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The move to open community laboratory testing for tender is contributing to a crisis in pathology services, says the professional body for pathologists.
New figures from the Royal College of Pathologists of Australasia showed the number of pathologists - laboratory doctors who diagnose 70 per cent of all diseases - had dropped by 7 per cent over the past five years, while the population had increased by 5 per cent.
And the shake-up of laboratory testing in New Zealand is not making the environment any easier for retention.
Chief executive Dr Debra Graves said tendering could pit pathologist against pathologist, while the fixed term contracts of tender winners create uncertainty over their staff's long-term employment prospects.
Short-term tender contracts can also remove the incentive for companies to invest in new equipment and testing regimes.
Dr Graves said the number of New Zealand-trained pathologists leaving the country had increased over the past few years, although the reasons for their departure were unclear.
Although they could earn more money overseas, Dr Graves said this was not the primary motivator for their departure.
The college's latest workforce analysis found that over the past five years, the number of pathologists in New Zealand had remained unchanged at 210.
But the number of full-time equivalents (FTEs) had dropped from 159 in 2003 to 148.
Thirty per cent indicated that they would retire in five to 10 years.
New Zealand has one pathologist for every 20,000 people, compared with one in 16,000 in Australia, where there is an acknowledged severe workforce shortage.
In the United Kingdom, the population ratio is one in 12,000.
Dr Graves said that in order to get to Australian levels, New Zealand would need another 58 pathologists. Based on the current rates of retirements, incoming and outgoing graduates, there was an annual net gain of about four FTEs a year.
She met the Director General of Health Stephen McKernan and Health Minister Pete Hodgson this week to discuss the future of pathology.
"It's the first time we've actually had a positive reception I think for some time."
Dr Graves said they took note of the college's position on a national approach to training pathologists.
And the shortage was only going to get worse unless there was work done now.
"The complexity of work's gone up dramatically," Dr Graves said.
"Ten years ago for example, to diagnose a breast cancer, an anatomical pathologist would've looked at maybe two slides under the microscope.
"Now that can be anything up to 50 or 70, and that's driven by the clinicians wanting that sort of information to actually get better individual diagnosis for patients."
