Lab-charges plan for private patients

By MARTIN JOHNSTON

Patients treated by private specialists or surgeons would have to pay for their own laboratory tests under a scheme floated by Auckland public health managers.

Virtually all blood tests and other disease checks at community laboratories are state-paid, at a cost of about $200 million a year.

About $25 million of this is spent on private specialists' patients and those treated in private hospitals.

The Auckland District Health Board is investigating making these private patients pay, asking the association representing the country's 21 boards to draw up a proposal for the Ministry of Health.

The board has exempted general practitioners' patients from the user-pays push, saying it has more control over GPs' laboratory spending.

The Medical Association and Cancer Society said the proposal would force private patients to switch to overloaded public hospitals.

Health Minister Annette King gave qualified support for the idea, but said there would be difficulties, such as how the laboratories could tell the difference between public and private patients.

User-charges for laboratory tests were last mooted under the National-led Governments of the 1990s.

Now the Auckland board, scrambling to reduce a projected $86 million deficit, wants to cut back on the $64 million it and the other three northern region boards spend annually on community laboratory tests.

In March, it advocated having doctors hand-write all test order forms as a way of cutting down on unnecessary tests - an idea ridiculed by many doctors.

More than 900 tests are available for all types of diseases, from food poisoning to skin cancer. The most common include blood samples for glucose, blood-cell counts, cholesterol and kidney and liver function. The average price, including sample collection, transportation, processing and reporting, is just under $10.

Cindy Kiro, an acting senior manager for the Auckland board, said demand for community laboratory tests had grown about 13 per cent a year, because of population growth and ageing and the introduction of health schemes such as hepatitis B screening and the wider use of "statin" drugs to lower cholesterol levels.

But Dr John Matthews, clinical director of Diagnostic Medlab, the largest community laboratory, said average growth was 5 to 6 per cent.

He said laboratory prices were lower in New Zealand than comparable countries like Australia.

Medical Association chairman Dr John Adams said the scheme would encourage some people to use the state system, so "it's not going to save that much money and will create a two-tier system".