In Canada it is a commonly held belief that patients have a right to a diverse, high quality array of healthcare (1-6). To provide this type of care to patients it is necessary to govern and regulate the healthcare system at every level (1-6). This system allows all stakeholders to have their interests protected at the provincial and national levels to constantly improve healthcare in Canada with the fundamental aim of meeting the patients’ needs (1-8).
The Canada Health Act is a set of federal legislations which serve as guidelines to govern provincial and territorial administration of healthcare (1). This act covers healthcare for all Canadian citizens equally regardless of socioeconomic factors including but not limited to medical history, personal income and standard of living (1). The Canada Health Act stipulates that healthcare in a province or territory must be publicly funded and determines the funding the provinces will receive for healthcare from the federal government (1). Critics of the Canada Health Act speculate that the Canadian healthcare system may be less efficient than a private system in terms of wait times (1). However, the system in place ensures equality, affordability and accessibility which may not be possible with a private system (1).
The Canada Health Act has five basic tenants that aptly summarise its scope and intentions. Provincial or territorial coverage must be administered by a public authority on a non-profit basis (1). All necessary care must be covered comprehensively (1). Healthcare coverage must be universal in that all residents must receive the same coverage (1). Coverage is portable (1). If a resident relocates, they are still covered for a pre-determined waiting period (1). All Canadians insured must have reasonable access to covered healthcare while still ensuring fair compensation for the practitioners (1).
The Ministry of Health and Long-Term Care works to help patients to get all the value possible out of the healthcare system (2). They value patient focused, integrated care with emphasis on sustainability (2). Their day to day operations focus on planning and offering guidance to involved parties (2).
In Canada there are also organizations that focus on chiropractic’s role in the healthcare system. The Canadian Chiropractic Association acts on a national level to help chiropractors provide excellent patient care (3). They focus on integrating chiropractic into Canadians’ existing healthcare teams, strengthening inter-professional relationships, while emphasizing integrity and ethics (3). The Canadian Chiropractic Protective Association was formed by the Canadian Chiropractic Association in 1986 (4). Its focus is the protection of its members through safe work habits, proper record keeping and high standards of care (4).
When seeking treatment patients are in a vulnerable position so to preserve patients trust in the healthcare system it is necessary to protect the personal information of the patients (5). The federal Government is involved in the protection of privacy rights through the Office of the Privacy Commissioner of Canada which acts as an Agent of Parliament (5). This office oversees adherence to the Privacy Act and Personal Information Protection and Electronic Documents Act (5). Their purview includes all matters involving federal institutions, businesses and individuals (5).
Patient privacy is also protected provincially (6). The Information and Privacy Commissioner of Ontario works independently of the government to ensure the protection of personal information as is the patients’ right (6). They function in accordance with the Freedom of Information and Protection of Privacy Act, the Municipal Freedom of Information and Protection of Privacy Act and the Personal Health Information Protection Act to control access to private records, healthcare and otherwise (6). The commissioner also provides a forum to voice complaints, request records and file appeals regarding the records they protect (6).
Within Ontario there are two main organizations that oversee chiropractic (7; 8). The Ontario Chiropractic Association works in the interest of its members by furthering understanding of chiropractic and its role in a patient’s healthcare team (7). Membership to this organization is voluntary (7). College of Chiropractors of Ontario differs in that every chiropractor that wishes to practice in Ontario must be registered member (8). Its duties are laid out by the Health Professions Procedural Code and set high standards of practice to regulate chiropractic in Ontario (8).
With all these legislations and governing bodies working cooperatively, in the interests of patients and practitioners creates a diverse and rigorous regulation process of the healthcare system. This multifaceted system of governance of the healthcare system is necessary to include many diverse viewpoints to reflect the diversity of patients in Canada. All the systems in place ensure all stakeholders’ voices are heard and taken into account to constantly improve patient care.
- Canadian Health Care. Canadian Health Act [document on the internet]. Canada; 2007 [Cited 2016 Sept 25]. Available from: http://www.canadian-healthcare.org/page2.html
- Ministry of Health and Long-Term Care. About the Ministry [document on the internet]. Canada; 2016 [2016 Sept 22]. Available from: http://www.health.gov.on.ca/en/common/ministry/default.aspx
- Canadian Chiropractic Association. Vision, Mission, Strategies & Values [document on the internet]. Canada; 2016 [Cited 2016 Sept 25]. Available from: http://www.chiropractic.ca/about-cca/strategy-vision-mission/
- Canadian Chiropractic Protective Association. About [document on the internet]. Canada; 2016 [Cited 2016 Sept 22]. Available from: http://www.ccpaonline.ca/about
- Office of the Privacy Commissioner of Canada. The Personal Information Protection and Electronic Documents Act (PIPEDA) [document on the internet]. Canada; 2016 [Cited 2016 Sept 25]. Available from: https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/the-personal-information-protection-and-electronic-documents-act-pipeda/
- Information and Privacy Commissioner of Ontario. Collection, Use and Disclosure of Personal Health Information [document on the internet]. Ontario, Canada; 2016 [Cited 2016 Sept 25]. Available from: https://www.ipc.on.ca/health/collection-use-and-disclosure-personal-health-information/
- Ontario Chiropractic Association. Position on Treatment Recommendations and Discounts [document on the internet]. Ontario, Canada; 2016 [Cited 2016 Sept 25]. Available from: http://www.chiropractic.on.ca/wp-content/uploads/Position-on-Treatment-Recommendations-and-Discounts.pdf
- College of Chiropractors of Ontario. What is CCO [document on the internet]. Ontario, Canada; 2009 [Cited 2016 Sept 22]. Available from: http://www.cco.on.ca/english/About-CCO/What-is-CCO/