(CPSI) to develop programs and tools aimed at improving patient safety: Canadian Disclosure Guidelines, CPSI Safety Competencies, Canadian Patient Safety Officer Course, Patient Safety Education Program, and the Advancing Safety for Patients in Residency (ASPIRE) program. Nevertheless, as noted by the 2008 Canadian Healthcare Safety Symposium, there is more work to be done to improve patient safety: The progress of the patient safety movement is being stymied by regulatory, structural and attitudinal problems, according to speakers at the eighth annual Canadian Healthcare Safety Symposium. A 'huge gulf' exists between the number of Canadian patients injured by negligence and those who receive compensation, said University of Alberta law professor Gerald Robertson. 'One must seriously question the efficacy of a model which compensates so few who are entitled to it.' Only about 2% of patients injured by negligence in Canada receive compensation, he said, basing his calculation on figures from the Canadian Medical Protective Association research estimating the number of preventable adverse events in Canadian hospitals. Meanwhile, the number of lawsuits against Canadian doctors is dropping — down 30% since 1998 (from 1339 suits commenced in 1998, to 928 suits in 2007) — and only 30% of plaintiffs seeking compensation are successful in court, Robertson noted. Medical negligence cases are complex, time-consuming, expensive and almost always undertaken on a contingency-fee basis. As a result, lawyers are unlikely to take on cases unless there is a chance of a settlement valued over $100 000, he said, noting that lawyers usually seek a fee equal to 30% of a successful settlement. The patient-safety movement may 'raise consciousness' about the need for better compensation for patients, since it will likely raise awareness about the frequency of adverse medical events. One claimant who received compensation, Campbellford resident John Lewis, said "one of the main barriers to patient safety in this country" is the Canadian Medical Protective Association. "It's extremely powerful because of the political influence it wields." Critics of loser-pays rules and bans on contingency fees say such efforts discriminate against patients who can't afford to pursue a claim. However, Canada's loser-pays rule is rarely invoked by the CMPA, largely because most plaintiffs are not in a position to pay. Liability protection The CMPA describes itself as a "mutual defense" organization for doctors. In other words, it is not an insurance company. There is no contract between the CMPA and member physicians ensuring that the CMPA