From: The New Zealand Institute of Medical Laboratory Science
Contact: NZIMLS President, Mr. Chris Kendrick
Subject: Current restructuring of laboratory services provision by New Zealand’s DHB’s.
The Medical Laboratory service throughout New Zealand (NZ) is under siege from the District Health Boards. In the name
of cost savings, well established laboratory services are being closed down, consolidated or contracted out, in some
cases to providers with no current track record in NZ. The savings to the NZ tax-payer will only be short-term and the
real cost will be the loss of diagnostic expertise within this essential service. Approximately 70% of all patient
diagnoses require some form of laboratory testing. This rate is higher in patients with disease requiring monitoring of
expensive medications.
It’s not only the Pathologists (doctors who specialise in Laboratory Medicine) who will be affected by rationalisation
within the sector, but also the Medical Laboratory Scientists and Technicians who run the laboratories. These medical
laboratory professionals make up 90% of the staff who perform the specimen analysis, validate the results and ensure
that laboratories meet and maintain the quality standards that make this service world class. With the proposed changes
at a growing number of locations and the resultant redundancies, highly trained and experienced scientists will be lost
to New Zealand, further contributing to the knowledge drain from the country.
Three NZ universities (Otago, Massey and AUT) currently offer the Bachelor of Medical Laboratory Science (BMLSc) degree.
These institutions are already struggling to obtain practical training placements for their 4th year students and some
students are already choosing to go to Australia to complete their programmes. With further rationalisations in the
sector yet to come there is the real risk that student training will be further compromised in the years ahead.
Laboratories are not well funded for scientist training but most are committed to training out of a sense of
professional responsibility and the desire to maintain a succession of highly qualified staff. This policy has in the
past ensured a continuation of the excellent diagnostic services that exist in NZ. The profession is concerned that new
laboratory providers, who have won contracts on cost alone, will not have a similar commitment to provide for the
training of BMLSc students in the future.
By international standards, New Zealand has a very cost effective medical laboratory service. The current round of
laboratory rationalisations fails to address the real drivers of the increased costs facing laboratories. The current
strategy of community based medicine seems to expect GP’s to manage more complicated cases at the same time discouraging
any increase in their use of diagnostic tests. A more appropriate strategy would be to recognise that increased
laboratory testing has the potential to improve patient outcome that in the long term will result in a reduction in
overall health expenditure. Diagnostic laboratories have no control over the level of testing performed in their labs,
yet it is they who are the targets of the administrators. The strategy of punishing the gate keeper undermines the role
of the laboratory in the diagnosis of disease and is preventing improved patient health services. The most recent
decision by the combined Auckland DHB’s to award the contract for laboratory testing from Diagnostic Medlab to Labtests
Auckland, is another example of cost cutting in the sector. In doing so the DHB’s have threatened the high quality
community laboratory service that currently exists in the region but also the training of medical laboratory scientists.
Chris Kendrick
President
New Zealand Institute of Medical Laboratory Science
www.nzimls.org.nz
ENDS