Arthur Morgan (Louth, Sinn Fein)
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Question 87: To ask the Minister for Health and Children the position regarding the rationalisation of hospital laboratory services; if she will confirm that the Association of Clinical Biochemists in Ireland was not consulted in the drawing up of the Teamwork report on this matter, despite her statement in Dáil Éireann on 8 December 2009 that stakeholders were consulted; her views regarding the report by Teamwork Management Services which claimed that the quality of laboratory services here is of a poor standard; if she and the Health Service Executive have examined the danger of fragmentation of services with the separation of testing in primary and secondary care and the weakening of clinical liaison and input under the proposed privatised and centralised model; her plans to commission a cost benefit analysis of a system that would see these services outsourced, many of them possibly abroad; and if she will make a statement on the matter. [19994/10]

Mary Harney (Dublin Mid West, Independent)
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Approximately 77 million laboratory tests are undertaken annually across 44 public hospitals. At present the annual cost of this service is approximately €470 million. The workload comprises both urgent and non-urgent tests and a significant proportion of the activity originates in the primary care setting. As with all other parts of the health service, and indeed the public service generally, it is essential that laboratory services are delivered as safely and as cost effectively as possible.

An external review of laboratory services was conducted for the HSE by Teamwork Management Services in 2007. The HSE has stated that Teamwork, in undertaking the review, consulted with the Association of Clinical Biochemists in Ireland amongst other stakeholders. The review highlighted limitations in the organisation of laboratories which had an adverse effect on quality, turnaround time and cost. It found at that time that "the whole system quality" of laboratories was not of a sufficiently high standard. The review also found that the overall proportion of individual laboratory medicine disciplines that had achieved accreditation status was low, "end-to-end" information systems were unsatisfactory and logistic services were inadequate. It found as well that the general condition of the laboratory estate typically was of traditional design and was outmoded.

In light of the review, the HSE announced plans in the early part of 2009 to modernise laboratory services and to achieve significant efficiencies in the configuration and operation of these services. The HSE has already had significant engagement with stakeholders in progressing this initiative. Groups such as the Faculty of Pathology, the Medical Laboratory Scientists' Association and the Association of Clinical Biochemists in Ireland will continue to have a significant input into the process.

As part of this initiative, the HSE has commenced discussions with the National Development Finance Agency about the capital financing of a small number of dedicated "cold" laboratories to process the large volumes of routine patient tests generated from the primary and community care sector which are currently undertaken in hospital laboratories. The HSE is also having a business case/cost-benefit analysis undertaken to assess a number of options which have been put forward for the processing of cold laboratory work. Any new laboratory service arrangements will need to satisfy a range of service and quality requirements, including supporting the provision of integrated care to patients.

I am pleased to acknowledge that a number of improvements in laboratory services have taken place since the completion of the Teamwork review. The number of individual accredited laboratory disciplines has increased significantly. In addition, some reconfiguration of laboratory services has been achieved by transferring work undertaken in a number of small laboratories to larger laboratories. This has allowed for a higher level of throughput. The HSE has indicated that improved processes, introduced in the past year, have achieved non pay savings in 2009 of some €5m.

I am satisfied that the measures being taken by the HSE, with ongoing input from stakeholders, to modernise laboratory services are necessary and appropriate for the reasons which have been outlined.