NIAGARA FALLS, Ont. — Patient advocates are backing a blueprint by Canada's largest doctors group to transform the health system by focusing on patient-centred care, but they admit the road forward could be strewn with obstacles.

On Monday, delegates attending the annual meeting of the Canadian Medical Association debated how to go about altering the health-care system to make it more responsive to individuals, based on a new charter of patient-focused care.

The charter — part of the much larger, recently released CMA plan for overhauling medicare — drew praise from one of Canada's best-known patient advocates, who called it an important move by doctors.

"You will make patient-centred care the heart of what you're going to fight for in terms of transformation," Durhane Wong-Reiger told about 250 delegates representing 72,000 doctors from across Canada.

"The patient-centred charter is something that we would consider to be a covenant," said Wong-Reiger, who played a major role in advocating for patients infected with HIV or hepatitis C as a result of tainted blood in the late 1980s.

"It's a promise between the doctors, the Canadian Medical Association and the patients."

However, Wong-Reiger said there are "huge problems" with funding and staffing the system to ensure affordable and universal access to care as set out in the Canada Health Act. And those problems will likely continue to throw up stumbling blocks as efforts are made to refine the system.

"But if we are all driven by the gold standard in terms of that transformation — and that is how does this improve patients' care — I think we will end up with a system that does put patients at the very centre," she said.

Outgoing CMA president Dr. Anne Doig said the need to transform the health-care system is urgent — and building a culture of patient-centred care is the first pillar of change.

Doig said many individuals may feel their doctors are focused on their needs during one-in-one interactions, but that rarely seems to translate across the system.

"When we take that out into a system perspective, we see that being diluted and we see the fact that there is more concern about administrative issues, more concern about budget and overruns and costs than there is about the specific individual patient."

"So patients often get lost in the system. If you're on a waiting list, you get lost, you might get lost."

Wong-Reiger said there's nothing revolutionary about the concept of patient-focused care, but she agreed it's probably not what most Canadians experience when they are navigating the health system.

She pointed to a CMA-commissioned poll released Monday that suggests the majority of Canadians are concerned about the sustainability of the system, given the spiralling costs of providing care against the background of an aging population.

"And it's certainly a huge concern of patients that the budgetary, economic concerns might in fact be what drives transformation."

The CMA wants Ottawa and the provincial and territorial governments to back its charter, but it's unclear what form that might take.

Typically, the federal health minister addresses delegates and takes their questions on the opening day of the annual meeting.

But Leona Aglukkaq was accompanying Prime Minister Stephen Harper on his tour of the North, and her stand-in, Human Resources Minister Diane Finley, did not take questions from the floor after her address to delegates.

Finley touched on an array of subjects, including the federal government's investment in health-promotion programs and the move towards electronic health records.

In an interview with The Canadian Press, Finley said she does not know how her government will respond to the charter or the rest of CMA document, which is still under review by Aglukkaq.

Despite Aglukkaq's absence, Doig insisted that "politicians are aware of what is happening."

"And when they see a united front, when they see groups of people who have normally not spoken together and spoken with one voice ... they will be interested, they will in fact respond.