Sandy Milne

On March 2, Health New Zealand (HNZ) announced that it has started working on “a national plan for the troubled pathology lab sector, reminding us that “pathology labs are vital, but a choke point in processing virtually all the samples of patients from hospitals and doctors”.

Why did it take HNZ and our Ministry of Health so long to carry out their duty of care for patients?

Patients in outer Mongolia are no worse off than patients here.

Auditing of this costly New Zealand(largely private) service was non-existent.

As regular Beacon readers should be aware, I am particularly concerned about the vital service of diagnosing and managing infectious diseases, especially for patients in the many communities like ours outside the main New Zealand centres.

Disease bugs can kill and are the source of a huge range of serious or troublesome diseases.

Many bugs can be identified in 10 minutes, simply with the use of a microscope, slides and stains, and this gives health workers an early steer on which antibiotics or other treatments are indicated.

For at least 37 years, prompt and correct treatment of diseases in Eastern Bay GP patients has been empirical, ecause these specimens have been couriered to a for-profit private lab in Tauranga, which on September 2, 2019, advised users that they would accept specimens up to 72 hours after they were taken from the patient.

By that time, patients could be well, or dead. Many would have endured or suffered an unpleasant infection.

All of the international guidelines for handling microbiology specimens emphasise the need for immediate transport to the lab bench.

Readers can visit Archiva Biologists, or other internet sites, to confirm this. I possess guidelines of a US Pathlab outfit which includes this, “Specimens should be delivered to the laboratory immediately after collection to preserve viability of fastidious organisms, to prevent overgrowth of fastidious organisms by rapidly growing ones and to prevent multiplication of clinically insignificant (harmless) bacteria which could be erroneously interpreted as being clinically significant.

“The maximum time between collection and receipt in the laboratory should be less than two hours.”

I have been regularly corresponding with Stanford University Emeritus Professor Ellen Baron of the USA’s Infectious Diseases Society of America (IDSA), whom I met in Auckland 10 years ago.

The Beacon health reporter interviewed her in September 2015. She was on the teams that set the global standards and has been very supportive of our efforts in Whakatāne to get New Zealand to follow best or even acceptable practice for handling specimens. Prof Baron sent me another encouraging email two weeks ago.

Thirteen years ago, Dr Rosemary Ikram, a private pathologist, sent our Ministry of Health the IDSA guidelines which require microbiology specimens to reach the lab bench within two hours. They have been ignored by our private sector for years.

Dr Ikram was at that time the microbiologist representative on the Medical Technical Advisory Committee of International Accreditation New Zealand (IANZ) whose “expert” visited my home for a lengthy meeting attended by Beacon reporter (now editor) Neryda McNabb.

I have a mountain of letters and documents which prove the egregious activities, which former Ministry of Health and district health board officials (plus others), indulged in year after year. The upcoming inquiry is long overdue.

I am busy composing an invitation to Audrey Sorenson, Director General of Health, and her deputy, John Whaanga, to visit Whakatāne soon to study the evidence I possess. I will invite Dr Victor Luca to join us. His expertise and understanding of healthcare issues is considerable.

I have a request leaders of Eastern Bay communities to please join me in getting the Government to reverse the costly privatisation of pathology services, especially clinical microbiology.

This matter is far more serious than the successful hepatitis B campaign, where we prevailed despite serious opposition from the very officials and staff should have done the work.

If readers have advice on how this battle can be won, please let me know.

It would be great if we received the kind of support we received in Kawerau during our hepatitis B campaign.

The whole community got in behind me and paediatrian Dr Chris Moyes; led by the mayor (the late Lynne Hartley) and whole council, including unions and teachers and nurses.

Please help us match that.