Sunday, April 08, 2012

While my guitar gently weeps (Musings on CBS's ongoing behavior)

Updated: 23 Oct. 2016 (Fixed broken links) 

Wow! After writing a blog about claims of CBS arrogance in closing its blood component production and distribution centre in Saint John, NB
Canada's national blood supplier seems to have 'done it again' with its decision to close a plasma collection centre in Thunder Bay, ON.

By done it again, I mean badly communicated a business decision and alienated an entire community.

Non-Canadians may find the details interesting as it deals with how national blood suppliers manage change and treat staff, volunteers, and donors.

The blog's title is from a 1968 Beatles ditty by George Harrison, While my guitar gently weeps

While it's too early to determine what actually happened in Thunder Bay, here are the facts as documented on the CBS website and as yet unsubstantiated allegations reported in the media:

FACT: CBS announces closure of Thunder Bay Plasma Centre effective April 12, 2012. (29 Mar. 2012). 
 "All Canadian Blood Services employees in Thunder Bay - 28 full-time and part-time employees combined, and two contract physicians - will be affected and were informed earlier this afternoon."
The above was removed from CBS website. See instead Open Letter to Thunder Bay Donors, Volunteers, and Community Partners (29 Mar. 2012)
MUSINGS
Sounds like they gave staff 2 weeks notice. Sound fair? On this point, a letter to the editor from a plasma donor notes:
I'm very disappointed with the way this closure was mishandled. Announcing the closure just weeks before it was to occur is wrong and irresponsible. Canadian Blood Services must have made these decisions many months ago and chose to spring it on everyone.
Their reason for not informing anyone earlier? Coun. Larry Hebert said CBS officials told him "it would be better for staff."
Not telling staff about impending bad news rings bells with me because this was the paternalistic modus operandi of the powers that be (health region physicians and administrators) when ~ 40% of Edmonton's laboratory technologists lost their jobs in the early to mid 1990s.

Of course, the main reason for keeping staff in the dark is typically so they do not make trouble (become a nuisance) for decision makers and loyally keep slaving away until they are jettisoned.

2. ACCUSATION: CBS is accused of deceit in citing reduced demand without mentioning buying plasma from USA

In a notice on its website about the closure of the plasma centre, CBS states:
Over the past two years, new replacement products and a decline in hospital demand have led to a decrease in the need for plasma for transfusion. Based on current projections, Canadian Blood Services must plan for a reduction of approximately 10,000 units to our plasma collection program this year.
Others claim this was deceitful, i.e., a convenient lie, and that CBS chose to save $ by buying plasma from the USA, a practice documented in a 2011 report

Source: CBS Financial Report March 2012 (p32)
Demand: Plasma is shipped for transfusion or fractionation and is collected through the apheresis program or recovered from whole blood collections. In 2010/11 total litres shipped for transfusion fell 11.2% as demand shifts to synthetic products within the plasma protein products business line. 
In 2010/11 Canadian Blood Services started a pilot program to purchase surplus recovered plasma from the United States (collected by organizations with an FDA licence) which will continue in 2011/2012.
MUSINGS
So, what's the scoop? CBS needs less plasma OR CBS needs less Canadian plasma because operating a Canadian plasma centre is more expensive than buying surplus plasma from the USA? If true, why not just say so?

Is the need for plasma derivatives on the wane? Provinces spend much effort and money on controlling utilization costs for IVIG, etc., e.g., BC PBCO and Transfusion Ontario. And it's an on-going challenge.

Regardless, if we need less plasma, why are we outsourcing  plasma collection to the USA? If it's all about cost, soon CBS may outsource much more to our friends to the south.

And what ever happened to Canadian plasma self-sufficiency? Has it been abandoned because it's too expensive?
This year, we also re-introduced the collection of source plasma at our existing plasmapheresis sites across the country, laying the foundation for Canadian Blood Services to improve our plasma sufficiency - one of the basic principles of the blood supply as outlined in Justice Krever's report.
Take home message

I literally grew up at Canadian Red Cross BTS and later worked in several capacities for its successor, CBS.  Like all health professionals, I wanted to be proud of my employer as its behavior reflected on me.

Has CBS behaved arrogantly or deceitfully in its recent business decisions? That's for time to tell and you to assess.  Here's how I feel about CBS today:
Some lyrics unused in the final version that caught my fancy:
I look at the trouble and see that it's raging,
While my guitar gently weeps.
As I'm sitting here, doing nothing but ageing,
Still, my guitar gently weeps.
Another unused line:
The problems you sow, are the troubles you're reaping,
Still, my guitar gently weeps.
For Fun
More thoughts on CBS:
FURTHER READING