Time for a Patients' Bill of Rights?

B.C.'s nurses say they have a solution to growing surgery wait lists, harsh service cuts, facility closures, contracting out and layoffs in the B.C. health care system.

The nurses have issued a Patient's Bill of Rights which proposes significant improvements in what patients can expect when they go to an emergency room, require surgery, seek community health services such as home care, need a bed in a nursing home, require palliative care in the last days of their lives and want access to information about their care.

With British Columbians struggling to cope with hospital overcrowding, bed closures and the elimination of long term care nursing homes, nurses' reps claim this proposed Bill of Rights presents an opportunity for the provincial government to engage in a dialogue with health care providers about the resources that are needed to ensure patients get the care they need in B.C.

Bill has wide support in field

"As care-givers who are directly involved in working with patients in hospitals, in the community and in long term care we have an obligation to speak out and say what British Columbians should be receiving from our health care system," says Debra McPherson president of the B.C. Nurses' Union. "Unfortunately, because of the provincial government's fiscal policies, the government has forced its health authorities to cut back on health care services throughout the province, creating a very difficult situation for patients."

This proposed bill also has the support of B.C.'s Registered Nurses and Registered Psychiatric Nurses associations and the B.C. Health Coalition. If adopted, McPherson insists it would require any governing party in B.C. to provide what she calls "adequate funding" to safely operate a non-profit public health care system.

"The Patient's Bill of Rights establishes what we believe the health care system should be providing if the government was supporting it properly," she said. "Among other things that means ensuring there is an adequate supply of registered nurses and registered psychiatric nurses to provide safe, quality care by improving working conditions and addressing nurses' workloads."

This Bill of Rights includes providing freedom of movement and choice for residents of urban and rural communities to access an emergency department within a maximum of one half hour travel time.

It also would provide the right to be assessed (triaged) immediately; treated immediately if needing resuscitation and within15 minutes for urgent cases, and the right to be discharged, transferred to another hospital or admitted to a hospital bed within six hours, as well as subsidized travel for patients who can't get the treatment they need in their own communities.

It also calls for maximum wait times for diagnostic, therapeutic, surgical and rehabilitative treatment, established through a public process that includes input from the public and health care providers, as well as greater emphasis on good health maintenance and prevention measures through health education in public schools.

Patients would get direct say

Finally, it calls for guarantees that patients will have a direct say in the planning and administration of their treatments, including direct access to information on their treatments and on the performance of the health care system.

But the government says there may be no need for such a bill, claiming that its new budget provides for patient services and guarantees the right of access to health services within a reasonable time.

Finance Minister Gary Collins, in his budget speech, maintained this as a priority, despite no significant funding increases for health care this year in the face of facility closures, layoffs and growing wait lists for surgeries. "We will focus this year on patients," he said. "It's their turn this time."

He referred to the proposed Bill of Rights as a tall order that is not fiscally feasible. Collins also repeated his stance that there is no room in the budget for any salary increases for nurses or other health care providers.

Marco Procaccini is contributing editor to The Columbia Journal where this piece first appeared.