DHBs look at charging for private tests in labs

Many patients of private hospitals and specialists face the prospect of having to pay for their blood tests.

Reviving a plan last floated in 1999 under a National-led Government, district health boards in Auckland and Wellington are considering imposing laboratory user-charges on private patients.

The three Auckland boards' consideration of the issue is revealed in their request for bids on running the region's community (non-hospital) laboratories.

Test volumes are increasing at 5 per cent a year. The Government spends around $200 million a year on community lab tests, including $80 million in Auckland, and health funders are trying to drive down costs.

Community labs perform tests ranging from blood and urine samples to tissue tests for cancer. The average price per test is around $10, but some cost many times that.

Private hospital patients routinely have up to several hundred dollars worth of tests.

Waitemata District Health Board chief executive Dwayne Crombie yesterday argued that it would be consistent for private patients to pay for their lab tests rather than having that part of their care financed by the state.

"They pay 98 per cent of the other costs of a private operation; why don't they pay for those [lab] costs? It just seemed to us to be more consistent and logical."

But Dr Crombie said the plan had not yet been before board members and would need their approval, and Health Minister Pete Hodgson's, to be implemented. Mr Hodgson's spokesman said he had not been involved.

Some doctors said that since general practitioners were not named in the proposal, specialists would ask their patients' GPs to order lab tests, if the scheme proceeded - but one discounted this, saying it would involve too much extra letter-writing.

Fertility New Zealand executive director Sian Harcourt said having to pay at least $700 for the tests needed with in-vitro fertilisation would make IVF unaffordable for many of the "large chunk" of patients who did not qualify for the limited public funding and paid as private patients. IVF costs $8000 to $10,000.

Orthopaedic surgeon Geoffrey Horne said the DHBs' proposals were unfair in singling out private specialists. "If they are going to do this, they should do it right across the board."

Medical Association chairman Ross Boswell agreed. "There should be national consistency and if they are going to do this it should be well signalled in advance so insurance companies can decide if they will pick up those costs and let patients know. If they do they would probably have to adjust their premiums."

Southern Cross, New Zealand's largest health insurer, covers limited laboratory testing, depending on the type of policy.

Southern Cross Healthcare group chief executive Dr Ian McPherson said it would look more closely at lab-test coverage if the health boards opted to charge private patients.

Urologist Dr John Tuckey said private patients paid taxes and were entitled to the same state-funded tests as public patients.

* Two Wellington community laboratories that have put in a joint bid for the regional contract say theirs is the second preference of the region's two DHBs.

One of the labs, Wellington Pathology, said it understood the DHB laboratories had made a bid and were negotiating with the health boards.