A Patient Charter of Rights: How to Avoid a Toothless Tiger and Achieve System Improvement

Abstract

A patient charter of rights should achieve greater clarity and awareness of the nature and extent of patients’ rights but also, if well designed, it should help drive improvements in the quality and timeliness of care, improve overall accountability of health care system actors, and reduce costly litigation.1 However, experience demonstrates that it is easy for a patient charter to be a paper tiger – a mechanism to merely talk about improving the patient experience and reforming the health care system. To be effective it is essential that patients have access to an independent Ombudsman or Commissioner who can expeditiously and cheaply resolve their complaints or concerns. Health care professionals concerned about a culture of complaint should be palliated by evidence that these alternative dispute resolution mechanisms significantly avert subsequent formal disciplinary complaints – thus both patients and health care professionals are winners. Moreover, an Ombudsman/Commissioner, armed with information-gathering powers, can also weigh in on systemic matters such as resource allocation decisions by the government, wait times, systemic safety issues, etc. The international evidence here is more mixed but suggestive that moral suasion from a sufficiently resourced, independent Ombudsman/Commissioner can positively drive system change.