Hate to Say I Told You So, But…

When the newly-elected United Conservative government directed Alberta Health Services to cancel the Edmonton Hub Lab already under construction, lab workers were apprehensive. They told us the lack of modern space and equipment would have system-wide ripple effects and entrench the already widespread infrastructure deficit. When the UCP claimed the ‘savings’ would be reinvested into ‘frontline’ healthcare, lab workers told us their resources were already cut to the bone. Meanwhile, the costs of penalty clauses and site remediation were shrugged off as expendable millions.

When, mere months later, the UCP announced an out-of-the-blue name change for the AHS-owned lab subsidiary APL — from Alberta ‘Public’ to Alberta ‘Precision’ Labs — lab workers told us it was a portent of further privatization and a devastating about-face on the plans to centralize lab services under a wholly public system.

When, during a once-in-a-century pandemic, politicians praised lab workers for going above and beyond to provide round-the-clock Covid-19 testing, and then dropped a Request for Proposals to outsource community lab services, lab workers told us the UCP government did not understand or value their role in every day medical diagnosis or in managing a public health crisis. They told us they would continue to use their skills, expertise, and the best available scientific evidence to manage the pandemic and keep our primary healthcare system running — at significant risk to their own health. They also told us they were already near breaking point.

When consulting group Ernst & Young told us this outsourcing would save over $100 million per year, while AHS figures indicated a drastically smaller potential savings of $18-36 million, lab workers told us those false economies would come at a cost. They told us that the plan would impact patients, increasing waiting times, reducing access to collection sites and certain tests, and risking delays in diagnosis. They told us the costs of the plan would be borne by themselves and their colleagues in moral injury and burnout (as workers were encouraged to prioritize volumes over thoroughness), in lost seniority and stability, in reduced benefits, in loss of pension plans, and in increased workload (as staff teams were split and new procedures imposed). They told us yet another reversal of policy would further destabilize a system that had still not fully recovered from catastrophic policy decisions over two decades and multiple governments.

So when the successful proponent of the RFP, DynaLIFE, announced that the transition of services from APL would be delayed by six months as they simply did not have the staff capacity to implement the changes, lab workers said, “I told you so.”

When, following the transition in December 2022, wait times for routine community collections skyrocketed in places like Calgary and surrounding zone, Medicine Hat, and rural communities, when STAT testing became a Kafka-esque process sending patients from their previous hospital outpatient labs to DynaLIFE and back to the hospital lab, when heartbreaking mistakes and indignities were heaped on Albertans in their most vulnerable moments, lab workers said, “I told you so.”

When the union representing both APL and DynaLIFE lab workers, HSAA, had to beseech the Labour Relations Board to ensure that transitioning workers would continue to receive their pension contributions, when it attempted to hold DynaLIFE to its commitment to provide equal pay and benefits for incoming and existing workers — to no avail —, lab workers said, “I told you so.”

When newly-transitioned DynaLIFE techs revealed they were instructed to double-bill AHS for missed home collections appointments, when APL pathologists expressed concerns over certain testing being phased out in hospitals as DynaLIFE does not process them, and when decisions with medical implications became increasingly predicated on financial grounds, lab workers said, “I told you so.”

When continued staffing shortages (up to 200 vacancies as of April 2023) at new DynaLIFE collections sites generated negative headlines and AHS offered up APL staff to alleviate the pressure, lab workers said, “I told you so.”

Public workers and public resources are now being diverted to bail out a private, for-profit corporation — one that refuses to pay its workers the same wage as those coming to their rescue.

This exhaustive and exhausting litany of entirely predictable disasters is not presented here to lionize lab workers. They don’t want a medal, even if they deserve one. It is to tell Albertans that these SNAFUs are not accidents: they are the inevitable result of deliberate policy choices on the part of the UCP.

The goal was never to create better laboratory diagnostic services prioritizing quality patient care and a thriving workforce. It was to win an ideological battle, shave a few theoretical zeros off the balance sheet and hand them to a private company, even if the costs to the public far outweighed the benefits.

What is the alternative? What can demoralized lab workers and tired, frustrated Albertans hope and fight for?

The wholly public, hub-and-spoke, province-wide system proposed by the Health Quality Council of Alberta and adopted by the Alberta NDP in 2017 still represents national and international best practice: an evidence-based, viable plan for an effective lab system for the province. With the days of this election campaign ticking down, the contending parties are not talking about labs. Should the UCP win a second term, Albertans can expect more of the same across our healthcare system. The ANDP has given no indication that they intend to return to their public plan should they return to government. They may feel, pragmatically, that the financial and political costs are too great. Lab workers, however, tell us that the benefits for Albertans would be much greater.

Perhaps it’s time to listen to them.

 

Image credit: Photo by CDC on Unsplash