I See Dead People
On being asked his occupation, a pathologist friend of mine dryly answered, “I see dead people”. That’s the kind of humour you expect from doctors who think that naming disgusting, oozy pathology after their favorite meal is amusing.
I would like to assume that same quirky humour was behind the remarks of Dr. Debra Graves, the CEO of the Royal College of Pathologists of Australasia, but I suspect she is serious. Commenting on the tender process between DML and Labtest…
“Dr Graves said it appeared that tendering had contributed to the (shortage of pathologists) by destabilising the industry.”
Apparently, she is basing this astounding observation on the fact that Labtests will be employing 17 instead of the 24 pathologists employed by DML. It seems to have escaped her attention that this indicates a surplus of pathologists (in the private sector, at any rate) rather than a deficit.
While there may indeed be a shortage of pathologists in the public sector, the current change to Labtests represents a perfect opportunity to recruit them. Of course, the poor remuneration packages normally offered will make this difficult and we may well lose these pathologists overseas. This is not the fault of the tendering system, but of the lowest payscale for doctors in public service in the first world. The fact that 58 of our 268 New-Zealand-trained pathologists are working overseas just emphasises the point (I understand this is a lower percentage than average for other specialist disciplines).
Dr. Graves then goes on to say that diagnostic services should not be “treated like a laundry service”. May I ask why not? As long as the tendering system ensures that labs meet a certain standard, then labs should be treated exactly like a laundry service. There is nothing sacred or special about diagnostics. If the same service can be rendered for less money, why would you want to pay more for it?
DML have implied that the cheaper service offered by labtests will somehow be less accurate than their “premium” service. This is likely to be abject nonsense. I fully expect DML to competetively tender for the next contract at a substantial discount, giving the lie to the “cheaper and nastier” argument.
Stopping the tender system will not arrest the slow drift of pathologists overseas, even if it is replaced by a national laboratory. While there may be a worthwhile argument for a national laboratory service, recruitment and retention of pathologists won’t be part of it.
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Apr 3 09 6:59 am
so if there’s the same pile of dirty things to get through and same ANZ laundry standard to meet, who’d rush to be one of the 17 washing machines.
Doesn’t appear that anyone is rushing to be one of the 17 pathologists either.
Apr 3 09 9:32 am
Mac, you should look at the deal. There is no real cost saving, only now different people will pay, there will be fewer centres to go to, and less capacity with GP’s expected to provide the additional capacity. It’s a Wayne Brown special, hide the cost and make someone else pay for you, it’s something he has proven to be very good at.
Apr 3 09 2:38 pm
Any ideas how a country with a gdp/capita in the bottom third of OECD (NZ) can compete on salaries with a country in the top third gdp/capita (OZ). Healthcare costs don’t anything to raise a country’s productivity doc, which is required to raise salaries, which is required to compete with OZ!
Apr 7 09 11:10 am
I don’t think the tendering of laboratory services is at all equivalent to laundry services. Laboratory services are a medical service, not just house-keeping and the effect of errors aren’t just about a few dirty sheets but potentially peoples lives.
Will the DHBs consider tendering the medical and surgical services?
What about tendering for the general medical or general surgical service and building up a team of Drs, nurses, ancillary staff etc from nothing. Would this even be considered? I think not because of the substantial risks and clear stupidity of such action. Labortory services are another health service and should be treated with the same respect given to these medical services. They would fall over if there was no laboratory service.
Apr 7 09 11:23 am
Marianne: Will the DHBs consider tendering the medical and surgical services?
DHBs already tender out some surgical services – notably Ophthalmology and Urology.
Note that I was talking about the tendering process when comparing Lab to Laundry. Only an idiot would think that accurate tests are not vastly more important than clean sheets. From a tender point of view, a lab can be external to the core services a DHB wishes to run, whereas a basic medical or surgical service clearly can not. In this respect (and this respect only) a lab is like a laundry service in that both services can be tendered to external sources at the lowest acceptable bid price (acceptable means “likely to be able to offer the quality of service demanded”).