The agency charged with monitoring and reporting on the quality of Canadian health care says provincial and territorial governments have not lived up to the promises they made in the health accords of 2003-04.

The Health Council of Canada, created in Dec. 2003 following the recommendations of Roy Romanow's Royal Commission on Health Care, says the jurisdictions have failed to create a system that allows health care access to be compared from province to province.

Under the 2004 health care accord, all provinces and territories except Quebec and Alberta agreed to create such measurable standards by the end of 2005.

The lack of compliance raises questions about whether the agreements should be regarded as binding contracts or merely agreements in principle.

In the 26-member council's second annual report, it says only four jurisdictions made public their plans to increase the supply of health care professionals by the end of last year. These were to include targets for recruitment and training.

The 2003 accord committed $36 billion in federal funds over five years, and the 2004 deal increased that amount by $41 billion over 10 years.

Council chair Michael Decter said the focus on wait times has led politicians to forget about quality, citing "adverse patient events" and regional disparities in care in the report, titled "Health Care Renewal in Canada: Clearing the Road to Quality."

It said Canadians spend an estimated 1.1 million unnecessary extra days in hospital due to such "adverse events," suggesting doing things right the first time would drastically improve wait times.

The Council also believes electronic health records should be available for all Canadians by 2010.

"I believe that many Canadians think that when they are in a hospital bed, or they're in an emergency or they're in a doctor's office, that that provider does have access to a great deal of information that they don't actually have access to," Decter said.

"There is a very fragmented paper system at the moment.

"If we're going to deliver quality care in the country, those people providing care have to know all the medications you are on, have to be able to know all the conditions you have, or it's a little too much of a hunt in the dark."

Council members were appointed by the participating provinces, territories and the Government of Canada. They come with a broad spectrum of health care experience including community care, Aboriginal health, nursing, health education and administration, finance, medicine and pharmacy.

Some of the Council's key recommendations include:

• To improve patient safety, make accreditation for health care facilities mandatory, a condition of public funding.
• Speed up the development of electronic health records.
• Strengthen legislation to ban all forms of direct-to-consumer advertising of prescription drugs in Canada.
• Create information systems that identify patients whose waits are becoming unusually long, triggering an audit.
• Increase the number of inter-professional teams providing primary health care beyond the goal set out in the 2003 and 2004 agreements, which currently call for 50 per cent of residents to have 24/7 access to health care teams by 2011.
• Address the needs of people without any drug coverage or without coverage that protects them from catastrophic drug costs.