Introduction

Much discussion has taken place over the past few decades about the concept of network governance, and what it might mean for liberal democratic regimes. This notion, which goes by many other names, including collaborative governance (Ansell and Gash 2008), New Public Service (Denhardt and Denhardt 2002), Public Value Management (Stoker 2006) and inter-organizational innovations (Mandell and Steelman 2003), is well described as “…a spectrum of structures that involve two or more actors and may include participants from public, private, and nonprofit sectors with varying degrees of interdependence to accomplish goals that otherwise could not be accomplished independently” (Ibid.: 202). Several writers have seen network governance as instrumental in strengthening liberal democracy in modern times by establishing a broader base for inclusion in public policy issues (Stoker 2006; Denhardt and Denhardt 2002; Box et al. 2001). The argument is advanced that the level of complexity surrounding many public policy issues today is such that, in order for issues to be successfully resolved, mechanisms need to be established that allow for the active participation of all interested stake-holders. It follows, therefore, that civil society, positioned as it is “outside the reach of state bureaucracy and beyond the interests of the private sector” (Morison 2000: 105) has a key role to play in this notion of governance.

Few question that the voluntary sector plays a key role in public health. It is estimated that there are approximately 5,300 voluntary sector organizations (VSOs) that are involved in work in the health field in Canada (Imagine Canada 2007a). Unfortunately, no estimate is available of how many organizations are involved in the various dimensions of public health. Despite the centrality of the voluntary sector for public health in Canada, many knowledge gaps remain in this area. (Brock et al. 2007) While there is no precise estimate how many VSOs are directly involved in public health, given the breadth and diversity of the sector, it is safe to assume that the number is quite impressive. More than simply a question of numbers, however, is the role they play. Public health departments and agencies at the national, provincial and local levels often rely on VSOs to reach vulnerable clients at the community level. In addition, there exists a myriad of organizations playing an advocacy role on a full range of issues, including mental health, infectious diseases, chronic diseases and injury prevention. In this way, they provide a “window” into the interests and concerns of the community of interest. VSOs can also be repositories of considerable expertise, often playing a major role in research in such areas as heart disease, cancer and mental health.

The purpose of this article is to discuss the place of the voluntary sector in public health governance in Canada. We will begin with a brief overview of the voluntary sector in general, as well as its place in Canada, and more specifically in the national public health arena. Following this, a typology will be proposed of the various types of relationships between voluntary sector organizations in the public health sector with government at the national level, providing examples of each type of relationship for purposes of illustration. We will then conclude with a discussion of what the current configuration means for the prospects of network governance in the public health sector in Canada. Our general proposition is that while the voluntary sector has a key role to play in the governance of the public health area, much of this potential remains untapped, and that while there are a few recent examples which appear to “break the mould”, it is far from clear whether these should be seen as aberrations or as indications of new directions for the future.