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Discusses total quality management from the point of view of the user not just the provider of services and in terms of the TQM drive for perfection of standards that continue to move upwards. Long‐term commitment to quality depends on empowerment of employees and factors such as knowledge, training, experience, additive and organizational culture.

Pursues an organizational review and analysis of the Human Resource Department (HRD) in a large Canadian health care facility, when a decision was taken to make all management activities the purview of an independent board. Identifies objectives, examines the many different functions of HR management and makes recommendations. Implementation is vital, regardless of risks, whether the review has been conducted internally or externally by consultants.

Reports on the Canadian public service sector, which has led the way in providing employer‐sponsored on‐site child care for employees. Suggests that such child care may be one way to recruit and retain staff, reduce staff turnover and absenteeism and increase staff morale in hospitals particularly, where irregular hours make the problem of child care especially acute.

Drawing on the Canadian experience of collective bargaining in the health care industry, highlights some common elements which may have wider application and are required in the preparation and planning of negotiations.

Quebec was the first Canadian jurisdiction to legislate on pay equality. It did so through the adoption of the Charter of Rights and Freedom, in 1976, a passive legislation since it is based on complaints. It seems to be a matter of time before the Quebec Government passes a pro‐active legislation on pay equity and, in doing so, it will likely draw its inspiration from the Pay Equity Act (PEA) passed by the Ontario Government in 1987. One of PEAs important features is the emphasis on institutional structures and practices in determining the appropriate unit for the purpose of achieving pay equity. In practice, such units will often match up with the usual job families (e.g. clerical or office vs production jobs). However, the historical development of jobs families is intertwined with the evolution of occupational segregation between men and women in the labour markets.