July 1st 1962: Community Health Centres and the Fight for Public Health Care

On this day sixty-three years ago, the Saskatchewan Medical Care Insurance Act came into force. The College of Physicians and Surgeons, which had advocated for a model of health care mirroring the U.S. two-tier system, declared that physicians would withdraw their services in opposition.

On July 1, 1962, at one minute past midnight, most doctors in the province closed their doors. That same night, a baby tragically died of meningitis as his parents drove through the darkness, desperately searching for care. With lives at stake and the dream of universal public health care hanging in the balance, grassroots communities organized.

Community members and courageous doctors came together to build nonprofit, community-governed, team-based health clinics across the province. Remarkably, 25 Community Clinics were rapidly organized across Saskatchewan.

This is the story of how Community Health Centres helped win the fight for public health care in Canada.

What the medical establishment did next has shaped the health care crisis we face today. But the lessons from that struggle continue to offer a powerful roadmap toward a better future.

IMAGE: Public Voice for Medical Insurance Issue 2: 14 July 1962 

Community Health Centres embody a higher quality of health care

The first of the Community Clinics opened in Prince Albert on July 1, as the medical establishment closed its doors. The idea spread quickly. Within days, a second clinic was operating in Saskatoon. In Regina, more than 300 people attended an enthusiastic organizing meeting ahead of the clinic’s official launch. In Biggar, 380 families, representing 1,400 people, came together to establish their own facility.

IMAGE: Staff working at the Saskatoon Community Clinic

The Community Health Services (Saskatchewan) Association was formed to help coordinate the expanding network of clinics. Health workers and volunteers traveled across the province, assisting local communities in setting up their own centers. By March 1963, nearly 15,000 families, representing more than 50,000 people, had joined the Community Clinic movement, and 25 clinics had successfully established facilities across Saskatchewan.

The doctors who staffed these clinics risked their careers by defying the medical establishment. They did so because they believed in a better model of care. Nonprofit, community-governed, team-based health services marked a paradigm shift in health care delivery. It moved away from the transactional nature of medicine toward a system focused not only on treating illness but also on preventing it and improving overall health.

Public Voice for Medical Insurance Issue 2: 14 July 1962: 

While the immediate origin of these clinics lies in the need to secure normal medical services for members and families under the Medicare Plan, their broader significance is in the promise they embody for a higher quality of health care...

The Opposition of the Medical Establishment

As early as 1933, the Saskatchewan Medical Association supported private pay and private delivery as the only way to fund and receive health care. In drought-stricken rural areas, many doctors were paid salaries by local governments, ensuring stable incomes and access to care. Urban specialists, who earned more through fee-for-service, opposed salaried models, fearing a threat to their business interests. The Saskatchewan Medical Association then endorsed private insurance as the only acceptable model of care. When rural communities tried to hire foreign-trained doctors willing to work on salary, the College of Physicians and Surgeons refused to license them.

Consistent with this stance, their counterproposal to Medicare, as outlined in their submission to the Advisory Planning Committee on Medical Care, was identical to the U.S. two-tier model. The Canadian Medical Association and the Colleges of Physicians and Surgeons held two distinct roles: one represented physicians’ financial interests, and the other responsible for licensing and regulation. By blurring these boundaries, they used their institutional authority to control policy.

IMAGE: Statement made at the 1960 annual meeting of the Canadian Medical Association in Banff 

The medical establishment vocally opposed the Community Clinics movement. These clinics posed a direct threat to their profits and their control over the health care system. The treatment of Community Clinic doctors by the establishment had lasting and devastating consequences.

At a press conference on May 11, 1963, Dr. Samuel Wolfe, speaking on behalf of physicians working in community health centres, condemned what he described as a coordinated campaign of hostility toward clinic-affiliated doctors. He viewed this hostility as deliberate and widespread, intended to deter new physicians and drive out those already working in the clinics.

One of the key issues he raised was the widespread denial of hospital privileges to clinic-affiliated doctors. As he wrote in the CMA Journal on August 1, 1964:

More community clinic doctors have experienced difficulties in obtaining hospital privileges than all other doctors combined in the history of the province of Saskatchewan.

Physicians who publicly challenged the authority of the medical establishment faced reprimands, suspensions, and even threats to their licenses.

Despite the valiant and enduring efforts of many communities, only five clinics established in 1962 remain today. 

The second phase of Medicare calling us to action

In 1962, the College of Physicians and Surgeons ultimately backed down and agreed to the implementation of a public single-payer system, but the victory came at a cost. The College imposed a critical restriction: funding for health care outside of hospitals would be limited to physician services. Instead of ensuring that primary care was universally available and publicly funded, like hospitals and schools, access became dependent on individual family physicians and their ability to operate small businesses while also providing essential care. As a result, 6.5 million Canadians today lack access to a family doctor or nurse practitioner.

The decision to cement physicians' status as private contractors created significant barriers to the global budgets needed to sustain nonprofit, team-based, community-governed care. Community Clinics were central to the creation of public health care in Canada, but they were ultimately prevented from becoming part of its foundation.

Tommy Douglas, the political leader of the Medicare movement, foresaw these challenges, often reminding the public that Medicare was never a finished project. At the 1979 S.O.S. Medicare Conference, he said:

I am concerned, as many people are, about Medicare — not with its fundamental principles, but with the problems which we knew would arise. Those of us who talked about Medicare back in the 1940s and 50s and 60s kept reminding the public that there were two phases for Medicare. The first phase was to remove the financial barrier between those who provide health services and those who need them... The second, the harder, is to alter our delivery system so as to reduce costs and place the emphasis on preventive medicine... We must now move increasingly toward group practice, whether it is community clinics, cooperative clinics, or clinics set up by the doctors themselves.

The health care crisis we face today is not without a solution. We need a movement to finish what was left unfinished 63 years ago.

The story of Community Clinics in the fight for Medicare is one of both struggle and hope. It reminds us that we already have the tools to build a better, more equitable health care system. And while there is still much to resist, there is just as much to believe in and to fight for.