Social Policy and Practice in Canada: A History (review)

This book is a useful synthesis of a great many, mostly secondary sources about the ideas and process behind social policy in Canada. Part 1 consists of three inadequate chapters on very different societies (Aboriginal, French and English Canada) in the pre-Confederation period, which could be covered by one analytical chapter on the period when family relationships and private charity provided support for the disadvantaged. Part 2 covers the post-Confederation period to 1950, which includes the effects of the Great War, the Great Depression, and the Second World War on the coming of the welfare state. Historians have written extensively about the late nineteenth century and the early twentieth century, and as Finkel tries to deal with the many threads (workhouses, workers' compensation, the Social Gospel, to name a few) relating to emerging social policy, part 2 reads a little like a shopping list.

In part 3, 'The Welfare State 1950–80,' Finkel hits his stride and in five chapters discusses two success stories (old age pensions and medicare) and three failures (child care, housing, and anti-poverty programs) – policies that all were compromises. Between 1950 and 1980, government support for the elderly increased and was an important achievement that raised their level of comfort and independence. Organized business consistently supported private insurance plans, and even when public programs were introduced, pension managers ran the funds without input from pensioners or other interests.

The fascinating chapter on medicare depicts the dismal state of health care services before any public input, doctors' opposition to a public system, their advocacy of a private system, and their role in promoting their own group private insurance plans. 'Not one recognized organization of health professionals in Canada placed itself on record as supporting medicare, with the exception of the nurses' association in Saskatchewan where medicare already was an established program.' Emmett Hall's report pushed the federal government towards support for medicare, but the doctors won the 'fee for service' demand.

The provision of child care was linked to the discourse about the desirability of mothers' working, which changed from condemnation to begrudging acceptance, and Finkel might have added to the current 'conservative' argument about a mother's 'choice' to remain a full-time homemaker. Despite women's increased role in the labour force, the lack of a national child-care policy has continued to place the onus on women to find proper care for their children if they worked. A low-cost housing policy has been minimal, partly at the insistence of private developer and real estate interests, although Finkel includes an interesting section on cooperative housing. Inadequate anti-poverty policy existed until the 1970s, when the weakened economy adversely affected public support for social programs as neo-liberals declared war on the poor.

In part 4, entitled 'Neoliberalism,' which covers the 1980s to the present, Finkel documents the budget-cutting and program-slashing as politicians became captives of aggressive business interests that financed research against the social welfare state and promoted free trade, privatization, competitiveness, and profit. Only around 2000, when consumers resisted privatized medical services, did politicians put some money back into medicare. The issue demonstrated the political strength of health entrepreneurs but also that the public supported the public health care system overwhelmingly and pro-medicare lobbies were organized to protect it. Finkel is clear about the destructive impact of the neo-liberal era on social policy and does not mince words. It is not a pretty picture.

Between 1945 and 1975 the author concludes that the provision of social services for Canadians advanced. The programs always were contested by progressive public groups (unions, churches, women's groups) who supported social justice, and by elites (business, politicians, realtors, doctors) who protected their privileged positions and favoured the status quo. The resulting programs were compromises. Canada is far from having a social policy that creates an integrated society in which all citizens live at a decent standard without regard to class, gender, race, or level of...