Independent Covid PCR Testing Capacity Report Highlights Laboratory Profession Woes

Terry Taylor, New Zealand Institute of Medical Laboratory Science (NZIMLS) president.

The NZIMLS totally acknowledges the inherent issues that led to the overestimation of the Covid PCR diagnostic capacity in our laboratories. The background issues that have plagued the provision of all diagnostic laboratory services since the first initial DHB contracts in 2006 have fully emerged into the public domain during the past 12 months of the pandemic. For the dedicated and hardworking but always understrength frontline of dedicated medical laboratory scientists and technicians the testing capacity situation in February was always going to happen. This group of consistently under resourced and respected health professions bore the brunt of being caught in between political expectation and real time system failures.

Our diagnostic laboratory structure and governance currently operates with no overarching national authority or direction. The individual providers decide how and where samples are tested and how laboratory priorities are assessed and actioned with operational functions including staffing based on business model strategies. As the media have consistently found during the pandemic, getting past the closed doors of our diagnostic laboratories to understand the difficult situation that frontline staff face has been a difficult assignment. Ironically, full transparency around service provision and fiscal performance involving diagnostic laboratory providers both public and private has never been one of the system strengths.

From early in the pandemic the NZIMLS lobbied for an expert independent diagnostic laboratory specialist with the authority to direct and override existing financial and service barriers between the competing laboratory providers. This would have effectively provided the knowledge and clout to create the bones of a truly national operational and governance approach to our pandemic testing response. The total reluctance to acknowledge that expert specialist medical scientists do understand more about national laboratory testing than politicians, health officials, medical doctors, mathematical modelers, and epidemiologists was obviously too bitter a pill to swallow.

It is imperative that the learnings from the pandemic testing response are used to formulate the future diagnostic laboratory system within Health NZ governance. The health professionals who have worked tirelessly and under very difficult working conditions deserve to be part of a future structure that best utilises their skills and aspirations. Having our current fragmented and business driven models has led to practitioners voting with their feet by leaving this undervalued frontline workforce. To have lost 5% of the medical laboratory workforce on top of the single busiest and stressful period for diagnostic laboratories sends the clear signal that things need to change quickly to stop the slide becoming an avalanche. This is unfortunately not a one off but a cumulative effect that is the result of nearly 20 years of poorly negotiated DHB diagnostic laboratory contracts that have directly led to the fragmented system and workplace conditions we currently have.

‘Our workforce on the ground need the reassurance that their expertise and ability will not continue to be taken for granted by all levels of health governance’, says Terry Taylor, the NZIMLS president.

‘It would be an expectation at the very least that having an expert specialist medical laboratory expert in a senior governance role is imperative to providing the balance and operational clout for any future diagnostic testing service decisions. For too long our expert opinions have been swept under the carpet and have directly led to the perilous situation our profession is now in’, says Taylor.

‘I am optimistic that having strong medical laboratory scientist leadership within the national public health agency will assist in forging the pathways between research and diagnostic laboratories. This will strengthen any future national health responses plus add speed for incorporation of new diagnostic methodology and pathways’, says Taylor.

The strong relationships and operational networks that a fully integrated diagnostic laboratory service will provide is essential to the successful functioning of all health services within Health NZ. The Covid pandemic has reinforced just how critical and vulnerable this expert workforce is and any future health decisions need to reflect the ramifications for the entire health system of the current situation. Our best and brightest scientists deserve to work in an environment that best harnesses their talent and expertise not one that works them into the ground and forces them to rethink their career choice due to poor strategic governance decisions made without professional consultation.

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