Canada - World Health Organization Regional Office for Europe

Health systems in transition Canada 55
on medical errors, and critical incidents; however, the Canadian Patient Safety
Institute has led a major initiative to produce guidelines for the disclosure of
medical errors, with a revised version released in 2011 (CPSI, 2008, 2011),
while other researchers associated with major health care agencies in Canada
have suggested disclosure guidelines in situations where a given error affects
numerous patients (Chafe, Levinson & Sullivan, 2009).
A number of provincial governments have issued general statements
and booklets concerning the public health care benefits to which residents
are entitled. These statements are generally available on ministry of health
websites. Similarly, the federal government has used its departmental websites
to provide information on the health benefits provided to (for example) eligible
First Nations, Inuit and veterans.
2.9.2 Patient choice
Within the limits imposed by geographical distance and isolation, provincial
and territorial residents are at liberty to choose the physician, hospital or
long-term care facility. Even residents living within a particular RHA can
choose to access the services of a facility in another RHA in the same province.
However, other than in an emergency, they cannot obtain insured medicare
services in another province or country without a prior referral by an eligible
authority in their own province.
In the last 15 years, a patient’s choice of primary care provider has been
constrained by the supply of family physicians in some locations as well as the
desire by some physicians to limit their roster to potentially less demanding
patients (Asanin & Wilson, 2008; Reid et al., 2009). Since family physicians act
as gatekeepers in most provinces, patients are prevented or discouraged from
approaching consulting physicians directly. However, at the point of referral,
Canadians do have a choice of specialist.
2.9.3 Patient rights
Two royal commission reports, one in 1964 and a second in 2002, have
recommended a pan-Canadian patient charter of rights (Canada, 1964;
Romanow, 2002). Despite this, there is no national patient charter of rights in
Canada. In addition, no province or territory has implemented a patient charter
of rights or other laws defining specific individual patient rights (Smith, 2002).