Bill 114: Who broke trust?

Your editorial refers to a breach of trust between patient and physician, and to damage to the relationship between physician and government as a consequence of Bill 114.1 The Canadian Association of Emergency Physicians (CAEP) believes the only breach involves the physician–government relationship.

Our emergency departments are functioning solely because of the dedication of emergency health care providers, who deliver quality care despite the inadequacy of today's health care system. The public clearly understands that the disruption of service in Shawinigan this summer was yet another example of the many stresses being imposed on our emergency departments.

Emergency health services must be available continuously in urban and nonurban settings. However, governments that act in isolation are unlikely to establish successfully an effective emergency health care system for all regions. Canadians can develop and maintain a well-coordinated regionalized system of care by taking advantage of the unique perspective of emergency physicians, emergency nurses and other emergency personnel. If governments and administrators listen to these emergency workers and act on their advice, they will find the solutions they seek.

This is why CAEP is calling for a National Forum on Emergency Health Services. This forum, which must be supported by the federal, provincial and territorial governments, would focus on designing a template of excellence for emergency health services in all regions of Canada. It would move beyond mere guidelines and result in practical and applicable national standards that ensure the patient's right of access to the best emergency care. A national forum would also give an opportunity for input to all levels of government, emergency, family and rural physicians, emergency nurses, paramedics, hospital administrators and regional health authorities.

Although Bill 114 has exacerbated the schism between physicians and government, the real consequence is an infringement on patient rights. Now more than ever, a collaborative approach is required if we are to maintain an effective emergency health care system. This system is the Canadian patient's right.