After months of delays, the official handover of community laboratory services from Alberta Precision Laboratories to DynaLIFE took place on December 5. With that, the political tug-of-war within and over Alberta’s medical laboratory system enters yet another round, but Albertans are the ones who will lose out.
Successive governments have destabilized the system with knee-jerk changes, from a cancelled contract to outsource lab services to Australian corporation Sonic, to the planned establishment of a wholly-public provincial system, to the demolition of those plans and the Edmonton hub lab already under construction, culminating in – surprise – a return to a scheme of further privatization, which Albertans had already rejected twice over and that is in no one’s interests but the shareholders’.
Albertans wondering about what the new arrangements will mean to them have been reassured that they won’t even notice the changes, as DynaLIFE already had a near-monopoly on non-hospital testing. But the company is assuming even more sway over medical testing and training in Alberta, with concerning implications for patients, workers, and the sustainability of our lab system.
In January, a study from Parkland Institute found that not only would further outsourcing save less money than claimed but also AHS had not conducted a cost-benefit analysis comparing privatization to the fully-public option already in the works. The study surveyed laboratory professionals working in DynaLIFE and Alberta Precision Laboratories (APL), who expressed concerns about the sector’s capacity to adapt to yet another ideological makeover. Their fears appear well-founded, as the transition has placed more stress on an already overstretched workforce.
The changes are sending ripples throughout the sector, as laboratory services across Canada are experiencing a staffing crisis due to a perfect storm of factors: a demographic shift in the workforce that has its roots in the Klein era cuts; Covid-related departures from the profession (burnout linked to increased workload, increased risk, and fewer resources); and a bottleneck in training spaces.
Student practicum hours are on hold as DynaLIFE doesn’t have sufficient staff to accommodate them. Meanwhile, NAIT – which recently saw DynaLIFE CEO Jason Pincock appointed to its board of governors – has been told it needs to increase seats in the program by 50% by September 2023.
In response to these pressures, DynaLIFE has been shifting to “in-house” training that doesn’t adequately prepare employees for all the technical aspects of the job, deskilling and downgrading roles as workers with technical expertise and experience are in short supply.
The shortage of staff has already forced temporary closures at collection sites, most recently in Medicine Hat. The risks posed by short-staffing, hasty training, and facility closures are delays in diagnosis and testing errors. Both have potentially deadly consequences.
Despite claims by AHS that Albertans will see no change in their access to services, small and medium communities are already seeing closures of collection sites and new facilities delayed. Other communities will see the loss of outpatient lab services at their local hospital – including all hospitals in the Edmonton zone.
Patients will be “redirected” to DynaLIFE. This has implications for turnaround times. Hospital labs are currently able to process STAT specimens (time-sensitive tests) onsite. Now, patients will have to go off-site and their sample will need to be transported, adding precious time to receiving a diagnosis. (DynaLIFE has also limited the types of tests that can be ordered as STAT).
The poor communication by DynaLIFE and AHS over this transition confirms what many lab professionals already knew: when public services are outsourced to private providers, transparency and accountability suffer. The public knows little about how laboratory services will be impacted, but even lab workers themselves are not being kept informed. Within APL, updates are limited to roles that are directly transitioning to DynaLIFE, with little context being provided concerning the system as a whole.
Physicians will also be impacted. Yet, even a DynaLIFE document intended to inform physicians of changes to essential processes around requisitions, collections, or ordering supplies was hopelessly vague. Under “Understanding Impacts in Your Community”, physicians were advised to “come back for more detail soon.” Whether this is a deliberate attempt to restrict information or merely another indicator of how ill-prepared DynaLIFE and AHS are to implement the logistics of the deal remains an open question.
This op-ed appeared in the Edmonton Journal on December 16, 2022.
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