Labtests' patients at risk, says health watchdog

Health and Disability Commissioner Ron Paterson has taken his concerns about Labtests to Health Minister Tony Ryall. Photo / Brett Phibbs

The country's top health watchdog fears public safety may be threatened, after he received a series of complaints against Auckland's controversial new community laboratory service.

Health and Disability Commissioner Ron Paterson has taken his concerns about Labtests to Health Minister Tony Ryall and sought an explanation from Auckland's three district health board chief executives.

"I consider there is a real risk that patients could be harmed as a result of the delays and confusion that seems to exist around reporting of results in particular," Mr Paterson told the Weekend Herald.

The complaints range from long waits at Labtests collection centres to a 13.5-hour delay in home-testing and reporting on a newborn who, on the basis of the results, had to be urgently admitted to the Starship hospital on Thursday night because of the risk of bleeding.

The delay created a "small risk of serious harm", but no actual harm resulted, said a specialist involved in the case.

One of the complaints comes from a general practice the DHBs appointed to give them feedback on the transition. It says its comments to the boards on the problems are at odds with the Auckland DHBs' public statements on the changeover.

In response to the problems at Labtests, the DHBs on Monday began intensive monitoring, including posting some of their own staff at the firm's core laboratory in Mt Wellington.

Mr Paterson said the formal complaints had been coming in "thick and fast" and by yesterday he had received 13, from GPs, specialists, a midwife and patients, in addition to several "inquiries" from people who simply wanted their concerns recorded.

"The information I have received indicates there may be a risk to public safety given the broad concerns that have been raised."

Mr Paterson's comments come on top of a Weekend Herald survey of GPs this week that found widespread worries about Labtests.

Sixty per cent of the 150 respondents rated its service "bad" or "very bad", in contrast to the 85 per cent who said the service from Diagnostic Medlab before it lost the taxpayer-financed contract was "very good".

Labtests won the DHBs' contract, worth around $70 million a year, in 2006 and, after a protracted court battle with DML, opened for business on August 10 in Counties Manukau. It completed the transition on Monday and is now testing up to 10,000 patients a day.

Mr Paterson said the concerns raised by senior doctors at Auckland City Hospital were particularly serious. "They include haematology hard-copy results not being received, faxed results being misdirected, a renal patient facing a one-month delay in going on the transplant list because blood results were not available, and an HIV test result being misdirected.

"The situation was described to me as recently as [Wednesday] as 'very disturbing' and 'just a matter of time before something significant goes wrong'.

"Failing to report significant test results promptly is always a serious matter and puts patients at risk."

Mr Paterson rejects Labtests' repeated assertion that the matters raised by GPs and patients are "teething problems".

After meeting Counties Manukau chief executive Geraint Martin yesterday, the commissioner said the DHBs realised the seriousness of the situation and were doing all they could.

But his concerns would not recede until the flow of complaints, especially from senior doctors, abated.

Labtests chief executive Ulf Lindskog declined to comment on the complaints ahead of any findings Mr Paterson might make if he conducts a formal investigation.

But he said patients were no longer experiencing excessive waits. The average was 20 to 30 minutes and the maximum early this week was 50 minutes - in Henderson on Monday.

Operations project manager Malcolm Stringer, when asked about test turnaround times, said they were already good and would improve. For INR - a test of blood coagulation for those on blood-thinning drugs and one which has attracted complaints - 97 per cent of results were reported to doctors within six hours of the sample being taken.

Mr Lindskog said his firm had acted on doctors' concerns about waiting on the phone by increasing call-centre staff, handling separately the many calls about collection centre locations, setting up a dedicated line for clinicians (0508 LABRESULTS) and posting its pathologists' cellphone numbers online.

Auckland DHB chairman Pat Snedden said that although Labtests had all the technology necessary, too little attention had been paid to establishing all the relationships necessary for a successful service. The intensive monitoring group would provide local knowledge to help rectify this.

Mr Snedden said no thought had been given to inviting DML into a dual-contractor role to help out.

Mr Ryall said he had told the DHBs that the problems "must be fixed". The board chairs must keep the pressure on Labtests to deliver a safe service.