April 4, 2018


Fit for Purpose: Findings and Recommendations of the External Review of the Pan-Canadian Health Organizations – Summary Report

Response from the Canadian College of Health Leaders

Bringing together over 3,000 Canadian health leaders from every discipline, region, career stage and sector, the Canadian College of Health Leaders (the College) creates extraordinary opportunities for members to connect, learn and inspire their leadership. Working within the College, LEADS Canada partners with organizations to develop high impact leadership programs customized to context and based in the LEADS in a Caring Environment framework (LEADS). LEADS presents a common understanding of what good leadership looks like, across all levels of service provision in healthcare.

Commendations for Fit for Purpose

Fit for Purpose (“the Report”) reviewed eight Pan-Canadian Health Organizations (PCHOs) making recommendations on the future state of federally funded health organizations. The overarching vision of bringing Canadian healthcare into the 21st century was associated with a slate of recommendations. These recommendations essentially suggested a transformation of the status quo—and included the phasing out of three of the organizations. Read a summary of the Report written by André Picard for the Globe and Mail.

The College commends Federal Health Minister Ginette Petitpas Taylor for demonstrating leadership by commissioning the external review of the PCHOs.

Further, the College congratulates the authors, Drs Danielle Martin and Pierre-Gerlier Forest for their thorough review, reflection and timely recommendations contained in the review. Their leadership in the evolution of the Canadian health system is evident within the report and respectively within each of their careers.

The College also applauds, in particular, the three PCHOs who were identified as achieving their purpose; the Canadian Centre for Substance Use and Addiction, the Canadian Partnership Against Cancer and the Mental Health Commission of Canada. Achieving change within the complexities of the Canadian health system require strong and consistent leadership and is worthy of acknowledgement.

A call for adaptive and distributed leadership

The Report identifies key challenges, gaps and vulnerabilities impacting the Canadian health system. The recommendations contained within the document are designed as high impact solutions. Despite the high quality content and well-thought out resolutions, missing in the Report is a call for adaptive and distributed leadership.

Distributed leadership

Distributed leadership is leadership regardless of title. It equates with shared, collective and extended leadership that builds capacity for change and improvement. It can be considered the ‘flattening of the hierarchy’ in which everyone plays a role in system transformation. Distributed leadership is like Geese flying south—the V formation and constant switching up of ‘who is in front’ allows for equal participation and sharing of the workload.

Fit for Purpose calls for greater collaboration and integration amongst provincial and territorial health authorities as well as local health systems. Distributed leadership is paramount to the achievement of the recommendations of the Report.

Adaptive leadership

Adaptive leadership enables organizations to transform and evolve to maintain relevancy and impact. Western Union, for example, who began delivering handwritten notes on horseback in 1851, is a model of organizational transformation. By the 1970s it owned the first commercial satellites in North America and is now a focused financial services organization. Adaptive leadership allows organizations to not just survive—but thrive as their environments change.

The report suggests that: "Canada's health systems need to move rapidly into the 21st century, welcoming technical and clinical advances, and adapting to economic, demographic, and culture shifts, behavioural and social change." In essence Fit for Purpose calls for system transformation to ensure its long-term relevance and sustainable development. As such, deliberate and focused attention must be paid to adaptive leadership to supply leaders the skills to navigate through uncertain and often turbulent times.

Deliberate attention to growing capacity for leadership

The recommendations contained within the Report represent an opportunity for a common leadership language—such as the one supported by LEADS—to contribute to moving Canada’s health system rapidly into the 21st century. Deliberate attention must be paid to growing leadership capacity as the implementation plan is formed.

The College believes in the power of effective leadership

The College believes in the power of effective leadership to influence change in the Canadian healthcare system. While collaborative and integrated actions are important—it is leadership that has the power to bind disparate activities and nurture solutions for success. As Canadian healthcare organizations rally around aspirations to be global leaders, it is imperative that leadership—skills and tools—be incorporated.


Brenda Lammi, MSc, BHSc (OT), BPHE, BA (Hlth)
LEADS Canada
613-235-7218 / 1-800-363-9056

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