Expert reports on the state of medical lab services in Edmonton make for grim reading.
Seventy per cent of major health decisions are based on a lab result, but Edmonton’s facilities are aging and outdated.
It’s not just the private DynaLife headquarters, which are crowded, stuck in a downtown office tower never designed to host a state-of-the-art lab. Equipment in Edmonton’s public labs is obsolete. More than three-quarters of the lab equipment owned by Alberta Health Services is considered to be at the end of its useful life, according to a 2017 report by the Health Quality Council of Alberta.
In that same report, experts call lab services the “fastest changing area of health care.” Scientists are constantly finding more precise tests, now using gene analysis to diagnose patients more accurately and earlier, with the promise of reducing overall costs.
But Alberta’s current system for regulating lab services is so fractured and political, decisions around new tests drag on and on, physicians say. It’s “as hard or harder” to get an outdated test removed. Even a simple decision, like moving all Alberta labs to the same test requisition form, had been under discussion for three years when the 2017 report was written. Alberta is falling behind.
I hope that puts UCP Leader Jason Kenney’s promise to cancel the new superlab and its new equipment in perspective.
Heavy equipment is on the construction site of the Edmonton Laboratory Clinical Hub, or “Super Lab,” east of the South Campus LRT station, 11330 65 Ave., in Edmonton on Wednesday, April 10, 2019. DAVID BLOOM /POSTMEDIA
Construction started on the $590-million project last month. Backhoes and bulldozers are preparing the site and retaining walls are being built beside the South Campus LRT station in Edmonton.
Kenney says he’ll save $640 million by also cancelling the $50-million contract to buy out DynaLife. But does he think the status quo with end-of-life equipment is an option? Public labs across Alberta need reinvestment whether it goes into a single new building with DynaLife included or not.
The lab situation has a long and tortured history.
In the mid-1990s, Alberta went through mass consolidation and former premier Ralph Klein cut laboratory services by 40 per cent. In Calgary, that led to a new public-private partnership, a centralized Calgary lab service.
In Edmonton, that didn’t happen, likely because two major hospitals are run by a separate provider, Covenant Health. Lab services stayed fractured, and eventually Alberta Health Services signed a 15-year contract to have DynaLife handle all the community-based lab work.
In the 2010s, Alberta Health Services decided to contract with a private company to create something like the Calgary lab in Edmonton, with consolidated hospital, academic and community lab services. It was going to be a 15-year, $3-billion contract with significant reinvestment.
Major multinational corporations bid on it, seeing little Edmonton as a toehold into the Canadian market. Three were shortlisted and an Australian corporation was picked. But DynaLife took the province to court in frustration and won. A judge ruled the bidding process was compromised.
In May 2016, a new government, the NDP, announced the public superlab model as one part of a plan to integrate services across the province. The Edmonton hub would work in partnership with Calgary. The common lab network, with a shared information system, would give researchers access to a vast quantity of population-level data, something unthinkable in the fractured, private network of American hospitals.
Alberta Health Minister Sarah Hoffman unveiled the location for a new integrated public lab facility in Edmonton on Dec. 21, 2017. LARRY WONG / POSTMEDIA NETWORK
Kenney says he supports the new information sharing system, but is undecided on whether to keep the new oversight body, Alberta Public Laboratories. He argues Alberta will get better results through choice and competition with private players, rather than one public monopoly.
At the end of the day, both public and private models have benefits. Private companies are more likely to prioritize capital investment as key to ongoing success. In Calgary, for example, the private-public central lab was eventually bought out by Alberta Health Services and saw its capital budget decrease to 10 per cent of what it had been. Now 60 per cent of its equipment is considered end of life.
University of Calgary pathologist Dr. Jim Wright watched the NDP plan with some trepidation. In a 2018 opinion piece for Academic Pathology, he wrote about the benefit of the public model: province-wide integration. It promised to come with a strong, science-based board to take politics out of decision making. That could make it nimble, allowing Alberta to invest in new technology to cut expenses and increase patient care, while capitalizing on research potential.
I’m not impressed with Kenney’s plan to cancel the deal, especially when he has no plan but the status quo to replace it.
He accuses the NDP of being ideologically motivated — stuck on the idea that health care must be entirely public. I hope his own ideology doesn’t blind him just as much.
Sure, it makes a good campaign speech to announce $640 million in savings. But that’s a fantasy. Fixing Edmonton’s medical labs is much more complicated.