- Universal Health Care in Canada - Public Accountability Support for Nursing Practice in the
Canadian Health Care System
Universal health care in Canada is available to all members of the society.
The Canada Health Act ensures
that all members of Canadian society are eligible for medical insurance
regardless of the ability to pay or the presence of pre-existing illness.
Public accountability is essential in a publicly funded system of universal health care. In
Canada there are three ways that this accountability is supported and maintained.
Nursing Laws and Other Legislation Affecting Nursing Practice in Canada
Nursing laws govern the
nursing profession in some provinces in Canada.
In other provinces all health care professionals are regulated under the same law (regulated health
care professions legislation) with different regulations for their areas of professional practice.
All health care providers would be expected to know the laws that might affect their professional practice.
This would be laws such as the Mental Health Act, Freedom of Information and Privacy laws, Child Protection Laws,
Abortion Access Laws and the Infants' Act to name a few.
1. Professional Legislation and Regulation
As part of the public safety structure in health care in Canada, legislation regulates
health care providers. This includes doctors, nurses, physiotherapists, chiropractors, massage therapists,
midwives and other such care providers.
Legislation creates regulatory bodies to protect the public interest by
making sure that members who enter the profession have the required knowledge and skills to
provide safe, ethical care within their legislated scope of practice.
processes to investigate and discipline members when complaints are received.
Anybody can make a complaint about a regulated health care provider.
There are many variations in the way that professional practice in health care in Canada is regulated.
Although all provinces embrace the mandate of public protection, how this is done is not exactly the same
across the nation.
For example, legislation and regulation of midwives, respiratory therapists, and the
nurse practitioner are not universal across the country.
In some provinces these roles are not even legal.
In those provinces that have laws and regulations that govern health care providers,
the absolute bottom line of that regulation is the
protection of the public.
2. Labor Unions and Labor Laws
The labor union and labor laws are
important in ensuring the public safety in system of universal health care in Canada.
There are three parties that must work together in Canadian health care in the interest of all Canadians.
The provincial government is the funder and it is from them that all funds flow to employers in order to run the
Canadian health care system.
The employer is either the provincial government, a regional health authority or a contract provider. Employers receive the funds
from the government to provide health care services.
The workers in the system are the front line personnel who are the employees and do the
hands on work of delivering health care in Canada. Not all health
care employees are regulated. For example there is no regulation for nursing aides or nursing
assistants and they are not required to be licensed.
All three parties must act in the public interest to provide health care.
From time to time the interests of these parties may be in conflict, and so the foundation of labor laws provide the Canadian public
with the assurance that the system that has been established to run in their best interest will
not be derailed when there is conflict among the interests of these three groups.
Labor laws govern such things as strikes and job action in the public sector.
Labor laws in Canada guarantee the right of workers to form a
labor union and regulate when and how the
workers may go on strike.
The role of the labor union as a pillar of public accountability, is to work to protect
jobs so that an employer cannot force an employee to work below an
acceptable standard of safety or ethics.
This level of protection is essential for public safety and trust.
The expectation of Canadian citizens is one of trust in their health care
providers. They expect that when they are ill and vulnerable, the actions of all health care professionals
will be directed toward their best interest.
This public trust is the very foundation of the public accountability framework for universal health care in Canada.
3. Professional Ethics
Professional ethics are a strong foundation in the education of regulated health care providers
in Canada.
Education of health care professionals goes beyond establishing the technical competence needed to
work within a legislated scope of practice.
Health care professionals such as nurses, who work in the public interest,
must also be able to apply concepts such as
duty of care, profession responsibility and accountability, and provision of service to the public.
A general education with a strong foundation in professional ethics that includes an ethical theory base supports the
health care professional in making decisions that are in the best interest of the public they serve.
Ethical reasoning becomes important in guiding practice decisions when there are competing interests
among stakeholders, care providers, or client groups.
Universal Health Care in Canada Key Points About the Public Accountability Framework
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