Delays ‘inevitable’ for patients in plan to send tissue samples by road

A proposal to courier patients tissue samples by road from Nelson to Christchurch for testing will inevitably lead to delays in patient care, a scientist working in the Nelson laboratory has warned.

It comes as Nelson mayor Nick Smith has written to the Health Minister and MPs to try and stop the plan to shift the service to close the histology services in Nelson.

Nelson MP Rachel Boyack has also made representations to the lab company, Awanui, on behalf of health workers and others concerned about the planned move. She said it was important that core health services were retained in the region.

Awanui says no decisions have been made, and if it goes ahead patient care will not be compromised.

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Last week, Awanui informed staff of the proposal to slash the workforce in the top of the south, with 10 jobs going and nearly all histology services – tissue testing – being transferred to a Christchurch facility.

The proposal is open to feedback until May 31. Awanui is contracted to provide laboratory services for Te Whatu Ora – Nelson Marlborough.

Amongst those affected is medical laboratory scientist Jude Escreet. She warned shifting the service would lead to delays for patients.

The sort of samples being tested in Nelson include skin biopsies and samples taken in theatre, such as breast tissue for cancer diagnosis, she said.

“Awanui are proposing to send all these specimens by road to Christchurch to be processed and return the slides produced back by road to Nelson to be reported. There are obvious inherent potential disasters when transporting specimens in large volumes of formaldehyde by road in addition to the extra time this will take,” she said.

Because the samples would be couriered, samples taken too late in the day would immediately have to wait an extra day to be sent.

That, combined with the fact there would be more demand on the staff in Christchurch, would lead to delays of up to two to three days, Escreet said.

There was a shortage of staff in the low-paid industry, so there was “no way” they would be able to attract extra staff to meet the new demand in Christchurch, she said.

Nelson MP Rachel Boyack said on Friday she was hopeful that the representations that had been made would lead to the proposal not going ahead. She said Nelson had recent experience of being isolated after flooding and slips closed state highways, which heightened the risks of relying on road transport.

Nelson Mayor Nick Smith said he was concerned about the loss of highly skilled scientists from the region.

“My deeper concern is that this is just the beginning, under Te Whatu Ora, of Nelson losing health services of the new centralised health structure.”

It was “inevitable” the changes would lead to delays for the 18,000 patients and 20,000 samples a year, he said.

“Delays in healthcare in areas like cancer diagnosis can make the difference between a life being saved or not.”

David Munro from the APEX union said it was “ludicrous” to suggest services would be improved by transporting samples to Christchurch.

“How this accords with Te Whatu Ora’s stated objective of providing diagnosis and treatment ‘closer to home’ as it moves to tackle the ‘post-code lottery’ in the health system, is anyone’s guess.

“The people of Nelson- Marlborough are being let down by this huge private sector business that paid a $42 million dollar dividend to shareholders last year, and which has shared ownership between the NZ Super Fund, a Canadian pension fund and local iwi interests.”

Amongst the reasons given for the proposal was high staff turnover, but that could be easily fixed by improving pay and conditions, Munro said.

Te Rūnanga o Ngāti Rārua pouwhakahaere Shane Graham said the proposal was difficult to understand at a time when a key driver of change in the health system was reducing inequality.

“Improved local delivery of patient-centric health services for Māori was a key driver of the Te Whatu Ora and Te Aka Whai Ora reforms. Contractors should be supporting the intent of these reforms,” he said.

“Instead, this proposal moves the service further away from patients.”

An Awanui spokesperson said the proposal would “enable Awanui to have the right level of staffing and technical expertise, support the implementation of digital pathology, and use our national network to ensure our organisation and services are sustainable and viable going forward.”

Patients would not be affected, they said.

“Patient safety is our top priority, and no changes will be made that negatively impact patients.”

Pathologist reporting of results would remain on site in Nelson.

They did not respond to questions about provisions for transporting samples in the event of road closures.

Te Whatu Ora – Nelson Marlborough interim hospital and specialist services lead Lexie O’Shea said they had been meeting with Awanui to ensure the changes would not impact services for staff and patients.

Contract delivery was regularly measured against KPIs, she said.

If it goes ahead, the new structure would be operational in July.