Canadians are shareholders of the health-care system and deserve to know whether it's working well, the Roy Romanow said in the report on health care tabled Thursday morning.

To that end, the report says it is time to create a new public watchdog to ensure the high-quality health care and responsible spending Canadians expect.

Canada spends $100 billion a year on health care, but no one really knows if that money is used effectively, the health-care commission concluded.

"The public are demanding better accountability from the system and regular information that allows them to judge the results that are being achieved," the report says.

The watchdog body, which would advise the federal and provincial governments, would also measure performance, report on accessibility and quality and assess new technology.

Mr. Romanow suggests the Canadian Institute for Health Information (CIHI) should form the backbone of the proposed new council.

"It seems to me that it is a fairly reasonable suggestion," John Millar, CIHI's vice-president of research and analysis, told globeandmail.com Thursday.

"CIHI was created to do much of what the council functions are recommended to be. CIHI was created to develop indicators on the performance of the system and make regular reports to the public. We've already been doing that for several years now."

It seems quite reasonable that we continue that work and roll it into this counil, which is the word Mr. Romanow used."

The 14-member board would be made up of three public representatives, four experts from the health community and seven government appointees. Board members would each serve three-year terms, with the possibilty of one reappointment for an additional three years.

Its annual reports should tell Canadians where their overall health and their health care stands in relation to other countries, the report said.

"Ultimately, the council should be a collaborative mechanism that can drive reform and speed up the modernization of the health care system by 'de-politicizing' and streamlining some aspects of the existing intergovernmental process," Mr. Romanow writes in his report.

Mr. Romanow says dysfunctional intergovernmental relationships have left Canadians confused about which level of government is responsible for addressing specific health care issues.

The idea for such a body was first broached by the Canadian Medical Association (CMA), the group representing Canada's doctors.

The CMA declined comment on the Romanow report Thursday.

The watchdog, as conceived by the CMA, would also try to establish guidelines for such details as waiting lists.