Roy Romanow proposed the reinforcement of the current Canada Health Act principles, along with the creation of a new Canadian Health Covenant that would outline the collective vision of health care in Canada on Thursday in his report on Canada's health-care system.

The former Saskatchewan premier proposed the establishment of the Canadian Health Covenant "to express Canadians' collective vision for health care and updating the Canada Health Act."

Central to this new, "mission statement" on health is the proposal that care be patient-centred, Mr. Romanow says. The covenant was established after Mr. Romanow heard from many Canadians that they wanted some sort of binding statement on the health care they should be entitled to receive.

The Covenant will be presented to the first ministers at a meeting in the new year for endorsement, and the federal government will also be asked to back the statement.

Mr. Romanow also proposed a sixth principle for the five-principle CHA — the principle of accountability for the provinces.

"A new principle of accountability should be added to the CHA to address Canadians' concern that they lack sufficient information to hold the appropriate people accountable for what happens in our health-care system," Mr. Romanow writes in his report. "Canadians have a right to know how their system is being adminstered," he says.

The health act governs how services are administered and delivered by the provinces, but it is the provinces that maintain responsibility for providing health care to their residents.

They currently must follow five criteria under the act: public administration; comprehensiveness (which means all provinces must provide health insurance including dental, medical and hospital); universality, meaning that 100 per cent of residents of a province or territory must be able to get coverage; portability, meaning if residents move from one province to another they must have uninterrupted access to health care; and accessibility, meaning patients must have reasonable access to care.

Mr. Romanow is also recommending revisions to the act to include coverage for home care in rural areas and for diagnostic health services such as MRIs.

As well, he is recommending that people with mental illnesses receive better quality of care and support that would be managed under the principles of the new Canada Health Act, and that the act provide coverage for palliative home-care services for those in the last six months of their life.

Dr. Cal Gutkin, executive director of the College of Family Physicians of Canada, said doctors in his association welcome the addition of these aspects to the Health Act.

He told globeandmail.com that doctors have long been advocating medically necessary palliative care.

Mr. Romanow also recommended that the federal government immediately establish a new, dedicated cash-only Canada Health Transfer as part of the Canada Health Act.

The new transfer will require a higher share of funding from Ottawa and will include an "escalator provision" that is set in advance for five years to "ensure future funding is stable, predictable and increases at a realistic rate."

Provincial premiers have been asking the government for $7-billion in new money.

Saskatchewan Premier Lorne Calvert called it "a historic day in the life of our nation." Saskatchewan is the province where the universal medicare system was born under former premier Tommy Douglas.

NDP health critic Judy Wasylycia-Leis told CBC Newsworld after the release of the report that Mr. Romanow "touched the soul of Canada, giving us universal access to quality health care in Canada."

The Canadian Health Coalition said in a statement that it is now up to the Prime Minister and the first ministers to implement the Romanow plan quickly.