Historically, Saskatchewan residents have enjoyed a high standard of health care services. This system had its emphasis on illness and favoured the physician as the entry point to curative treatment. Until recently little attention or resources were focused on health promotion and illness prevention (e.g. immunizations being a notable exception). The Registered Psychiatric Nurses Association of Saskatchewan believes it is timely to move to a system based on Primary Health Care to better serve the health needs of our citizens.

The Declaration of Alma-Ata (1978) states: "Primary Health Care is essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally acceptable to individuals and families in the community through their full participation and at a cost that the community and country can afford and maintain at every stage of their development in the spirit of self-reliance and self-determination. It forms an integral part both of the country's health system, of which it is the central function and main focus, and of the over all social and economic development of the community. It is the first level of contact of individuals, the family and community with the national system bringing health care as close as possible to where people live and work, and constitutes the first elements of a continuing health care process."

Thus the principles are; equitable distribution, community involvement, an emphasis on prevention, appropriate technology and a multi-sectorial approach.

Dorothy Hall (1987) illustrates the components as:

The Declaration of Alma-Ata, 1978, asserts Primary Health Care as consisting of at least the following eight (8) components:

1. education concerning prevailing health problems and the methods of preventing and controlling them;
2. promotion of food supply and proper nutrition;
3. an adequate supply of safe water and basic sanitation;
4. maternal and child health including family planning;
5. immunization against the major infectious diseases;
6. prevention and control of locally endemic diseases;
7. appropriate treatment of common diseases and injuries; and,
8. provision of essential drugs.

The Registered Psychiatric Nurses Association of Saskatchewan endorses the inclusion of all eight (8) components in a health care program recognizing and allowing the tailoring of the components to mesh with the identified needs of the community. In addition, because the needs of a community are dynamic and shifting, the emphasis on any one component may vary both between communities and within any community over time.

The Registered Psychiatric Nurses Association of Saskatchewan believes the registered psychiatric nurse has unique knowledge, skills and attitudes to function as an effective interdisciplinary team member in the delivery of primary health care. Registered psychiatric nurses are ready and eager for an expanded role as providers of care, health educators, administrators and researchers within a Primary Health Care System. The Canada Health Act allows for health care providers other than physicians to provide primary access or entry points to the health care system. Allowing registered psychiatric nurses to be entry points to the health care system is in keeping both with the Provisions of the Canada Health Act and Primary Health Care. Our new Wellness Model and Regionalized Board System bode well for moving Saskatchewan forward and present an opportunity for the province to once again be a leader in Mental Health Delivery. By utilizing the registered psychiatric nurse in a Primary Health Care role and as an entry point to the health care system we can remain accessible and responsible to the community and be cost effective and efficient.

Approved by Council
March 1993