Sunday, September 20, 2009

Complaint No 14

Open Letter to the Disability and Health Commissioner


Rae Lamb
Deputy Health and Disability Commissioner, Complaints Resolution

Good morning Ms Lamb

I refer to your earlier correspondence in which you advise:-

"However, our focus is on whether there is potential risk to patients, or issues relating to the standard of care. "

Accordingly, I wish to lodge a formal complaint over the current state of affairs viz a viz blood testing services in the regions covered by the Auckland, Waitemata and Manukau District Health Boards.

There are reports that an orchestrated campaign of industrial sabotage against the current supplier Labtests is being waged by DML and certain general practitioners. It is obvious to a dispassionate observer that such a campaign is damaging the service itself and already has put in jeopardy the safety of patients. It seems to me it will be only a matter of time before there is a death which may be attributed directly to this alleged sabotage.

Would you kindly investigate and report on the following specific allegations.

  1. Since the changeover, a number of general practitioners have marked ALL their sample requests as 'urgent,' thereby flooding the system and causing considerable delay in provision of test results.
  2. A number of general practitioners have failed to include the Labtests identifying codes on request forms, leading to inevitable delays in and misdirection of test results.
  3. A number of general practitioners have actively encouraged their patients to lay complaints against Labtests.
  4. A number of general practitioners have permitted DML staff to subject patients to a barrage of anti-Labtests propaganda during the weeks leading up to the changeover of providers. This has been my personal experience.
Would you agree that if such an alleged campaign is being carried out, that it would potentially jeopardise public safety and is unacceptable?

I'd be obliged if you would advise as follows:-
  1. The total number of sample requests processed within the bounds of the three DHBs during the five weeks following change over and during the same period last year.
  2. The number of requests carrying incorrect NHI numbers or doctor identifiers during that period and the same period last year.
  3. The number of requests marked 'urgent' during that period and the same period last year.
  4. The identity of any General Practices where the number of urgent requests has substantially increased compared with the previous year - say by 20% or more.
  5. The identity of any General Practices producing above average numbers of requests carrying incorrect numbers or identifiers.

Adolf Fiinkesein is a blogger pseudonym. The writer has no personal, business or financial connection with the medical/health industry or anyone in it, with the exception of his personal GP. He will identify himself in person to the Commissioner if requested, subject to the Commissioner's prior written agreement of confidentiality.

Yours faithfully

Adolf Fiinkensein


Anonymous said...

I'd have asked for the links between the DHBs, DML, and Labour. Time to stop pussyfooting.

Anonymous said...

"It is obvious to a dispassionate observer "

Rofl comedy gold.

Mike said...

Well we have a couple of bloggers on jihad - one who backs companies depending on how she would like the CEO in the boudoir and one who has a very strange idea of what capitalism is.

Be prepared to be very embarrassed.

Adolf Fiinkensein said...

Mike, do tell. Put your reputation where your mouth is but before you do, deal with the issues.

Do you believe there has NOT been a carefully orchestrated campaign of industrial sabotage waged against Labtests?

Come on now. Give is your opinion.

WAKE UP said...

This would be drop-dead funny if it wasn't about the grave threat to Auckland's public health brought about by accepting a tender from a company THAT DIDN'T EVEN EXIST. Insider trading and corruption barely begins to describe the process that brought the current appalling situation about - and still you are only concerned about some current lapses of judgement by protesters.

Adolf Fiinkensein said...

WakeUp, you are deluded. Commercially, New Zealand is but a small part of Australasia. Your foolish comment simply points to the fact that you have no comprehension at all of commercial reality.

Cactus Kate said...

Jihad? That's for the towel heads Son.

Mike, you seem to have the problems. The situation is far from ideal, Adolf and I have blogged on this. I would like 20 suppliers of blood all competing at the lowest possible price, but we accept contracts and the rule of law over the monopsony/monopoly/free competition ideal.

If Labtests are breaking the contract then there should be legal action. But if DML and the DHB by omission have not assisted in the handover then Labtest have a very large case for commercial contract frustration and with it YOU the taxpayer/ratepayer/health user paying them a very large sum.

Paracelsus said...

Wake Up, if you would have the DHBs consider tenders only from laboratories already up and running in Auckland, then, given that there was only one such laboratory in 2007..?

Anonymous said...

You've still yet to explain
1) what you know about diagnostic testing
2) how Auckland's health is at danger.

You see, as someone who knows a little bit about diagnostic testing, it seems strange that, despite all your bleating, no-one has died yet.
With a population draw to the EDs of Auckland approximating 180,000 patients per annum, and with an outpatient draw about twice that per annum; considering a strike rate of approximately 30% of those patients needing rapid diagnostic turnaround, you could see a fairly high chance of someone dying very quickly if things were troublesome.

What strikes me as clearly dubious is the DML practice of focusing on bleeds and well people. This, to me, shows that Labtests at least seems to have the rapid turnarounds going OK. And they are the most critical interface.

So, WakeUp, do you have data on how many MIs have not got their TnI/TnT in the 90min window? How many ab pains have not got GGTs etc. back in 60mins? How many Hb's are not getting through in 15min? How many smear tests have come back incorrect? Because if you don't have hard info like that, its hard to take you, or anyone else at DML, seriously. And you should have it by now.

Anonymous said...

Yes - and the links between ProCare and DML. The e-mail below has been sent to all Auckland GPs by ProCare (the PHO that has consistently opposed Labtests). You would have to ask why any issues would need to go to ProCare first, rather than being sent straight to Labtests?

Subject: ProCare sets up regional Labtests Issues Response Team for all Auckland GPs

Dear all,
ProCare has set up a regional Labtests Issues Response Team for all Auckland GPs to help identify and communicate issues of patient safety and quality to the DHBs and Labtests.
Based on the infrastructure developed during the novel influenza (H1N1) influenza pandemic, ProCare offered to lead this issues response team to coordinate and streamline GPs’ concerns, and our offer was accepted by the Auckland DHBs’ regional recovery team.
The issues response team will collect and provide information from all General Practices in Auckland to a single point of contact within the DHBs’ regional recovery team.
ProCare has begun liaison with all primary health organisations in the region.
Please forward any issues you or your patients are having with Labtests, especially any serious concerns for patients safety, by completing and faxing the attached form to 09 369 7148 – or emailing the form to
This service is now available for all GPs and practice staff in the greater Auckland region.
This process does not replace the need for practices to contact Labtests for service requirements and urgent problems.
If you wish to take advantage of this service please disseminate this email to your practices, regards Peter

Peter Tranter
Manager Business and Support Services
ProCare Health Limited
Mobile: 021 222 1029, DDI: 09 369 7155
110 Stanley Street,Grafton, Auckland
Postal Address: PO Box 105 346, Auckland
Tel: 09 377 7827, Fax: 09 377 7826