Tuesday 31 March 2020

Coming Down the Tracks



Mass testing means lower fatality rates from coronavirus because it allows detection of Covid-19 even in patients who suffer few or no symptoms, and who have a much better chance of survival.

 

The nose and the back of the throat are the two sites where the virus replicates. Swab tests are taken to the pathology lab and used to match the genetic material captured with the genetic code of Covid-19.

 

Medical staff taking the samples need to wear personal protective equipment including gloves, gowns, masks and face shields.. I was horrified to hear from a friend working as a hospital doctor that they are short of these PPEs. But never mind because Boris Johnson assures us that mass testing for Coronavirus is ‘coming down the track’ and will be taking place ‘as soon as possible’.

 

As I wrote yesterday, pathology labs in Germany have been conducting about 160,000 coronavirus tests every week. In the UK they average less than half that. And the pathology labs which undertake all this have been undergoing privatisation for over twenty years.

 

The Tony Blair / Gordon Brown governments reduced the number of hospitals that had their own pathology services and initiated their privatisation. Under the ‘hub and spoke’ model NHS trusts were encouraged into partnerships with private companies.

 

Pathology Clinitician, Denise Cooke, at Frimley NHS Foundation Trust has said, “The big difference with an NHS-led pathology service is the add-ons you get with it … So you absolutely get a clinically-led service and that is not something you have to contract for or buy, that is just the nature of the beast … On top of that you get all the other things the NHS offers; so there is a very supportive training and education programme … And then there is the ethos of it. The public sector is about doing good for the public, it is about making good use of taxpayers’ money for the public good … I think there is a different ethos in the private sector … I’d say 99.9% of people working in NHS pathology don’t do it for the money – they have some connection with the NHS and what it strives for and its reason for being.”

 

Here are just a few of the private companies involved today with our pathology labs:

 

Viapath (Serco) who have been found to overcharge the NHS for diagnostic testing amid allegations of cost-cutting and clinical failings. Senior consultants have claimed that staff cuts and a lack of investment since privatisation have left some laboratories close to disaster. One claimed that Viapath had an “inherent inability… to understand that you cannot cut corners and put cost saving above quality.”

 

Integrated Pathology Partnerships who were accused by Public Health England of running NHS labs with quality weaknesses. They concluded that: 'A number of working practices, particularly within the laboratory, compromise service quality and potentially patient safety'.

 

Synlab who were excluded from providing pathology services to Royal Free London and UCLH as the company lied - the company said it was in the process of developing a laboratory close to the two hospitals which would meet the requirements of the tender, but this was not true.

 

Other private companies involved today in NHS labs are, Alliance Medical, InHealth, Health Services Laboratory, Sodexho, Life Healthcare, The Doctors Laboratory Ltd and Mediscan Diagnostic Services. There are more.

 

A survey of 103 histopathology departments conducted in 2017 by the Royal College of Pathologists, found that only 3% said they had enough staff to meet the current clinical demand. 45% of departments had to outsource work, while half of the departments were forced to use more expensive temporary workers.

 

I worry about what is really ‘coming down the tracks’.

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