Canada. Medical Services Branch : Although the Department of National Health and Welfare's (NHW) Medical Services Branch (MSB) was not created as an independent entity until 1972, many of its activities are those which support some of the oldest federal government public health functions, including quarantine, the inspection and medical care of immigrants, and the treatment of lepers. MSB is now responsible for the provision of health care services to the native population of Canada and residents of the North; the promotion and conservation of the health of public servants, the travelling public, and VIP visitors to Canada; and assistance to Canadians, prospective immigrants, temporary residents, civil aviation personnel and those in need of emergency medical services to protect their health.
Responsibility for quarantine, the inspection of immigrants, and the care of sick mariners results from the passing of the Quarantine Act and the Sick Mariners Act in 1868, which were originally administered by the Department of Agriculture. The medical inspection of immigrants was subsequently carried out by the Department of the Interior between 1892 and 1917, and the Department of Immigration and Colonization from 1917 to 1919; all three functions were assumed by the Department of Health in 1919.
Beginning in 1880, the Quarantine Service was also responsible for apprehending and confining lepers and the administration of the leprosariums (lazarettos) at Tracadie, New Brunswick and D'Arcy Island, British Columbia. The latter was established in 1892 and later moved to Bentinck Island near the Albert Head Quarantine Station in 1924. However, such activities carried out by the Quarantine Service were not actually confirmed by law until the passage of the Leprosy Act of 1906. As treatment techniques progressed, a continuing scarcity of patients led to the closure of the Bentinck Island Lazaretto in 1957, and in 1960, NHW decided to treat lepers in their local neighbourhoods under the supervision of local health authorities. Confinement at Tracadie, although a possibility, was considered to be a last resort in cases where local conditions made treatment difficult, and the Leprosy Act was finally repealed in 1971. The Quarantine Service itself was transferred to the Health Protection Branch in 1987.
Federal government health services to native Canadians, a key component of the MSB's present activities, are not grounded in legislation but stem from two clauses contained in Treaty Number Six, signed by the Plains and Wood Cree of Saskatchewan in 1876. The famous pestilence" and medicine chest" clauses stated that the federal government would provide assistance in the cases where the natives were overtaken by any pestilence, or by a general famine", and that a medicine chest shall be kept at the house of each Indian Agent for the use and benefit of the Indians at the discretion of such Agent." No other health-related provisions were included in subsequent treaties.
In 1880, the government reacted to widespread and rapidly disseminated epidemics of smallpox and measles and an alarming increase in the incidence of tuberculosis amongst the native population by removing responsibility for native affairs from the Department of the Interior and placing it with the newly created Department of Indian Affairs headed by Superintendent General Sir. John A. Mcdonald. The first General Medical Superintendent, Dr. P.H. Bryce, was appointed in 1903 and served until 1910. Travelling field nurses, employed to teach native women about personal hygiene and child care to help lower infant mortality rates, were first appointed in 1922, and in 1927, Colonel Dr. E.L. Stone was appointed as the second General Medical Superintendent.
With the dismantling of the Department of Indian Affairs in December 1936, responsibility for health services to natives was invested in the Indian Health Services Division of the Department of Mines and Resources. Similar services for Eskimos were administered through the Northwest Territories Branch of the same department. Under the authority of Order-in-Council P.C. 6495 of 1 October 1945, responsibility for native health was transferred from Mines and Resources to the newly-created NHW.
The Civil Service Health Division (later renamed Public Service Health) was created in by Order-in-Council P.C. 3686 of 24 May 1945 to supervise the environmental conditions of all federal government work places, prevent and control disease, provide emergency medical and dental care , and advice and assistance on health matters to civil servants. The Civil Aviation Medicine Division, established by Order-in-Council P.C. 94/4516 of 30 October 1946 but not active until May 1948, acted as a medical advisory board to the Department of Transport in all matters pertaining to the health, comfort and safety of both aircraft crews and passengers. Both of these divisions became part of the organizational unit which immediately preceded MSB, Medical Advisory Services (MAS), which was established in 1953. MAS was also responsible for the Blindness Control, Hospital Design and Narcotic Control Divisions until late 1954.
The responsibility for provision of prosthetic devices was transferred from the Department of Veterans Affairs to the Medical Rehabilitation section of NHW's Health Services Branch by Order-in-Council 1965/218 of 1 April 1965. This was done in order to ensure that both handicapped veterans and civilians received appropriate artificial limbs, braces and orthopaedic boots. This function was renamed Rehabilitation Services in 1968, became part of MSB in January 1972, and was ultimately devolved to the control of the provinces between 1977 and 1989.
Changes in the federal government's civil defence responsibilities affected the development of MSB after 1972. Civil defence, originally the responsibility of the Department of National Defence, was transferred to NHW by Order-in-Council P.C. 985 of 23 February 1951. As a result of the Civil Defence Order drafted by the Diefenbaker government in May 1958, all activities of agencies involved with civil defence were to be coordinated through the Emergency Measures Organization attached to the Privy Council Office. NHW then divided its responsibilities into three divisions: Emergency Health Services (EHS) within the Health Services Branch, Emergency Welfare Services (EWS) within the Welfare Branch, and the Canadian Civil Defence College. After a series of departmental re-organizations from 1961 to 1978, EHS and EWS joined the MSB and were renamed Emergency Services in 1979.
During the 1980s, the MSB was composed of four directorates: Occupational and Environmental Health Services, First Nations and Inuit Health Programs (formerly Indian and Northern Health Services), Non-Insured Health Benefits, and Program Policy, Transfer Secretariat and Planning.
The Medical Services Branch was dissolved effective 1 July 2000, as part of a departmental realignment. Many of the activities previously conducted by the MSB were continued by the new First Nations and Inuit Health Branch. Other activities were transferred to other new branches; for instance the activities of the Occupational Health and Safety Agency were transferred to the new Environmental and Product Safety Branch.
