Privatisation of hospital laboratories
The Association of Salaried Medical Specialists (ASMS) is so concerned by plans to privatise the public hospital laboratories at Wellington and Hutt Hospitals in the greater Wellington region that it is taking steps to alert local mayors, district health board chairs and chief executives to the possible consequences.
“We want to make sure that the people making decisions about the future of the public hospital laboratories are fully informed about the risks of what they are doing,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).
“If they do end up privatising the public hospital laboratories, it will pose a significant threat to the quality and safety of patient care in the region and the ability of senior doctors and dentists to make timely clinical decisions. Laboratories are at the heart of New Zealand’s public hospital system and their importance cannot be over-stated. More than 70% of all clinical diagnoses involve pathology tests, and pathology also plays an important role in infection control and monitoring disease.”
Capital & Coast, Hutt Valley and Wairarapa District Health Boards (DHBs) want to merge hospital and community laboratories to improve efficiency and save money. They are considering two options involving either a partnership with a private company or a handing over of the region’s laboratory service to a single private laboratory provider, and they are due to make a decision next month.
Mr Powell says a big concern for senior doctors and dentists is the risk of privatised laboratory services not functioning as well as they have been, thereby affecting their clinical decision-making and treatment.
Specialists have advised the ASMS of their serious worry that if that happens, possible consequences might include delays in cancer diagnosis, compromises in infection control, risks to safety in blood transfusions, bed blockages in wards and emergency departments, hold ups in diagnosis and treatment for people who have had heart attacks or kidney failure, and variation in the quality of laboratory results and reporting.
However, the ASMS believes there are ways to enhance the region’s laboratory service without going down the risky path of privatisation, and it wants to work with the three DHBs to explore these further.
It is seeking assurances from the DHBs that the hospital laboratories will continue to be publicly provided and the people working in them employed by the DHBs. It is also asking the DHBs to review their process and work with the ASMS to develop a process that is clinically-led, which can then be used to strengthen the connections between the hospital laboratories and with the community testing provider. This could include the development of a shared data repository, identified previously as something the region’s laboratory service would benefit from.
“In essence, we don’t want the DHBs to rush into a decision that they’ll later regret,” says Mr Powell. “We think they don’t have all the information they need at their fingertips, and they need a bit more time to gather data and feedback, to hear from the people working in the laboratories and who rely every day on the diagnostic services they provide.”
He says the DHBs seem to be under several misapprehensions:
- They want to improve efficiency and save money but there’s no guarantee privatisation of the laboratory service will achieve that.
- They appear to think the laboratory service is ‘broken’ but their own documents show it is working well and would just benefit from some fine-tuning.
- They also seem to think senior doctors and dentists have been adequately consulted as part of the process leading up to their decision, but that’s far from the truth.
“Privatising the laboratories on the type of assumptions and faulty thinking we’re seeing would be like taking your car to the wrecker because it has a broken headlight,” says Mr Powell. “We know the DHB Boards want what is best for their communities and we’re urging them to take a bit more time to get this right. If this privatisation proceeds, it will the biggest privatisation in public hospitals in the 25-years history of ASMS.”
The ASMS has sent its document on laboratories to the Mayors of Wellington, Porirua, Hutt City, Upper Hutt and Wairarapa, in addition to the chief executives of the three DHBs and the chairs of the three Boards, and ASMS members. These documents and related correspondence are available here.