Medical professionals across Quebec are sounding the alarm about the provincial government’s plan to centralize all medical laboratories. Hospital personnel and union leaders have been summoned to meetings in medical establishments throughout Quebec about the government’s controversial Optilab project.
Optilab is part of a provincial reorganization of laboratory services, intended to save tens of millions of dollars a year. The government has set up 11 high-volume processing centres across the province, including at the McGill University Health Centre and the Centre hospitalier de l’Université de Montréal.
“We are worried and we are waiting,” Carolle Dubé, president of the APTS union which represents some 5,000 lab technologists, said in an interview. “We do not think the problems we are concerned about have been resolved.” Once Optilab is fully functional, Dubé said it will require the transportation of about 70 per cent of all test samples to centralized hubs and that is a risky business — especially since there were about 61.2 million lab tests carried out in Montreal in 2014-15, and 191 million throughout Quebec, according to the health department.
Increased transportation of samples boosts the likelihood of error or lost or ruined samples, said Doris Levasseur Bourbeau, president of the Ordre professionnel des technologistes médicaux du Québec. “These are critical, life and death samples,” Bourbeau said in an interview. “If the sample is lost, there could be serious consequences.”
A press aide to Health Minister Gaétan Barrette said the system is designed to provide the best, most efficient services. It is being implemented gradually, said Julie White, and there should be no short-term job losses, although positions may be reduced through attrition. No hospital labs will close.
Alberta Health Services (AHS) plans to buy out the private laboratory testing company Dynalife and transfer the services back to the province, effectively ending private lab services in the province.
AHS is expected to hire all Dynalife staff, including unionized lab workers and non-unionized managers. Dynalife employs about 1,200 people and provides lab testing services for Edmonton and northern Alberta.
AHS and Dynalife are expected to have a transition plan in place by Oct. 1, 2018 and a system for working out any disagreements.
Last month, Alberta Health Services announced it would extend Dynalife's laboratory services contract for another five years, a decision Hoffman said would allow an AHS administrative team to explore options for an "integrated system provincewide."
Dynalife runs northern Alberta's primary testing facility and 27 community sample collections sites in Edmonton and surrounding area, along with five collection sites and four health centre locations in northern and central Alberta.
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At the centre of the debate at the Centers for Disease Control and Prevention (CDC) is one of the leading experts on Zika virus, Robert Lanciotti chief of the lab responsible for developing tests to diagnose viral diseases. Lanciotti was demoted in May after he raised concerns inside and outside the agency about the CDC’s decision in the spring to recommend a new test for Zika. That test was substantially less effective than another established test, he said, and misses nearly 40% of Zika infections. He also said the agency withheld information about testing differences from state and local public health laboratories. The scientist was reinstated to chief in July after he filed a whistleblower retaliation claim.
The questions raised by Lanciotti prompted an internal investigation by the CDC who acknowledged in their report that testing for Zika is difficult and needs to be improved. The agency said it made improvements that will boost the new test’s sensitivity. The internal investigation also found that the CDC acted reasonably when it withheld the conflicting test data from state public health labs. Releasing it could have created “considerable confusion during an ongoing emergency response,” the investigators said. In a statement late Tuesday, the CDC said it had conducted a thorough independent investigation and determined the allegations were not substantiated by the evidence. The agency said it remains committed to providing its public health partners with the best available science and tools to combat the epidemic.