Kiwiblog

This is a stunning revelation. The Herald reports:

Counties Manukau DHB chairman Professor Gregor Coster apologised to the meeting over what he said was Labtests’ continuing underperformance although he added that the service had improved.

“They led us to believe they had a quality and safety system in place from the outset.

“It proved not to be the case. Frankly they lied to us.”

That is very strong language. In fact you wonder how there can be a successful partnership when the DHB thinks it has been lied to.

Labtests, which was not invited to the meeting, said later: “Labtests steadfastly refutes Mr Coster’s allegations. At all times the DHBs had full and detailed oversight of Labtests’ operations.”

That doesn’t rule out that claims may have been made which were not true.

Doctors recounted problems including near-misses for their patients, alleged misdiagnosis, slow turn-around times for results, unusual results, a flood of unwanted faxes, difficulty getting to speak to a pathologist, and a pathologist not seeming to understand his role of advising a GP.

Reflecting the mood of the meeting, Dr Tony Hay, of the Mt Eden Medical Centre, called for the health boards to go further than the 10 per cent of the contract they had returned to the previous provider, Diagnostic Medlab.

“I would have thought there were grounds to scrub the contract and go back to where we were.”

Auckland’s largest GP group, ProCare Health, said in a letter to the health boards that Labtests was continuing to fall well short of its promise it would match the DML service.

ProCare wants an urgent, independent review.

An independent review may not be a bad idea.

Diagnostic Medlab has effectively forced the Auckland DHBs into an embarrassing u-turn, and have been granted 10% of the medical testing market under a four year contract.

The big loser isn’t so much Labtests, but the DHBs themselves. The decision to move to Labtests was not necessarily wrong, but the transition plan in hindsight was woeful. The transition should have been done over six months or so, allowing a couple of suburbs to transition every fortnight, and make sure everything is working, before the next suburb moves over.

Diagnostic Medlab got much criticism for their campaign against Labtest, as the work of bad losers. But the campaign worked, and they just gained a $10.2 m/year contract.

Labtests loses $6.2 million a year for its reduced workload, and the DHBs (ie taxpayers) make up the extra $4.4m a year. This means the change overall does still save money, but a lot less than before.

NZMA say:

Today’s announcement has been welcomed by the New Zealand Medical Association.

“The decision by the Auckland District Health Boards goes some way towards reducing the inherent risk in the current arrangement of having a single provider and is therefore a step in the right direction,” said NZMA GP Council Chair Dr Mark Peterson.

And this raises the very valid issue of should they have gone with a single provider at all. Having both providers in the market will allow some comparisons of service, price and quality, and over time the one that performs better should end up with a greater market share.

Up until now I have not commented on the transition issues going from DML to Labtests in Auckland, as I always expected some transition issues.

However the concerns of the Health & Disability Commissioner indicate that the situation is getting quite serious, and there may be real issues of accountability for the DHBs to answer.

I don’t mean in the decision per se, but the transition. In hindsight it appears that they moved too quickly in moving the entire city over. I know it was a staged transition, but they seemed to have moved onto the next stages without measuring how well Labtests were coping with the areas already handed over to them.

Mr Paterson’s comments come on top of a Weekend Herald survey of GPs this week that found widespread worries about Labtests.

Sixty per cent of the 150 respondents rated its service “bad” or “very bad”, in contrast to the 85 per cent who said the service from Diagnostic Medlab before it lost the taxpayer-financed contract was “very good”.

Even in a transition, that is a pretty appalling rating.

Mr Paterson said the concerns raised by senior doctors at Auckland City Hospital were particularly serious. “They include haematology hard-copy results not being received, faxed results being misdirected, a renal patient facing a one-month delay in going on the transplant list because blood results were not available, and an HIV test result being misdirected. …

Mr Paterson rejects Labtests’ repeated assertion that the matters raised by GPs and patients are “teething problems”.

I wonder what incentives or penalties the contract with the DHB has, relating to complaints and satisfaction.