Provincial and territorial governments hold primary responsibility for the design, delivery and management of health care systems in their jurisdictions. As such, the federal government is not directly involved in the definition of patients' rights or related documents. However, the Canada Health Act does provide overarching national principles that guide provincial and territorial governments in some aspects of the design, delivery and funding of medically necessary hospital and physician services in their jurisdictions (see question 65). In recent years some provincial governments have explored a range of approaches from the use of legislation through to non-binding policy statements that express expectations for services. In some cases, provincial government mechanisms for patient complaints have also been instituted that are linked to policy statements that articulate patient rights. At the local level, many hospitals and other health care organizations have established guidelines or values statements to guide patient care, in some cases as a requirement of provincial legislation.