In the February 2003 Health Accord, our First Ministers committed themselves to "enhancing the transparency and accountability of our health care system while ensuring that health care remains affordable".

The public, stakeholders and even governments agree that the governance of our health care system needs an injection of accountability.

But scratch below this surface unanimity and there are a lot of questions: To whom should health care governors be accountable? Through what mechanisms can they be held accountable? How will we know when we have achieved greater accountability? Recent reform reports have recommended a variety of accountability mechanisms. They range from more and better performance data to quality councils. All are relatively new to the Canadian system.

The Health Network has directed a series of projects to map out the accountability relationships within Canadian health care system. The first of the series, by Fooks and Maslove outlined these relationships and the meaning of accountability. The next five papers elaborated on a number of different routes to accountability: legal; legislative; citizen engagement; performance measurements; and citizen governors. A final synthesis paper will outline the common issues and provide the "next steps" for understanding accountability in health care.