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of individual health-care professionals. If jurisdictional legal provisions allow, procedures should be implemented for the release of the system-improvement recommendations of quality-improve- ment reviews while ensuring contin- ued protection for the other infor- mation collected during the review process. The CMPA also says, based on the outcome of quality-improvement regimes, recommendations should be developed and system changes imple- mented. Glaim adds not all adverse events can be laid at the feet of health-care providers. She says while actions may name facilities in shotgun approaches to statements of claim, problems often boil down to pieces of faulty machinery or medication in which case it's the manu- facturers or pharmaceutical companies other way around." No one wants to pay large damages, he says, adding it does not necessarily follow that hospitals "are going to be looking to protect their patients. The I don't think hospitals, health-care providers, and pharmaceutical producers are openly disclosing their problems because of class actions. I think it's the other way around. COLIN STEVENSON, Stevensons LLP January 2007, the project springs from a recommendation by a Uniform Law Conference of Canada's working group on multi-jurisdictional class actions, and seeks to address some of the chal- lenges for the administration of justice and effective management of judicial resources that arise from multi-juris- dictional class actions. These include uncertainty for mem- bers of the public who may be included in more than one class action as well as being subject to conflicting court judg- ments, uncertainty for counsel as to the size and composition of class member- ship in a class action, and uncertainty for the judiciary as to the class partici- pants bound by their decisions. As far as decisions and payouts go, that wind up dealing with the situation. Stevenson says those are the cases health-care insurers such as the Ontario Health Insurance Plan like as they usu- ally wind up receiving payments. A health-care class action case "allows transparency that the medical profes- sion might not have advertised as well as it could have," says Stevenson. "I don't think hospitals, health-care pro- viders, and pharmaceutical producers are openly disclosing their problems because of class actions. I think it's the 34 • APRIL 2010 INHOUSE patients themselves and their lawyers are going to be doing that." Docken adds class actions in a health-care milieu add a layer of accountability. "When there's negli- gence, there's no reason the conduct shouldn't be corrected," he says. A good tool for counsel on both sides of class actions — health-related or otherwise — is the National Class Action Database, a project of the Civil Litigation section of the Canadian Bar Association. Listing actions since says Stevenson, they can be removed from the courts once a ruling is issued as the payouts move into the hands of a judicial administrator. He cautions a class action is "an enormous amount of work and investment of time and resources. The cost of proving a case is usually in the millions." He adds health-care class actions in Canada are not like those in the United States where lawyers can get extremely wealthy. In Canada that depends on how successful counsel are for class members. IH