The Great Depression, however, finally exhausted the average patient's ability to pay and engendered a national health-care crisis. A public hospital insurance scheme was first achieved in Saskatchewan in 1947 and nationally in 1957. Universal accessibility without fear of the financial consequences of hospitalization reflected concern for both the medical health of Canadians unable to pay for hospital care, and the economic health of the paying ‘patient of moderate means' threatened with medical pauperization. It also provided the resources necessary to address the modern epidemic of lifestyle diseases and to accommodate the demands of the post-war therapeutic revolution. Employing the historical records of selected individual hospitals, reports and data from all levels of government, a wide range of professional medical, nursing, hospital, and public health journals, and the international historiography of hospital history, David and Rosemary Gagan describe and account for the invention, rise, decline, and rebirth of the modern Canadian hospital between 1890 and 1950. They pay particular attention to the evolving interdependence of doctors and hospitals in the struggle to legitimate the social and cultural authority of scientific medicine, the evolution of hospital-based nursing, and the experiences of patients.

David Gagan is a professor emeritus of History at Simon Fraser University.

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Simon Fraser University

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"A nicely conceived, lucidly written and powerfully argued book. David and Rosemary Gagan provide a compelling story of the development of the public general hospital in Canada over the first half of the twentieth century. They at once provide an important foundation for future investigation of Canadian health care history and a context for addressing the present crisis facing medical and hospital care in Canada. No doubt it will be a touch stone for all future work relating to the history of the hospital in Canada." Colin Howell, Department of History, Saint Mary's University