The Royal Commission on the Future of Health Care in Canada, also known as the Romanow Report, is a committee study led by Roy Romanow on the future of health care in Canada. It was delivered in November 2002. Romanow recommended sweeping changes to ensure the long-term sustainability of Canada's health care system. The proposed changes were outlined in the Commission's Final Report, Building on Values: The Future of Health Care in Canada, which was tabled in the House of Commons on 28 November 2002. Although the Report of the Royal Commission dealt with a wide range of issues, much of the early attention was paid to the recommendations with respect to the financing of health care in Canada and especially transfers from the federal government to provincial and territorial governments. The Report set the stage for another round of federal-provincial/territorial bargaining leading to a significant agreement in September 2004 whereby the Government of Canada agreed to transfer an additional $41 billion over the next 10 years in support of an action plan on health. The new funding is meant to strengthen ongoing federal health support provided through the Canada Health Transfer (CHT) as well as focus resources on addressing the fact that Canadians, like citizens in other OECD countries, often have significant wait times for access to essential health care services. Issues highlighted by the Romanow Report Aboriginal issues The report identifies significant problems in the way that aboriginal health is managed. Surprisingly, this is largely not due to a lack of funding; there is simply a mismanagement of assets. Funding sources are fragmented and there is no established system to provide care. In addition, there are extensive equity concerns due to this fragmentation of funding and differential care available to different Aboriginal communities. As a result, the report suggests that new administration procedures be put in place. Integration of on-reserve healthcare into the current system is not a popular option amongst aboriginal leaders, although serves as a reasonable option for urban aboriginal healthcare. Specifically, the report suggests the formation of Aboriginal Partnerships that are an administrative authority composed of representatives from different levels of government and the aboriginal community. These partnerships may work in a method similar to a regional health authority. They will serve as an organization with a specific health goal, such as organizing the public health and primary care for a community. The partnership will