Canada - World Health Organization Regional Office for Europe

56
Health systems in transition Canada
The patient rights movement is relatively underdeveloped in Canada, at
least compared with similar movements in the United States and Western
Europe. While there are organizations (e.g. Canadian Cancer Society and the
Canadian Mental Health Association) that advocate for the rights of patients
with particular diseases, there are only a few individually oriented patient
rights groups and these tend to be very weak in comparison with the specific
disease-oriented organizations (Golding, 2005). While more general purpose
organizations such as the Consumers’ Association of Canada and the Canadian
Association of Retired Persons have engaged in some patient advocacy, these
efforts remain limited compared with individually oriented patient rights
organizations in other countries.
Historically, individual patient rights in Canada have largely been defined
in terms of a perceived “right” of access to universally insured medicare
services under the Canada Health Act. Since the introduction of the Charter
of Rights and Freedoms in 1982, there have been a small number of cases in
which patients have challenged provincial governments’ interpretation of what
the basket of universal health services includes. In addition, the question has
arisen whether section 7, the “right to life, liberty and security of the person”,
of the Charter of Rights and Freedoms encompasses a right of access to health
care within a reasonable time (Greschner, 2004; Jackman, 2004). Thus far,
the Supreme Court of Canada has not interpreted section 7 to include such a
right (Flood, Roach & Sossin, 2005; Flood, 2007). Indeed, while it appears
that the Supreme Court is concerned about provincial restrictions on private
insurance for medicare services and is prepared to extend the right to private
health services as demonstrated in the Chaoulli decision of 2005, it has not yet
been willing to use the Charter to extend or enhance current rights to publicly
financed medicare services (Cousin, 2009).
All F/P/T governments have general laws to ensure that disabled residents
have access to public facilities or to facilities that serve the general public. Since
virtually all health care facilities come within this definition, disabled persons
are ensured physical access to health services.
2.9.4 Complaints procedures (mediation, claims)
Historically, concerns about public health care were either expressed to
provincial and territorial ministries of health and their ministers or to members
of opposition parties, who would then question the governing party through
the media and in the legislature. It is likely that only a tiny minority of
patients ever used this highly political procedure and there has been growing