KEY POINTS:
A lack of blood testing during the laboratory workers' strike is increasing the risk of permanent disability for hospital patients, says a top surgeon.
Dr John Cullen's claim follows an earlier warning on health risks created by doctors giving extra drugs because of the lack of diagnostic tests.
Yesterday, Dr Cullen said statutory agreements meant union members had to provide blood testing and supplies for patients in immediate danger of dying, but those with less serious conditions were not covered.
Doctors were still obliged to treat patients even without diagnostic tests and supplies of blood for transfusions, said Dr Cullen, the Waitemata District Health Board's clinical director of orthopaedics.
"We can't morally or ethically leave that patient and not do something for them, but it does leave the possibility of the patient ending up with some permanent disability."
On Wednesday, Auckland City Hospital's chief medical officer, Dr David Sage, said that because of the strike, diagnoses were less precise and doctors sometimes had to prescribe extra drugs, increasing the risk of complications.
The Medical Council says doctors must provide the best treatment possible, but cannot be held responsible for the consequences of lab testing not being available.
The strike involves staff of 13 district health boards, three private laboratories and the NZ Blood Service.
The union says it wants a 5 per cent pay rise and an increase in the starting salary of laboratory scientists, to $45,000 from $40,000.
The health boards say they have offered a 5.5 per cent rise over two years.
Another group of patients considered at risk are those with vague symptoms, such as chest pain that may point to a small heart attack, which can be diagnosed only by a blood test.
If the problem is not accurately diagnosed, it could lead to the patient not being treated, creating the risk of a more serious heart attack.
Patients clearly having a heart attack can be identified by their symptoms and non-blood tests.
"The ones that concern me are those who don't present that way," said North Shore Hospital cardiologist Dr Tony Scott. "The only significant abnormality is the blood test. That is quite a large group of people."
Those in danger were people in hospital for something else who had a small heart attack and those who went straight to the hospital, he said.
If they went to a GP first, the test could be ordered, in Auckland, from the community-based Diagnostic Medlab.
However the clinical director of medicine, Dr Hamish Hart, added that all patients with chest pain were being admitted to the hospital and observed during the strike.
Those at higher risk could have a troponin test done on an automated machine but its capacity was limited.
Many chest pain patients were having early exercise tests before discharge to help separate the more at-risk patients from the rest.
