The philosophy that sustained the development of service delivery transcended the CSSSs' organizational borders as managers started to support and help other organizations on their territory.
(12) A number of managers seemed to agree that the most important gains to date were in the CSSSs' commitment to improve the overall supply of primary care services, whether these were provided in private or public settings.
For example, CSSSs in Montreal set up "health education centres" to expand the range of preventive services.
Managers in both CSSSs observed in our study invested in the same areas of activity.
The CSSSs will always need to provide short-term services in response to acute problems.
How far should the CSSSs go to maximize synergy between the two sectors at the local level?
Our results show that assigning population-based responsibility to CSSSs has led to greater integration of two sectors of service delivery that until now were considered to be incompatible within a single local governance structure.