In a bid to slash its overwhelming backlog of cancer tests at its Johannesburg facility, the National Health Laboratory Service (NHLS) – which receives about 4 000 specimens a month – has approached the private sector for help, reports BusinessLIVE.
The NHLS is considered the backbone of the public health system, providing tests used to diagnose and monitor diseases ranging from HIV to cervical cancer. But State patients in Johannesburg can wait as long as three months for the results of cancer tests, forcing them to delay treatment and potentially jeopardising their health and its success.
In the private sector, the results of urgent cancer biopsies are usually delivered within 48 hours, said PathCare CEO John Douglass, which already provides anatomical pathology tests to the NHLS in East London.
Now the NHLS had approached PathCare to gauge its capacity to help alleviate the load in Gauteng, according to its co-ordinator for histopathology, Fabio Crabbia.
“How much we can take on depends on our current capacity. We are going to help. And I am sure the other laboratories will help too,” he said.
DA MPL Jack Bloom sounded the alarm about the crisis earlier this month, and after visiting the NHLS histology laboratory at Charlotte Maxeke Hospital last week, said the facility was “desperately short-staffed”, with just four pathologists compared with the 15 employed five years ago.
The total backlog stood at almost 14 300, with 1 540 specimens in formalin waiting to be processed and 12 756 processed specimens waiting to be reported on.
“The biopsy backlog should never have been allowed to get so high, with unacceptable waiting times for cancer cases and other life-threatening cases,” he said.
The NHLS had committed to outsourcing the most urgent tests to the private sector, which could potentially do up to 3 000 tests a month, Bloom told BusinessLIVE.
Collaboration essential
The NHLS said collaboration was essential for maintaining services, but declined to comment on the terms of its contracts or its financial arrangements with private providers.
It attributed the cause of the backlog to shortage of pathologists, but the high volume of placental specimens being sent for testing was adding to the strain. It receives about 4 000 new specimens a month, including 400 placentas.
Tests on placental tissue can be used to determine whether a chronic condition during pregnancy, like uncontrolled hypertension or an infection, rather than an acute event shortly before or during childbirth, might have contributed to an adverse outcome.
Placental testing has spiked after guidelines issued by the SA Society of Obstetricians and Gynaecologists, which were open to interpretation, Crabbia noted. However, although placental testing was not necessary for low-risk pregnancies with healthy babies, many doctors were ordering tests anyway to protect themselves against potential medical negligence claims.
The NHLS said it was discussing a policy on placental testing with the Health department, to streamline referrals and ensure more efficient management of specimen volumes.
See more from MedicalBrief archives:
SA’s NHLS in ‘critical condition’
Private labs help NHLS through cyber crisis