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Thursday, December 20, 2012

Consider this: Canadian Blood Services as a model for pan-Canadian health care service delivery

Dr. Graham Sher, Chief Executive Officer, Canadian Blood Services

There has been much written and said about our ailing health care system, including comments such as: "It is not sustainable and not affordable,” or "If only the federal, provincial and territorial governments could get their act together, all problems will be solved.”

In a series of talks I have been doing at the Economic Club of Canada, I have been addressing one important aspect of what I believe is necessary to help transform the system.

Health care delivery is clearly the jurisdictional responsibility of provincial and territorial governments. The federal government has a role to play in funding, in standards setting, in overseeing the principles of the Canada Health Act, and does, in fact, deliver some health care (to First Nations, Métis and Inuit people, veterans, etc.).

But more and more we’re hearing about the need for pan-Canadian solutions. The essential question being: what can multiple governments do, across Canada, that no one province can do effectively or sufficiently well on its own? Where does it make sense to look at truly pan-Canadian collaborative solutions to what has traditionally been viewed as a provincial matter?

This theme became louder and more dominant following a meeting of all provincial and territorial premiers in Victoria, BC at the beginning of this year, in large part as they reacted to the unilateral funding arrangements imposed by the federal government at the end of 2011.

Some may consider this a bold statement. But I believe, as a result of our successful transformation of the blood system, by virtue of our unique governance structure and funding, and our multi-provincial mandate, Canadian Blood Services has some capabilities and experience that can be leveraged to help inform change elsewhere in the health care system.

With the specific exception of Quebec, (where we do not operate), everything we do is pan-Canadian in nature. We operate a single integrated cost shared system for blood, plasma, stem cells and, more recently, for organ donation and transplantation (OTDT).

We are a living, breathing example of collectively achieving a better, more sustainable outcome for Canadians that would be much harder to achieve for any one region on its own.

Consider that any Canadian anywhere in the country gets equal access to blood of a standard quality and consistency, no matter where they live. What you get in Charlottetown, you get in Moose Jaw.

Consider our plasma protein product purchases, which are a highly successful example of "common bulk purchasing of pharmaceuticals" - something that has been on the radar screen of governments for years.

We operate and manage a $500 million drug formulary program on behalf of all the provinces and territories (excluding Quebec). We have sole responsibility for tendering and procuring over 35 biological drugs used to treat diseases such as hemophilia and immune disorders. By leveraging the buying power of all provinces and territories combined, we are able to achieve two critical benefits for Canadians: best pricing and enhanced security of supply.

Consider the novel and important source of stem cells for clinical transplant therapy that comes from umbilical cord blood. For that reason, we are in the process of establishing a national public umbilical cord blood bank. This urgently needed pan-Canadian program will leave a lasting legacy by helping to close the gap in access to health care for those patients waiting for a stem cell transplant.

And consider the organ and tissue donation and transplantation strategy laid out in Call to Action, an exhaustive evaluation of the challenges and opportunities in the OTDT environment in this country. It establishes priorities for a new, integrated, cost-shared interprovincial system and presents sweeping, targeted recommendations that will deliver measurable and tangible benefits to Canadians.

Canadian Blood Services is, by virtue of its physical presence, its successful transformation and its multi-jurisdictional governance, a great example of what pan-Canadian health care delivery can be. To be clear, this is not about Canadian Blood Services seeking to deliver health care services beyond those in which we are engaged, nor is it about our model being the only one worthy of exploration. But, through sharing our model of success, we do want to participate meaningfully in this ongoing debate on pan-Canadian health care delivery.

We would be proud to share with others what this means, and how our organization's learning can be leveraged for all Canadians. We look forward to being active in this debate going forward.

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