Ireland's loss is Canada's gain

Dr David McCutcheon, president and chief executive officer of Toronto's Sunnybrook and Women's College Health Science Centre …

Dr David McCutcheon, president and chief executive officer of Toronto's Sunnybrook and Women's College Health Science Centre is no stranger to the Republic. A native of Glasnevin and a 1973 graduate of the Royal College of Surgeons, he is probably best remembered for his often turbulent three-year tenure as Tallaght hospital's first chief executive.

A man of undoubted integrity and vision, his innovative approach to health service management did not meet with widespread acceptance when he arrived in Tallaght in 1996. By the time he departed in 1999, Tallaght's activities were being supervised by a "management troika" and the new hospital was struggling with massive funding difficulties.

It is particularly ironic that, having spent the past two and a half years successfully managing the amalgamation of three Toronto hospitals on to one site, he has just been headhunted as the government of Ontario's assistant deputy minister for Health Services. From November this year he will assume responsibility for the provision of direct patient care to about 12 million people. His new post is broadly equivalent to that of assistant secretary of the Department of Health in the Republic.

The appointment reflects the free movement of managers from the hospital sector to the established civil service and vice versa. It is a healthy feature of the Canadian health system which undoubtedly helps to ensure a fluid exchange between those who deliver care and those responsible for planning and policy.

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With a budget of $23.5 billion (IR£13 billion) and a system that is struggling to continue a fine tradition of equitable access to high quality healthcare, Dr McCutcheon is looking forward to the change. "Our challenge here is to continue funding a system which is seeing a growth in services as well as a growth in demand for healthcare."

Dr Muiris HoustonA health system with equal access for all, at little cost beyond normal taxes, and almost non-existent waiting lists - is it a dream?

Dr Muiris Houston, Medical Correspondent, reports from Canada Health Check