Dr. Hastings’ first documented publications were a book review and a play that are filed with in Series 3 with his University of Toronto Schools material. This series encompasses his writings from the mid-1950s when he was beginning to establish himself professionally. Not all of his writings appear here but included are manuscripts both published and unpublished, some with several drafts. There is also occasional background material, covering correspondence,
some printed versions of manuscripts, reviews and commentary. Not every title is specifically referred to in the following commentary. Files are arranged by title and filed chronologically, except for the first two that consist of letters to the editor and book reviews.
Dr. Hastings’ research and writings broadly focus on issues in the Canadian public health care system – especially delivery, change and reform – along with writings about his
experiences with health care systems in other parts of the world. In 1954 he was hired as a part-time medical officer in the medical department of the Ontario Workmen’s Compensation Board and the following year produced a report on medical administration of that body in conjunction with the Department of Public Health Administration at the University of Toronto. Two analyses of claims, two surveys on the work done by chiropractors and a survey of electrical shock injuries that Dr. Hastings compiled for the Board apparently were not published. He was, however, a joint author of an article on the administrative practices of the Board in relation to the quality of medical care that was accepted by the American Journal of Public Health and published in August 1955.
Dr. Hastings’ visits to India in 1953 and to Japan in 1955 resulted in a number of addresses, both to professionals and to the wider public (see Series 8) and, with reference to Japan, an extensive report and several articles that appeared between 1956 and 1958. The drafts and covering correspondence are in this series; other correspondence and related files are in Series 3, 6 and 8.
In the summer of 1960 Dr. Hastings used a World Health Organization travel fellowship to study medical care, public health and the teaching of medical care in the United Kingdom, Scandinavia, the USSR, India, Ceylon, Singapore, Hong Kong and Japan. While the bulk of his files relating to his trip are found in Series V, his extensive report on his findings is in this series, along with a later article (1961) reflecting on his travels.
The remainder of his writings for the 1960s addresses numerous issues affecting public heath care in Canada, many of which were stressed frequently. They range from the challenges facing medicine generally, change, community health, establishing priorities, prevention, the challenges faced by nurses, and medicare. The last issue was the great debate in medical circles during the last half of the 1960s. Dr. Hastings made his support for the program clear in his writings. His 1962 report, Labour’s plan for a medical care program for Toronto (September 1962), was widely debated and praised. It described by one commentator several years later as “an excellent short review of the theory and experience of group medical practice”, the first such overall study in Canada. Between 1963 and 1965, Dr. Hastings co-authored a special study, Organized community health services, for the Royal Commission on
Health Services, that appeared in 1964 (his policy memo on public health in community health services had been presented to the Commission in January 1963). An article on medicare,
designed for American audiences, appeared in Current History in June 1963 and other articles in Canadian journals appeared after the Commission issued its report.
In July of 1967, Dr. Hastings was an invited participant to an international workshop of medical care experts in Geneva hosted by the International Labour Office. He produced the Canadian section of a monograph on the organization of medical care within the framework of social security that was formally published the following year and translated into French. Two years later he served as a consultant to the World Health Organization/Pan American Health Organization seminar on health administration for executive held in Tobago. His address on the role of the health services administrator was included in the final report, published in 1970.
Dr. Hastings’ first publication of the 1970s was an interim report on his Sault Ste. Marie study (see also Series 5); a related study is his article on pre-paid group practice in that city that appeared in 1973. This was followed the next year by two studies on the impact of social insurance on medical care, one of which was published. The files for his major study on community health centres, dubbed “The Hastings Report” and published in Canadian Welfare in 1972, are found in Series 5.
Between 1971 and 1975 Dr. Hastings headed a research project involving a survey of high level health administrators in Ontario, the results of which were published in 1976 under the title, Ontario Health Administrator Study. In the autumn of 1977 he was a consultant to the Hamilton-Wentworth District Health Council on the Chedoke hospitals and their relation to the district health system; his report was submitted in April 1978. In 1977 and 1978 the Department of Health Administration, with Dr. Hastings as principal investigator, surveyed over 4,000 practising health administrators across Canada. The survey, supported by the Department of National Health and Welfare, was published in 1981. Other articles published in the 1970s included a further analysis of the national health program (1972), a progress report on the community health program in the Faculty of Medicine (1977), and trends and issues in health services (1979).
In 1985 Dr. Hastings’ article, ‘The Canadian health care system – evolution, current status and issues’, appeared in Introduction to nursing management: A Canadian perspective. In it he summarized his thinking over many years. At the time he was also researching issues relating to primary health care at the international level. He was a consultant for the design of and Canadian study principal investigator for the WHO, Regional Office of Europe, Study on patterns of community participation in primary health care that appeared in 1986 and a consultant to the Centre for Public Health Research in Mexico City, the results of which were
published in November that year. 1986 and 1987 also saw the publication of articles on ambulatory care (Dr.Hastings had served for many years as a consultant on this issue to Mount
Sinai Hospital) and community involvement in health, and “The Ontario health system – an overview”, a chapter in Le system de santé de l/Ontario: enseignments pour le Quebec (1987).
A working paper for the Department of National Health and Welfare, Public involvement in health promotion and disease prevention, a comprehensive literature review and analysis, appeared in January 1988. It was co-authored with David Zakus, with whom he produced an unpublished report the next year on community involvement in decision making in health related matters. In the 1990s he continued to write articles and studies. These include his contribution on health services issues to a WHO/CINDI workshop in Toronto in 1990, and another co-authored monograph, Managed care in Canada: the Toronto Hospital’s proposed comprehensive health organization (1991). Further articles and reports on various aspects of health care in Canada appeared between 1991 and 1994.