Abstract

Recent discussion concerning the Canadian healthcare system has focused on how well the system provides access to patients awaiting care. Accessibility is one of the guiding principles of the Canada Health Act. This principle stipulates that "provinces and territories must provide reasonable access to insured health care services on uniform terms and conditions … unimpeded … by charges or other means [such as] age, health status or financial circumstances."

The notion of uniform terms and conditions speaks to equity of access - that fair rules apply in obtaining medically necessary services. However, when demand for medical services outweighs the supply of these services, the issue of "fair rules" concerning who comes first or who is most in need is a hotly debated subject. This debate has focused not just on how long patients may have to wait for access, but also on the question of how caregivers decide the priority of providing care. Central to this discussion is the need to develop a transparent methodology that fairly prioritizes patients based on urgency, timely access to services and acceptability to all stakeholders.

 

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    Healthcare Quarterly, 5(3) March 2002

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