The Future of Health Care Accountability: A Human Rights Approach

Abstract

The paper argues that there is an urgent need in Canada for a human rights approach to health care accountability. Taking as its starting point that health care decision-making must respect Canadian Charter and international human rights guarantees, the paper contends that accountability mechanisms, both in relation to the overall performance of the health care system and individual access to care, must be designed to reflect and reinforce these fundamental human rights principles, not only as a matter of domestic and international legal obligation, but in order to be effective. To make this case, the paper first provides a brief overview of the concrete steps governments have taken towards implementing the various accountability reforms that have been put forward in Canada over the past twenty years. It then considers the implications of the absence of a human rights approach to health care accountability, particularly for those whose needs are least well served within the current system. The paper goes on to suggest that what is required, moving forward, is not only the recognition that health care is a fundamental right, but the creation of institutions and mechanisms capable of enforcing that right at both the access to care and system performance levels. The paper points to the Alternative Social Charter as one possible model for achieving effective accountability within the health care system: a critical reform for the future of health and human rights in Canada.