Cost-cutting puts heat on lab tests

19:02, Jun 03 2014

Doctors are being asked to curb lab tests as part of a tightening squeeze on the Wellington health dollar.

Capital & Coast District Health Board has sent a memo to all its doctors, telling them to think more carefully about how much a test costs - and whether it is needed for their patients' care.

According to a DHB report, the memo came with a list reminding doctors of the cost of radiology and lab tests. It was suggested doctors do fewer monitoring tests on patients, and cut out tests that were considered unlikely to yield a positive result.

With limited health dollars, doctors needed to treat "every clinical decision as a financial decision", the report said.

It comes as the DHB scrambles to fix a sudden "fiscal deterioration" before the end of the month to avoid a budget blowout for this financial year.

The DHB has declined to disclose how far it is off budget, but a report into its hospital expenses alone showed that, in the year to April, the DHB was tracking about $11.8 million off target, with a deficit of $17.5m.


Last month, DHB interim chief executive Debbie Chin asked hospital staff to come up with cost-cutting ideas, urgently take annual leave and avoid using casual staff until the end of June. She has assured staff the cuts would not affect patient care.

Most doctors who spoke to The Dominion Post yesterday supported a tighter rein on lab tests, saying there were many well-meaning but unnecessary tests requested.

Shawn Sturland, who chairs the DHB's clinical practice committee, said cutting tests could even improve patient care, as well as saving money.

There were obvious double-ups when the same tests, some of which could be harmful themselves, were requested twice by different doctors, he said. "Doing a test that is unnecessary means someone else potentially misses out."

But Deborah Powell, national secretary for three medical unions, disagreed. She said the DHB was clearly putting cost savings before patient care.

"Doctors don't order tests on a whim, they are ordered for reasons of patient care."

Many CCDHB staff were deeply cynical about the cost-saving drive, she said. "It is a knee-jerk reaction. You save money for six weeks and then what?"

The DHB has been running multimillion-dollar deficits since 2007, peaking at $67m in 2009, and regularly receives emergency top-up funding from the Ministry of Health.

By last year it had clawed the deficit back to $9m through aggressive cost-cutting, but not without controversies. Three chief executives have quit in the past seven years, with at least one protesting the deep cuts forced on the DHB.

The Dominion Post