Non-participative policy development: the genesis of A New Perspective on the Health of Canadians

r D HE Green Paper, A New Perspective on the Health of , _: Canadians, was tabled in the House of Commons in g | 2 Ottawa in April, 1974. In the words of Sir George Godber, former Chief Medical Officer of Britain's Department of Health and Social Services: "The Lalonde &e ? Report from Canada (I9 74) has had a worldwide effect in making governments as well as the health professions realize that the promotion of health in future depends more on the pattern of living adopted by the individual than on technical or allied procedures...." (Milbank Memorial Fund Quarterly, Summer, 1977, p. 373). Reviews and citations in professional journals were myriad and enthusiastic, including Lancet, The New England Journal of Medicine, Preventive Medicine, The Journal of the American Hospital Association, and Health Education. Further, the Honourable Marc Lalonde (i), under whose aegis the Paper was written, received international awards for it, including the prestigious Dana Award from the American Health Foundation. What was unusual about the writing of the Paper was that it was done without the elaborate process of external and internal consultation usually followed in the production of a major government position paper. There was no departmental or interdepartmental task force, no editorial committee, no federal-provincial consultation, no discussion with outside interest groups in the field of health, and no preliminary circulation of drafts to other federal departments. Other federal departments became aware of the Paper only when it was presented to Cabinet in January, I974. Outside interest groups did not learn of the Paper until it was tabled in the House of Commons in April, I974.