So why did our lab workers strike for a 15th time last week?
Health workers are a dedicated lot that we all know have an inbuilt dedication to serve our patients and colleagues through good and bad. It is no wonder that many of our most prominent health professionals are the most valued and respected figures in our communities.
Then why on earth has such a large and critical essential health workforce seemingly been part of endless strike action over the past 18 months across New Zealand? This is, after all, the workforce that were celebrated worldwide as the "unseen heroes" of the Covid-19 pandemic.
Are they being greedy and unreasonable, or are things just extraordinarily bad inside our labs? Let’s set the scene for our Otago/Southland region.
Back in 2007, the then Otago and Southland DHBs, led by respective chairmen Richard Thomson and Dennis Cairns, and Minister of Health Pete Hodgson signed off the first major pathology services outsourcing (I prefer that term to privatisation) of publicly funded pathology services in New Zealand.
The pathology contract was awarded to locally owned and operated Southern Community Laboratories (SCL) after a tender process and the then DHB public laboratories across the Otago/Southland region were disestablished.
Since then, SCL has morphed several times as the result of corporate takeovers and on-sells as part of various national and international market changes. Awanui is the end morph of SCL and is responsible for all the publicly funded pathology services in the Otago/Southland region. Awanui is part of a nationwide bundle of privately run laboratories that make up around 65% of the national publicly funded pathology market.
Awanui is the largest of the three private laboratories doing publicly funded pathology work — the other two players are Medlab and Pathlab. All diagnostic pathology services for medical reasons are publicly funded by Health NZ Te Whatu Ora (HNZ) out of a budget for pathology of around $670 million. HNZ has inherited the previous DHB outsourcing contracts negotiated by individual past DHBs.
Clearly this has put HNZ in the unenviable position of being left to sort and untangle the myriad different regional outsourcing approaches that have included significant duplication, service inefficiencies and competitive posturing between the three private companies involved (Awanui, Medlab and Pathlab) and the remaining HNZ public laboratories.
Back to the worker issues. In October 2023, Minister of Health Dr Ayesha Verrall announced that signing of the pay equity deal for the public sector allied health and scientific health workers who had sex-based professional disadvantage proved as part of a long-standing historical claim.
This included medical laboratory scientists and technicians who were part of a national workforce that is 80% female. This confirmed what most of us knew already: our laboratory workers had been underpaid for years and years.
This claim was backdated to July 2023 and saw employees working with the HNZ public laboratories all gaining significant salary adjustments and progression criteria improvements that were mandatory and consistent across their workforce. This in real terms for most equated to an approximately 20-25% salary adjustment with a jump in merit steps instantly built in for technical specialists.
Unfortunately this agreement, despite all pathology services being publicly funded by HNZ, did not transfer to our outsourced (private) providers — who, it is fair to say, were caught in a difficult situation. It was made even more difficult because these workers employed by private laboratories were already being paid significantly less than their HNZ colleagues doing exactly the same publicly funded essential health work within public hospitals.
In dollar terms, this adjustment across the private laboratory providers equates to around $500 less per week for historically low paid predominantly female laboratory workers. Since the backdated July 2023 timeframe, this means these workers have missed out on a minimum of $45,000 per employee.
This money is highly unlikely to ever be retrieved and the meter is continuing to tick.
Our private laboratory workers have rightly been very agitated by the lack of progress in any advancement of this massive disparity by all involved parties over this time. The current industrial action is all around gaining parity with our HNZ colleagues, who incidentally are as frustrated as anyone over this avoidable discrepancy.
From a professional view this has created an obvious two-tiered pathology system, with issues such as recruitment and retention within the private laboratories being magnified and accentuated.
All regions in New Zealand which outsourced their publicly funded pathology services are now directly affected by this continuing deterioration in their laboratory workforce and services they are historically contracted to provide. There is a lot of politics, corporate posturing and lack of intent that has frustrated and added fuel to this significant dispute for all to deal with.
My plea as always is for this major issue to be resolved so we can start building back the workforce to where it should be. HNZ has been gifted an ideal opportunity to totally overhaul and transform how we govern and fund our pathology services, and finally have everyone with the same songsheet.
It should never be left up to the lowest paid and already stressed, exhausted and pushed to the limit health professionals to be the meat in this sandwich in such a major dispute. We should all be expecting more from those in high-ranking positions who need to show the genuine compassion and empathy that has been sadly lacking for this desperate workforce.
Otherwise the reality for everyone is obvious as this workforce simply has no other option than to withdraw the only thing that matters, at great personal and professional cost.
My challenge for health and political leadership is a direct and sensible decision that ends this madness. Then we can avoid the 16th day.
• Terry Taylor is a specialist medical laboratory scientist and past president of the New Zealand Institute of Medical Laboratory Science (NZIMLS).
