KEY POINTS:
Aucklanders treated by private specialists face having to pay for their own community laboratory tests - $5.6 million a year in total.
Four health boards in Wellington and the South Island have already closed the public purse to tests ordered by private specialists, forcing individuals or their insurers to pay.
Auckland's three district health boards have only watched these developments.
But the idea has resurfaced in plans for a huge consultation exercise - considered by Auckland DHB as at risk of being seen as an "expensive public relations exercise" - after last year's High Court decision which shook the boards' contracting for lab services.
Auckland board papers say: "Eight per cent of tests were through private specialists and it was proposed that they no longer be funded by public funds."
Medical Association chairman Dr Peter Foley, whose organisation opposes the move, said yesterday it was ridiculous that the Government allowed individual boards to act differently on this issue, rather than establishing a national policy.
"All this is, is transferring costs to patients. Patients go to specialists sometimes out of necessity because DHBs don't offer some services. It's no longer the realm of the rich."
All kinds of care were involved, including heart treatment, kidney disease and chemotherapy monitoring.
The largest area was tissue samples, such as diagnosis of suspected melanoma.
The tests mainly cost $10 to $500, although some are up to $2000.
Opponents of privatising the costs say it will push up insurance premiums and lengthen public waiting lists for surgery.
The Auckland boards' laboratory project manager, Tim Wood, said this proposal was included so that "if boards need to make a decision on that, they have the information", rather than having to consult specially.
The court ruling primarily overturned the Auckland DHBs' $70 million-a-year contract with new provider Labtests Auckland.
They subsequently negotiated a $72 million-a-year interim contract with the incumbent, Diagnostic Medlab.
The ruling also faulted their failure to consult primary health organisations.
To comply, the Northern DHBs Support Agency, owned by the three boards, has proposed a $175,000 public consultation exercise, but disagreement has broken out over the plan's size.
Expected to start in about a month, it would include delivering a pamphlet to all metropolitan Auckland households, patient focus groups, discussion forums for the public, general practitioners, primary health organisations, Maori, Pacific people, Chinese, Koreans, Indians and other ethnic groups; an on-line survey; and the opportunity to make submissions in various ways, including over the phone.
Counties and Waitemata DHBs have agreed in principle, but Auckland DHB has rejected the plan as "too comprehensive" and "over-designed".
It says the public may not understand that deciding on community laboratory services is a complex process.
It believes using a polling agency might get a better response than general public consultation.
