Company admits 'issues' but defends quality of service

When Labtests won the contract to do community pathology testing for Aucklanders, it promised "to deliver high quality laboratory services".

The region's three district health boards, which awarded the contract, promised that "the quality and timeliness of services will not be compromised".

In the countdown to the takeover last month, the new company said: "Labtests is legally bound by our contract with the [health boards] to ensure the service we provide meets all the same quality specifications as the previous service provided by Diagnostic Medlab."

The Weekend Herald asked Labtests chief executive Ulf Lindskog and his senior managers why it appeared the company was not hitting those high targets.

Lindskog - What we have here is a contract with the DHBs which is unique. It has performance measures, you actually have key performance indicator targets, etc. That information is not readily available from the ex-provider.

In terms of any set-up of this magnitude and in the nature of the pathology business, there were undoubtedly going to be some matters we need to resolve, there are going to be some issues, some complaints.

Yes we have had some issues, everyone is aware of that and those issues have been publicly announced ... and we are working through them very carefully.

Q: Why are we seeing continuing reports of long patient waits at collection centres, delays in some tests results coming back to GPs and results sometimes not coming back at all?

Lindskog - It's important to look at what is facts and what is not, what are the real issues and what is hearsay.

We are monitoring our collection centre network on an hourly basis. We note down on the request form the time when the patient arrives and when pathology is completed.

Yes, in the first two weeks there were some waiting times in Counties Manukau.

We did not see those waiting times in Auckland. We did not see those waiting times come through in Waitemata.

(He says average waits were 25-30 minutes in Counties Manukau last week, and the maximum was 45 minutes; 20-25 minutes on average in Auckland City; and around 25 on average in Waitemata this week, with a maximum at the Henderson centre on Monday of 45-50 minutes.)

Q: Are the complaints all related to "teething problems or are their deeper issues?

Lindskog - Over the three years since the contract was signed, there have been a number of practitioners who have been opposed to the change.

We have the contract, the contract is for eight years, people just need to get on board.

Medical director Dr Richard Lloydd - In almost every case [of complaints] there is no laboratory issue - a very few and where that has occurred we have considered the problem and changed our policy to meet that requirement.

Q: Have any lapses led to any patients coming to harm?

Lloydd - No adverse clinical outcome of any patient has been reported to me.

Q: Describe the case where there was a laboratory problem.

Lloydd - A lot of it has been incorrect doctor codes for example, or else a fax to a different number that's loaded in our system, but really I'm pretty happy with our performance.

Q: What is an incorrect doctor code?

Lloydd - There are a number where the doctor code [assigned to the doctor by Labtests] might be absent or it might be a DML code.

Q: Whose fault is it that a wrong fax numbers are used?

Lindskog - In many cases, information has not been given to us correctly and we just have to deal with that. In some cases we have made some errors ourselves.

Q: There are reports of phlebotomists (staff who take blood) having trouble getting the needle in.

Have you hired too few experienced phlebotomists?

Lindskog - No. We've had ... for the last three years an enormous amount of scaremongering going on out in the community.

Our phlebotomists are dealing with the coalface of that in terms of receiving very anxious patients

It is unacceptable for our frontline staff that are serving the community to become something of a battleground between two corporates.

Q: What proportion of your phlebotomists are trainees?

Project manager of operations Malcolm Stringer - 20 per cent. A lot are ex-doctors.

Lindskog - Many have experience from overseas as phlebotomists, but are classified as trainees in New Zealand.

Q: How many full-time equivalent staff do you employ?

Stringer - The plan was 520. We are probably 20 over that.

Q: DML had around 600 working on the community contract.

Lindskog - You have seen the processes, the automation. I don't think a like-for-like comparison is very relevant.

Q: You think you can provide a similar or better service with fewer staff, even though DML was also paying some GP clinics to take blood?

Lindskog - I cannot comment on the comparison between DML and ourselves.

Q: Should the transition have been designed with Labtests and DML both holding a contract for, say, six months?

Lindskog - No. From a provider point of view the transition we've had in place has worked well and has allowed a greater ramp-up of service ... This was our proposal in terms of how the transition will happen.

Q: Does Labtests need to apologise to the people of Auckland?

Lindskog - For what. I don't understand the question.

Stringer - There have been some teething issues. We all expected that. For those minor service disruptions, certainly we are apologetic. Apologise for saving them $15 million a year? Certainly there's no apology for that, that's a fact. Apologise for a service not meeting spec? Absolutely not, I don't think an apology is due.

Q: Is this an experiment that has failed?

Lindskog - Absolutely not ... I think we are delivering a good service in line with our expectations.