CANADA_

The politics of blood

Officials clash over replacing the Red Cross

D’ARCY JENISH February 3 1997
CANADA_

The politics of blood

Officials clash over replacing the Red Cross

D’ARCY JENISH February 3 1997

The politics of blood

CANADA_

Officials clash over replacing the Red Cross

D’ARCY JENISH

The objective established by the country’s health ministers was clear. Meeting in Toronto last September, they vowed to establish a new national agency within a year to operate Canada’s blood collection and distribution system. But the harmony that existed last fall has evaporated, due to a federally sponsored proposal that would allow the Ottawa-based Canadian Red Cross Society to continue running the system for another three years, under the supervision of a yet-tobe established National Blood Authority. Maclean’s has learned that the plan ignited a stormy debate during a Jan. 14 meeting in Toronto involving senior officials from Ottawa and five provinces. The rift deepened two days later, in a conference call involving nine deputy health ministers, when only Quebec and Nova Scotia sided with Ottawa. “Everybody else thinks that if you let the Red Cross run it for three years,” said a source close to the discussions, “they will run it forever.”

The uncertainty over the future role of the Red Cross flows from the tainted blood tragedy of the early to mid-1980s, in which an es^ timated 1,200 people contracted Ë AIDS and another 12,000 were infected with hepatitis C. For the past three years, Ontario Court of Appeal Judge Horace Krever has chaired an inquiry into the scandal, and he is scheduled to submit his final report to federal Health Minister David Dingwall by April 30. Krever is expected to be highly critical of some Red Cross employees, past and present; ajan. 17 Federal Court of Appeal decision gave him the right to assign blame to individuals.

Last week, new questions about the tragedy arose when federal Information Commissioner John Grace disclosed that government officials had destroyed eight years of tapes and transcripts dealing with the tainted blood affair to keep them from becoming public. The records were of meetings by the Canadian Blood Committee, an organization composed of highlevel federal and provincial officials that was formed in 1982 to supervise the blood system—including the Red Cross. Accord-

ing to Grace, the decision to destroy the records was made by Dr. Jo Hauser, then the executive director of the blood committee secretariat, shortly after a journalist requested material under the Access to Information Act in May, 1989. “Since the verbatim minutes contain sensitive information, it was agreed that they should be destroyed,” Hauser wrote in his notes at the time. (In 1991, the committee was transformed into the Canadian Blood Agency,

made up of provincial and territorial health officials.)

The country’s health ministers announced their intent to reform the system last April. Then in September, they declared that they wanted to establish yet another national agency, replacing the Canadian Blood Agency, that would be in charge of blood collection and distribution. By late December, federal and provincial officials, along with outside consultants and medical experts, had developed a comprehensive blueprint for that organization, to be called the National Blood Authority. But the role of the Red Cross has not been resolved. Many officials want the Red Cross removed from the system—or at best given a minor role as the collector of blood. “There’s no way you can affect any meaningful change without getting rid of the Red Cross,” said Dr. Robin Hutchinson, a physician in Nanaimo, B.C.,

and a past president of the Canadian Blood Agency. “The corporate culture of the Red Cross hasn’t changed one iota since the early 1980s.”

But that leaves one overriding question: will the health ministers support their officials? Critics contend that the federal government is too conciliatory towards the Red Cross—and preoccupied with the fate of a $300-million fractionation plant that a Red Cross subsidiary plans to build this year in Dingwall’s home province, Nova Scotia. The plant, which would employ 300 people, would process blood plasma into products required to treat cancer, burns and other maladies.

The possibility that the Canadian Red Cross Society would continue as the main player in the blood collection system emerged at the Jan. 14 meeting of senior federal officials and representatives from five provinces. The gathering was scheduled to last from 9 a.m. until noon but went on for most of the afternoon because, as one participant put it: “All hell broke loose over the federal proposals.” One of Dingwall’s top officials, Dr. Michael Shannon, presented a document entitled “Strategies for CRCS Negotiations,” prepared as advice for the country’s deputy health ministers, who were scheduled to meet in Vancouver for two days this week, and a mid-February health ministers’ meeting.

The document, which was made available to Maclean’s, suggested two possible approaches in negotiations with the Red Cross. Under the first, the organization would be offered the option of accepting a reduced role as the collector of blood, or negotiating the sale of its blood treatment centres and related assets to the National Blood Authority. The second approach involved negotiating “a transitional contract” with the Red Cross “for provision of all blood services, during which time the National Blood Agency can pilot and validate alternative, possibly more cost-effective ways of operating the blood system.” According to one observer, that proposal—which would leave the Red Cross in control of the blood system for another three years—was vigorously opposed by Ontario, Manitoba, Saskatchewan and British Columbia, with Ottawa and Nova Scotia supporting it.

After several hours of strenuous debate, the officials came up with a new “recommended negotiating strategy.” It incorporated the first approach suggested by Ottawa— offering the Red Cross a reduced role in the system, or the sale of all its blood-related assets to the new national agency. But Ontario, Manitoba, Saskatchewan and British Columbia insisted on a further condition: “Failure [by the Red Cross] to reply by Feb. 7,1997, or a negative response, will lead the ministers of health to direct the National Blood Agency to build a new parallel system to ultimately replace the Canadian Red Cross Society operations.” In any

event, the exercise proved futile: when the nine deputy ministers held their conference call two days later on Jan. 16, they focused on the two original approaches put forward by federal bureaucrats, as well as the hardline proposal favored by Ontario, Manitoba, Saskatchewan and British Columbia. Those talks proved inconclusive. Ottawa, Nova

'Hell broke loose over the federal proposals'

Scotia and Quebec were the only parties to favor a strong role for the Red Cross.

Meanwhile, talks have been held between former Alberta cabinet minister Louis Hyndman, acting as a federal-provincial negotiator, and the Red Cross. They have, however, been fruitless. “The negotiations to date have not produced an agreement on the role of the Red Cross, which has maintained the position that it would provide all blood system functions or it would withdraw from the blood system,” the provincial represen-

tatives concluded in a document arising out of the Jan. 14 meeting.

Red Cross officials have refused to comment on the negotiations. But some observers contend that the organization’s all-ornothing approach maximizes the pressure on the country’s health ministers, and increases the Red Cross’s chances of maintaining control of the system. “They’re very good at pushing politicians to the wall,” said Hutchinson, who has had many dealings with the organization. “They’re trying to make it so awkward, unpleasant and politically treacherous to reduce their role that they’ll be the only game in town.”

The outcome, for government officials and the Red Cross, should become clearer within the next few weeks. The deputy health ministers were expected to try to resolve the conflicts during this week’s Vancouver meeting. And the ministers are expected to make a final decision on the role of the Red Cross at their mid-February meeting. In the meantime, Krever and his staff of 12 lawyers and medical experts are sifting through 50,000 pages of oral testimony and 175,000 documents, which run to over 800,000 pages, to produce the inquiry’s final report. But whatever the politicians decide, and the judge concludes, it will not undo the damage caused by Canada’s tainted blood tragedy. □