A row is brewing between senior doctors and health chiefs in the lower North Island over a planned major reorganisation of medical testing services.
District health boards in Wellington, Hutt Valley and Wairarapa have sought proposals over a plan to integrate both hospital and commmunity medical diagnostic testing throughout the region.
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A request for proposal document outlines two possible ownership options as a partnership between a private lab and the DHBs, and a single lab provider.
DHBs say privatisation is a possible outcome, and consultations are also under way with staff and others over the wider plan.
Community medical testing in Wellington and Hutt Valley is already contracted out to a private firm, Aotea Pathology, in a deal understood to be worth approximately $30 million. But hospital medical testing is done publicly, and the DHBs say those services will continue to be provided at each of the hospitals, in Wellington, Kenepuru, Hutt Valley and Masterton.
The DHBs say the aim of the project is to better link community and hospital lab services across the region to improve patient care and reduce duplication. As well, they say changes will only be made to services if they will improve services.
But the Association of Salaried Medical Specialists, the senior doctors' union, is worried public hospital managers are poised to privatise all or part of the hospital laboratories that look after the health needs of the greater Wellington region.
Executive director Ian Powell said the DHBs were looking at two options - both of them poor and both involving privatisation.
Mr Powell said both options have the potential to further destabilise the laboratory workforce, which is already vulnerable, as well as fragmenting services and having implications for clinical decision-making and patient safety.
"The DHBs are hoping for efficiencies and savings, but we think the risks of going down the privatisation track will outweigh any benefits that might accrue.
"All of the analysis carried out so far indicates quite clearly that the hospital laboratory service is not broken. It just needs some fine-tuning, which is what the DHBs should be focusing on."
No difference to users, say DHBs
The chief executive of the Hutt Valley and Wairarapa DHBs, Graham Dyer, said there would be no visible difference to users of the service from the planned changes.
"For the DHBs we would hope to have the same or improved quality and ideally at a lower cost than we do at the moment," he said.
He said changes in the lab-testing industry over recent decades meant savings could be made, which had to be considered. He could not say at this stage what amount of money the DHBs would like to save.
Major changes to community medical testing in 2009, not involving hospital labs, are hanging over the process. Three Auckland DHBs switched the $560 million community lab-testing contract to a new provider, Lab Tests, but estimated savings were reduced from months of extra support needed by the DHBs as the new firm made the transition.
Medical Association chairman Mark Peterson said that level of disruption to doctors and patients cannot occur again. He said he is not worried about the privatisation possibility, but close engagement and cooperation is needed with clinicians.