I have been following the discussion and debate about charging fees for HP
services and have found it very interesting.

As Michael and many others have stated it is crazy that people should pay
large fees (i.e., more than $10) for such service within the confines of
institutions (i.e., hospitals, CHCS) that are funded by tax dollars.  It is
as he and others have stated what the Canada Health Act is for...whether it
is covering basic or health promotion services.  As Jean-Marc has said user
fees are slipping in everywhere and when will they stop.

I also agree with Barbara in that if someone is interested and willing and
capable to pay for such programming outside the confines of health
institutions then let them.  In realty, many of these prevention services
that people are willing to purchase often do not resemble health promotion
programs in any way shape or form.  By this I mean they tend to have more of
a wellness focus than that of prevention or promotion.

As a Health Promoter working in a self-help setting, The Self-Help Resource
Centre of Greater Toronto (http://www3.sympatico.ca/shrc), I find self-help
unique in its position on user fees.  Self-help groups by definition are
no-fee or low-fee for their members.  If a group charges more than a nominal
fee (i.e., to cover expenses incurred by the group, such as room rental or
coffee money) or is unwilling to wave its fee for those that cannot afford
it...it is not a self-help group by the very principles of self-help/mutual
aid.

This issue is of particular interest to me as I do a lot of work around
caregiver issues.  We host a Toronto network of self-helpers and community
agencies offering caregiver support groups.  We have recently seen a rash of
for-profit organisations and consultants offering "similar" caregiver
education series to the public.  The for profit groups tend to disappear
quite quickly after they start. But in the process of starting up many of
them also try to siphon off resources created and produced by community
agencies in order to do their work.

At the end of the day whether a for-profit group is interested more in the
bottom line (i.e., profit) than in providing a quality service to its
clients remains to be seen by each persons experience.  In my opinion the
community agencies tend to work from a very good standard of quality without
having to worry about making a profit.

Just some more thoughts to the discussion.

Take care,

G. Shawn Chirrey, MA MHSc
E-Mail: [log in to unmask]