Healthcare is amongst the highest priorities for any Government. Therefore, it follows that healthcare is highly politicised and driven by ideology as much as evidence and effectiveness. The reforms of the National Health Service under Mrs Thatcher from 1986 onwards were clearly driven by a set of political beliefs: free market economics, competition as a mechanism for improving quality and patient choice. Canada is unique in that the central level of government plays a very small direct role in the delivery of healthcare. Under the Canadian Constitution, healthcare is a matter of provincial/territorial jurisdiction except in the case of some groups of people, the most important being the Nations and the Inuit. Whilst ideologically a public system, Canada has 30% private contribution to total healthcare costs, comparable with Australia and considerably more than the United Kingdom, whether measured as a percentage or as an absolute figure per capita. Australia has the most overtly ideological approach to healthcare.
