Election
Auckland District Health Board
Date
September 28th, 2010

Can you state your position regarding the replacement of Medlab's services with that of Labtests?

Terry

Candidate Answers

Candidate

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Thank you for your question Terry, and I apologise for my tardiness in responding.

The contract change to Labtests was in effect instituted by the courts, and the Auckland Regional District Health Boards had no choice but to comply.

The situation now is that there are two providers currently, and a number of people are uncertain about their situation both as employees of the organisation and as users of the services. That is not good for anyone.

I hope that two providers may continue and that the opportunity may be taken to strengthen the provision of Pathology services to the people of the region, and to create a cooperative environment where there is security of service and services for all those involved.

I think the major lesson I would take from the whole sorry episode is that there needs to be a different approach to contracting for such services. There is considerable interest in the concept of “alliance contracting” that may provide a different way such important and sensitive issues may be addressed.

In other words we should be able to do better.

Hope that helps.

Chris

Hi Terry,

Observing from the outside (like you) I was shocked by the Labtests fiasco. I was shocked to learn about the blatant conflict of interest by a member of the board. I was further disturbed to later \"hear\" that the same person was an ex-Medlab employee who apparently had an axe to grind. The whole sorry saga was a tragic undertaking and a huge embarrassment for Auckland.

As a shop floor DHB employee myself, I was in a position to observe the huge difficulties that arose as the transition took place - problems which were foreseen by many, and yet still apparantly not able to be avoided.

However, we cannot turn back the clock, and I congratulate all of the people who worked long hours to ensure that we eventually received a safe and effective service again.

It is important to learn from mistakes. This one has highlighted the problem of a tendering process where only one provider is sought, and the challenge of dealing with escalating costs when there is only one embedded provider.

The final solution that we have now with two providers is ironically probably a better balance, as the existence of practical front-line competition should theoretically keep costs down better than just the more remote competitive arena of a tendering process.

I hope and believe that we are all wiser for the pain we have been through.

All the best.

Thanks & Regards

Jeanette Elley (City Vision Health)

 

My position has been consistent from when I first came in 3 years ago and has been reported in the NZ Herald. Ian Ward and myself are on public record as voting against the termination of the DML contract over 18 months ago.

Brian Fergus

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Terry,

I think the whole tendering process was a shamables  obviously not well thought through and poor due diligence.  Now because of the short comings of Labtests we are  in the situation whereby we have 2 providers.  For such a critical service  that was working effectively then far more work needed to be done to ensure that the new provider could deliver on what they contracted to do.  I do believe in getting value for money but you simply can\\\'t have, for critical health services, a organisation appointed because they say they deliver a lower cost service they must be required to prove that they can. What I would favor in the future to ensure continuity of service would be a phasing in of a new provider  with  test , pilot, and then gradual uptake while the incumbent is gradually phased out. 

Kind regards and thank you for your question

David Fraser

 

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Awaiting response The first problme with Medlabs was the contract process, if elected I will make sure that the contract propositions carefully set out what is required.  One problem was Medlabs and Labtests had two totally different ideas about what service was being sought.  I am strongly against people being on boards who have conflicts of interest, if people want shares in diagnoistic services then they should not be on a board that will determine such contracts. 

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Terry,

Thank you for your interest.

I resigned as a director and sold my shareholding in Labtests in April 2007 and have not had anything to do with the company since then.

My position is that community diagnostic services should be provided to the highest standard in the most cost efficient manner. The current model of service provision is not one that will give that outcome.

I do not support limited vendor funding models in situations where there is ample volume of service to be provided.There is nothing is the literature which would make me change that opinion at the moment.

I support value based contracting ( or some form of regulated competition) where the service specification is defined, the price set and the market is determined by the quality of service provided.

I hope that answers your question.

I was not on the ADHB at the time and my only information is from the media.

 Any changes must be supported by a robust and well informed business case ,coprehensive consultation with all affected parties especially consumers, well planned change processes and yeild clear benefits to health consumers for a change to gain my support.

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Terry,

 

At the time of being elected to the Board of ADHB the decision to appoint LabTests had already been taken by the previous Board chaired by Wayne Brown.

When I joined the ADHB Board though Medlab had appealed that decision  and we were awaiting for the outcome from the appeal.

As you will know the appeal Court confirmed the process and the awarding of the contract to Labtests.While one was waiting for the outcome of the appeal Medlab had continued to provide the service.

When the outcome of the appeal was known the three Boards then had to comply with the Court decision and require Labtests to take over.

An implementattion plan was established by the project governance Board established for the cross over. This governance group consisted of the three Chairs, The three CEO\'S and the three Chief Medical Officers and each Board was asked to agree to the implementation plan and the readiness of Labtests.

It is on public record that I voted against Lab tests being ready to implement  the contract at the time they did. I was one of only two Board members across the three DHB\'s that recognised that Labtests was not ready to commence providing the services under the contract. Brian Fergus was the other.

We both were not convinced at that time that Labtests systems and processes were appropriately established for them to commence administering the contract. We were proven correct.

If I had have been involved in the original decision I would also have argued for two providers in the region,  not one when the contract was tendered.

Brian and I were instrumental in Medlab subsequently being given part of the contract when it was clear that Labtests were not meeting the service levels required.

 

Regards

 

Ian Ward