Public hospitals and private pathology providers

Recent reporting from the Australian Financial Review shows that Capital Crescent, the private equity firm that owns Australian Clinical Labs, is experiencing some big financial problems. And they aren’t the first private pathology company to experience financial problems.

But what happens to the delivery of pathology in public hospitals when private pathology providers cut staff and services; or worse, go out of business?

We’ve regularly pointed out the real dangers in allowing private providers to deliver key clinical services, like pathology, in our public hospitals. It’s becoming more obvious that private providers are not more effective or efficient than in-house pathology services and are contributing to problems in delivering world-class healthcare; on the contrary. It is a major problem when turn-around times increase because pathology labs in public hospitals are closed and the work moved to locations based hundreds of kilometres away. Regardless of the strenuous defence of these moves by a hospital’s management, the research overwhelmingly shows that doing tests closer to where the sample is taken significantly improves turn-around times, reduces chances for spoiled samples and speeds up the time for a patient to receive treatment.

Increasing turn-around times for test results can have adverse outcomes for patients as test results need to be known before treatment(s) can start. Or it can result in patients taking up beds to only be told that there is nothing to worry about.

It also has flow on impacts in local regional and rural communities by increasing unemployment and reducing confidence in local health services. There are usually significant amounts of experience lost when private pathology services take over in-house testing. And there are unexpected consequences for other healthcare services like aged care, which rely on local pathology services in order to deliver care and ensure the health and well-being of mature aged people.

The reality of private pathology providers shutting laboratories was sheeted home in 2017 with Clinical Labs abruptly announcing the closure of two health service pathology laboratories.

With the privatisation of essential clinical pathology services in public hospitals, there is a need to ask: what happens to the quality of care in our public hospitals when a private pathology provider goes out of business or decides to walk away from a contract?

Judging by the Victorian Government’s apparent approval of the continued use of privatised pathology services, despite the concerns raised, public hospitals would be left without adequate in-house pathology services to ensure the safe treatment of patients.

Too often patients are being put at risk by the business practices and profit imperatives of private pathology providers. When samples are misplaced or go missing, and there are increasing delays in test results being made available, the government cannot idly sit by and allow public hospitals to outsource vital clinical pathology services.

The business model for all private pathology providers is to close down hospital pathology laboratories, sack scientists and move pathology testing to laboratories hundreds of kilometres away. Ongoing cuts to the scientific workforce means private pathology providers are unable to provide quality pathology services to the highest possible standards. It is anathema to the provision of high quality public health services to have private pathology providers cutting the very workforce which delivers quality results for treating clinicians and patients who rely on these.

The Victorian Government must stop allowing public hospitals from outsourcing vital clinical services like pathology if they want to deliver world-class healthcare to all Victorians.

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