Whatever happened to New Labour ? This sounds more like Old Communism !!.
The history of the last 100 years has shown that we make progress through
market forces, diversity and competition. The communist experiment with 10
year plans (sounds familiar) and standardisation lead to stagnation. Trevor
Tickner raises an important issue in relation to equipment procurement. We
need choice and competition to drive development. If we all have the same
equipment and use the same methods, it may all look neat and tidy, but
surely it is through people challenging conventional thinking that we make
progress.
Clinical Benchmarking has shown that larger laboratory organisations are NOT
more efficient. In fact they tend to be less efficient. This is probably due
to the difficulty of managing larger organisations. The span of control
becomes too large and managerial inefficiencies arise. A similar pattern was
shown by the York Health Econmomic Group a few years ago when looking at the
optimum size of hospital trusts.
To take the experience of PathLinks and apply it nationally is naive. This
was a group of similarly sized hospitals, with no major Teaching hospital
amongst them, who all stood to gain by working together, particularly by
bringing work back into the county.
I am not, in principle, against groups of hospital labs working more closely
together and have been involved in a similar set-up in Northumbria with 3
labs working together in the same Healthcare Trust. We have introduced a
common laboratory computer system (which I believe is the key step in labs
working together) and have done most of the other things outlined in the
Pathology Modernisation paper. However, to extend this principle to StHAs
would, in my view, be unworkable in many areas.
Paul Griffiths
Consultant Biochemist.
Northumbria Healthcare NHS Trust.
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