Understanding accountability in the Canadian health system

As the public sector in general and the health sector in particular undergo reform throughout the Western world to find systems that work better and cost less, the phenomenon of accountability becomes increasingly important to policy makers. In Canada, the most recent healthcare commissions, conducted by Romanow and Kirby, point to the need for improved accountability within the Canadian health system. Yet, although accountability is an ancient concept embedded in public administration and health system governance, its meaning is confused and its implementation is fraught with issues. This article aims to summarize the findings of a doctoral dissertation that was undertaken to clarify the concept of accountability within the health field, and to examine the issues related to improving health system accountability in Canada.