Monique Bégin
Authors: Andrew Green
Journal: The Lancet (2023)

Canadian politician, academic, and former Minister of Health and Welfare. Born on March 1, 1936, in Rome, Italy, she died on Sept 8, 2023, in Ottawa, ON, Canada, aged 87 years. As a politician and cabinet member, Monique Bégin “believed in fairness, equality, and social justice. She believed what we wanted for ourselves, we wanted for everybody”, said Kathleen Connors, the former Chairperson of the Canadian Health Coalition. That led Bégin to support several crucial pieces of legislation during her appointments as Canada's Minister of National Revenue and Minister of Health and Welfare, including increases in supplements for senior citizens and the creation of a child tax credit. One of the pieces of legislation for which she is best remembered is the 1984 Canada Health Act, which ensures all Canadians have access to timely medical services irrespective of their ability to pay. Bégin fought special interests and rallied political support for this legislation for publicly funded health insurance. “Canada owes a great deal to her”, said Jane Philpott, Dean of the Queen's University Faculty of Health Sciences and Director of Queen's University's School of Medicine in Kingston, ON, Canada. “She really provided the stability in the health system that was so necessary in the 1980s and has held strong until now.” Bégin received her bachelor's and then master's degree in sociology from the University of Montreal, QC, Canada, in 1961, before completing a doctorate at the Sorbonne University in Paris, France, in 1963. On returning to Canada, she became a founding member of the Quebec Women's Federation in 1966 and began serving as Executive Secretary for the Royal Commission on the Status of Women in Canada the next year. She was later elected to the country's House of Commons as a member of the Liberal Party of Canada, becoming one of the first women from Quebec to serve in the federal Parliament. “She broke moulds all the way through her career. She really carved her own path through life and leadership”, said Philpott, who was formerly Canada's Minister of Health. Former Canadian Prime Minister Pierre Trudeau offered Bégin a junior role in his cabinet in 1976 to oversee a status of women portfolio, but she turned him down because it came with no budget and no staff. “There was a strength there. There was that confidence that she could set the rules”, said Carolyn Bennett, a Member of Canada's House of Commons and a former Minister of State for Public Health and Minister of Mental Health and Addictions. Trudeau responded by appointing Bégin the Minister of National Revenue. In 1977, she became Minister of Health and Welfare, which was then Canada's largest department. “She was willing to put her shoulder to the wheel and get things done”, Connors said, including giving Indigenous communities more control over their own health services. At the same time, “she perceived the risk that health care was under because nobody around her was really paying attention”, Philpott said. That led Bégin to spearhead the adoption of the Canada Health Act, which “enshrined in legislation universality, comprehensiveness, portability between the provinces, accessibility, and public, not-for-profit administration”, Connors said. “It was the battle of a lifetime”, but she said Bégin succeeded by “bringing everybody into the room, having the discussions that were necessary, finding the common ground that would let people get their sense the issue belonged to them”. Bégin did not seek re-election in 1984 and moved into academia as the Joint Chair in Women's Studies at Carleton University and the University of Ottawa, ON, Canada, in 1986. 4 years later, she became the Dean of the Faculty of Health Sciences at the University of Ottawa, a position she held until 1997. In 2005, Bégin was asked to serve on WHO's Commission on Social Determinants of Health, led by Michael Marmot. “When people would come to the Commission and give evidence, she was very quick and her antennae were well attuned in sorting out who was worth listening to and who wasn’t”, said Marmot, Professor of Epidemiology at University College London (UCL) and Director of the UCL Institute of Health Equity, London, UK. Marmot describes Bégin as “constructive, challenging, helpful, canny, and warm”. Bégin was awarded an Officer of the Order of Canada in 1997 and was elevated in 2020 to Companion of the Order of Canada. She is survived by her sister, Marie Bégin, and her brother, Sébastien Bégin. “She was a brave woman in a man's world and she knew that she had to be smarter than everybody else to get things done”, Philpott said.