Sociology -- Human Services Governance and Leadership

Steven Ott (2001, p.1) defines governance as an "umbrella term that includes the ultimate authority, accountability, and responsibility for an organization." However, literature and several case studies have identified that leaders play a significant role in supporting governance (Lord et al., 2009) and there is a two-way link between leadership and governance. Leadership not only provides the direction for governance by promoting a shared understanding but also clarify the roles between the local and national actors (Craig, 2005). It also encourages interagency collaboration, team working and commitment at all levels of governance (Robinson et al., 2008).

According to ANAO (2003, p.15), "Leadership sets the 'tone at the top', and is absolutely critical to achieving an organization-wide commitment to good governance."

This paper discusses the case of "Tainted Blood Scandal" in result of which public lost trust in the Canadian Red Cross. This trust was then rebuilt by a forming a new institution with the help of governance and leadership in operation together which helped Canadian government to handle this critical situation. This case is a best example of examining and learning how the confidence of Canadian Red Cross blood system collapsed and how the situation was handled by transferring the responsibility to a new organization.

This tragic event took place in 1990 when a national icon, "Canadian Red Cross" was sued by hundreds of people who suffered from AIDS and HIV caused by the tainted blood. More than 20,000 were also infected from hepatitis C virus (HCV) which is a disease that damages the liver. The number of people who died in this incident is not exactly known yet but according to Canadian Hemophilia Society this number was in thousands.

As a result of this incident, public lost faith and trust in the government and in the system of governance, especially in its blood system. A poll was conducted in 1995 by Compas Inc., to find out the opinion of public about Red Cross. The results of the survey showed that thirty three percent of the Canadians refused a transfusion because they had doubts of taking the infected blood.

In order to investigate this issue, the Canadian government formed a Commission of Inquiry on the Blood System and appointed Horace Krever as its head. Krever worked on this issue in depth and released a report in which it was stated that the main reason behind this big disaster of "tainted blood" was the mismanagement. The report claimed that the expression 'blood supply system' is used for convenience but the truth is that no integrated system existed during the entire relevant period. The report further pointed out that the "Red Cross" which is considered as a most important organization for taking care of the safety of the blood supply is actually a "tentative and ineffective decision maker that recoiled from its responsibility to make timely decisions on matters of safety."

It also stated that leadership was not the only reason that resulted in tainted blood scandal, but lack of transparency was also a critical issue. One of the major problems Krever highlighted in this report was that the Health Protection Branch and the operator of the blood supply also do not have information about the spread of blood borne diseases and other risks that exists. The report also criticized local and national governments for showing such an irresponsible attitude and lack of leadership in them.

Krever also designed a map for the new blood system organization which focused on building transparency and include the participation of public in the new system. He highlighted in his report that leadership is an important building block that should be considered when establishing governance and should also be supported by organizational culture and communication.

Canadian Government realized the fact that their system needed leadership in order to do governance in the right direction. Therefore, it was very important for the Canadian government to rebuild the trust of people by doing governance with strong leadership and do something which brings back this trust and confidence in people about their government and its governance.

In order to bring back the trust of public, "Canadian Blood Services" was built in 1998 in replacement of Canadian Red Cross. This step was taken under the supervision of the federal, territorial, and provincial health ministers who established this non-governmental organization to serve the people. This way all the responsibilities of the blood system were transferred from "Canadian Red Cross" to "Canadian Blood Services" in order deal with the collapse of confidence in the blood system.

However, the capacity of the organization was improved and key stake holders were also involved in the decision making process. An executive team was designed who took over the management of the "Canadian Blood Services" as the main issue diagnosed with the Red Cross failure was the mismanagement. This executive team was responsible for working together with regulatory bodies, governments and other stake holders in order to solve the issues and make decisions that help to regain the trusts of public.
"Canadian Blood Services" first and most important task was to stabilize the supply of blood and rebuild the confidence and trust of the public in the security and safety of this new system. The next task of the organization was to lessen the fears of the donors so that they can donate with a trust that their efforts will not be wasted. This was also very important as without this the management can neither secure nor distribute the voluntary blood donations. In order to achieve these objectives and build the trust of public, Canadian Blood Services, did lots of hard work and tried its best to make the culture, structure and practices transparent for the people.

The chief operating officer and senior executives of the 'Canadian Blood Services' who have been with the organization since beginning say that there was always a need to make the decisions open and transparent. They were able to achieve confidence in the system not only by making the right decisions but also by making others see their right decisions. This was one of the Krever's recommendations that "the public must have access to information about the policy, management, and operations of the blood supply system and be represented in the decision making."

Therefore, the leadership of Canadian Blood Services designed organization in such a way that communication and involvement of the stakeholders was facilitated which also included donors, patients, hospitals, volunteers, partners, health care professionals, supports and the general public. All these stakeholders had the need to make sure that the blood supplied is safe for which the Canadian Blood Services takes ultimate responsibility and accountability.

Moreover, in order to institutionalize this organization, all groups of stakeholders were included in the board of directors. As per organization's charter, a group of thirteen board of directors should be completed by including a chair, four directors from Canada's geographic regions (i.e. one from each), two directors that represent the consumers and patients, and the remaining six directors from different areas of scientific, medical, technical and business expertise. This composition of the board of directors matches with the complexity of the blood system.

One interesting thing about the board of directors is that one of its members is himself the victim and is living with HIV and hepatitis C He is counted among those who badly criticized Red Cross blood system but six years back he joined Canadian Blood Services. This board is very much concerned about the transparency, therefore it makes public at least six to eight of its regular meetings, so that public is aware about the activities of the organization. This is an important step towards getting confidence and trust of the public.

According to Proust (2007), the committee system plays an important role in binding together a large and diverse organization. The board of "Canadian Blood Services" is also connected to the National Liaison Committee, which is an advisory committee and has a position of stakeholder. This Committee gives input to the board regarding the policy development issues, guides it about the threats of the safety of the blood system and also provides suggestions on the regular activities. This committee has twenty four members who are also members of many other external stakeholder groups in the different regions where the Canadian Blood services are operating. In order to keep National Liaison Committee independent, the stakeholder organizations select and nominate their members to the committee, which than serve a period of three years upon selection.

Furthermore, there are several Regional Liaison Committees which report to the National Liaison Committee. The role of these Regional Liaison Committees is to spread the Blood system network and make sure it reaches to all the communities. They also look for the threats to the blood system wherever they see it emerging.

After working for a decade of this incident, Canadian…