Editorial: LabPlus cover-up highly disturbing

Now at least we know that the failings of LabPlus were far from the sort of teething troubles that might afflict any new enterprise. The Auckland District Health Board's flippant contention about what ailed the country's top medical laboratory has been totally undermined by the release of a damning accreditation report. International Accreditation New Zealand's findings, which prompted the suspension of chemical pathology, immunology and virology testing, suggest a laboratory in desperate need of major overhaul. And it vindicates the Herald's case that the laboratory's woes were clearly a cause for public concern.

It was clearly not a view welcomed by the health board. A request for the accreditation report under the Official Information Act was greeted by unacceptable stalling tactics. Initially, at least, the board intended to deny the Herald's request for 20 working days, the maximum allowed for a response.

Most pertinently, however, the act requires agencies to reply as soon as is reasonably feasible. In this instance, there were no logistical problems preventing release and a clear public interest. Even so, it has taken the board more than a week to accede to the request. It has used that time to try to put the best possible slant on the debacle. So condemnatory is IANZ, however, that window-dressing is pointless.

As telling as any comment in the report is that on the attitude of LabPlus staff to the accreditation process. "The forthright and open manner in which most staff contributed to the assessment process was commendable and in the long-term best interests of the organisation," it says. Put another way, it appears the staff were sufficiently worried to voice their concerns bluntly.

And with good reason. LabPlus was taking 10 times longer to return urgent tests than before its 13 laboratories were consolidated in new $20 million facilities late last year. Patients' safety was clearly at risk while doctors waited for test results which would affect their diagnosis of the likes of hepatitis, heart attacks, and HIV-Aids. It is of no comfort whatsoever that the district health board says it received "no report that inappropriate treatment has occurred as a result."

Those delays are far from the end of the woes afflicting LabPlus. The accreditation report reveals a highly disturbing trail of inefficiency. LabPlus did not, for example, have a formal management review process, and had not kept staff training or competency records. In the virology-immunology area, a significant number of staff were performing work with either no documented record of competency in the area or with no evidence of review of competency.

Equally alarmingly, the failings in that area included six problems that had been raised in two previous accreditation reports but had not been addressed. The message had obviously not got through. "This has cast doubt on the effectiveness of the laboratory's internal auditing and corrective action procedures," IANZ says in a masterpiece of understatement.

It can also hardly have helped relations between staff and management that some staff had been subjected to high levels of formaldehyde. Short-term exposure to high doses of formaldehyde, which is used to preserve tissue specimens, can be fatal; long-term exposure to low levels can cause respiratory difficulty and eczema. Staff believed the safety level of fumes should be 0.3 parts per million. On the day of the accreditation assessment it was 1.5. Almost unbelievably, the alarm system was silent until thee levels hit 6.

The release of the report has been accompanied by a message of reassurance from the health board. Additional staff had, it says, been employed to address the problem of delivery to the laboratory and within the specimen reception area. That problem, however, was still being rectified at the time of the survey. Likewise, there was an assurance that the failure to address issues of documentation would not recur. Unfortunately, such pledges had also been given in the past.

There must be no repeat of the failing to apply effective remedies. If nothing else, the suspension of accreditation has bought the multitude of shortcomings to a head. It reflects poorly on the health board, however, that it was loath to acknowedge the interest of those most likely to be jeopardised - the patients. There should have been full and frank disclosure as soon as accreditation was suspended.