Laboratory Specialists Oppose Wellington Privatisation

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THURSDAY 29 JANUARY 2015

Laboratory Specialists Oppose Privatisation of Wellington Region Hospital Laboratories

“Pathologists and infection control specialists working in the Wellington region’s public hospital laboratories are expressing strong concern about possible privatisation of the laboratory service and the clinical risks that will arise if privatisation goes ahead,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

Hospital laboratories affect around 70% of clinical decision-making in Wellington and Hutt Hospitals.

The Capital & Coast and Hutt Valley DHBs are poised to make further decisions on the future management of the Wellington and Hutt Valley hospital laboratories by the end of this week, with all indications being that they will plump for pre-determined privatisation. If they do decide to do that, it will not be the end of the matter as the approval of the Minister of Health will still be required.

Mr Powell says the DHB boards seem to be under the impression that senior doctors and other clinicians working in the laboratories support the privatisation pathway the DHBs are heading down – but that’s not correct.

“It is abundantly clear from a telephone survey conducted by the ASMS that there is grave concern about the process used by the DHBs to determine the fate of the laboratories, as well as the potential effects for patients and clinical staff if the DHBs forge ahead willy-nilly with their privatisation plans,” he says.

The ASMS surveyed 15 ASMS members who are pathologists or infection control specialists working in the Capital & Coast and Hutt Valley DHB laboratories and who are expected to face a change of employer if the laboratories are privatised.

Key findings from that survey include:

• All 15 reported that specialists did not lead the process of deciding what was needed for the region’s laboratories. One person commented: “If SMOs (Senior Medical Officers) had led the project, privatisation would not have been a result, but other major gains could have been made”.

• Just 9 of the 15 specialists had had any formal involvement in the contract specifications for the laboratory service, although 8 out of those 9 were highly critical of the process. They described it as “non-specific”, “unclear”, “insufficient consultation”, “too little, too late”, and said they had not been involved from the outset “where it mattered”.

• All 15 said the contract specifications process had not been robust.

• All 15 believed or feared clinical risks would increase or be created if the DHBs went down this path. Risks included loss of breadth of diagnostic testing with the public then having to pick up the costs of excluded tests, loss of training capacity, a focus on profit rather than quality, loss of control by DHBs, financial and governance issues, adverse effects on infection control which would result in more hospital infections and longer patient stays, and job losses.

• Most thought there would either be a risk to collegiality among clinical staff or they weren’t sure, and just 4 felt sure there would not be a risk to collegiality. The risks were seen as particularly strong for specialists at Hutt Valley DHB, and several people commented that private laboratories do not understand how tertiary laboratories work.

• 13 of the 15 specialists said they opposed privatisation of the laboratories, with the remaining two unsure. However, all 15 said they opposed privatisation if it meant the loss of DHB employment or downsizing of the Hutt Hospital laboratory (which Hutt pathologists believe is likely).

• 7 of the 15 signalled they would be looking to leave the Wellington region laboratory workforce if their current right to receive subsequently negotiated improvements employment conditions was not protected under new privatised arrangements (which is unlikely) – they would actively look at options such as retirement or jobs elsewhere. One person planned to retire anyway, and the remaining 7 specialists said they would work for the new company because they had no choice.

“The comments made in the course of this survey were also very revealing,” says Mr Powell.

These included observations that the process could have been carried out in a better way, with a better result if SMOs had led the process or been consulted properly, that pathologists were not in favour, and questions about the ability of a private laboratory to fit the current ethos of a tertiary hospital.

“We’re strongly urging the DHB boards to reject privatisation when they meet to make further decisions about the laboratories. They need to listen to the hospital specialists they employ – and they’re saying in the strongest possible words that this is not going to work, they haven’t been properly involved, and there will be serious risks to services and patients.”

“If the DHB boards vote to privatise their hospital laboratories they will be going against the express advice of their own experts,” says Mr Powell.

ENDS

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