Doctors think scope of medical lab review too narrow

The review panel does not include a pathologist or medical practitioner. Photo / Richard Robinson

Doctors have welcomed plans to review the mangled switch to a new community laboratory company in Auckland, but fear the probe will not go deep enough.

Health Minister Tony Ryall has appointed two business experts to review the transition when newcomer Labtests took on the public contract from Diagnostic Medlab.

The transition was marred by problems at Labtests like excessive waiting times for patients and slow turn-around times for some results.

After the Health and Disability Commissioner at the time, Ron Paterson, voiced his concerns for patient safety, Auckland's three district health boards, which pay for community laboratory services, appointed their own safety and quality team to sort out Labtests' problems.

In October, the DHBs took 10 per cent of Labtests' work off the company - including testing for private specialists - and awarded it back to Diagnostic Medlab for four years. It left GP-referred testing with Labtests.

The review will be conducted by Graeme Milne, a business consultant and the chairman of several companies and the Waikato District Health Board; and Associate Professor Jens Mueller, a governance expert at the Waikato University Management School.

The review panel does not include a pathologist or medical practitioner.

Mr Ryall has specifically instructed that the review look only at the transition and not at the DHBs' choice of provider, which has been studied in detail by the courts.

The Medical Association, while welcoming the review, thinks the Government should examine wider issues from the fiasco because of their importance to the health sector.

"These include the problems of sole-provider contracts, and undue emphasis on cost versus quality," said the association's chairman, Dr Peter Foley.

"I don't think you can consider the transition issues in isolation from what you are actually transitioning. The transition wouldn't have been as difficult if you ... already had two or more providers," Dr Foley said yesterday.

He acknowledged the Auckland laboratory service had improved since the rehiring of Diagnostic Medlab, but it remained a "two-tier service" because the two companies were restricted to patients from different kinds of health practitioners. This was unsatisfactory.

He would "reserve judgment" on the absence of medical practitioners from the review panel.

Mr Ryall said the review panel would inevitably talk to many pathologists, but the review was about risk-management issues.

How we got here

* August-September 2009: Labtests took over community laboratory testing in Auckland from Diagnostic Medlab. Labtests had significant start-up difficulties - patient delays, slow turn-around times for tests, mix-ups of test results.

* September-December: District health boards sent in a safety and quality team.

* October: DHBs returned 10 per cent of the work to Diagnostic Medlab.

* May 2010: Labtests achieved full accreditation. DHBs now happy with its performance.