NHS pathology labs are ripe for privatisation and cuts

“Every sample is a patient … Every sample is a patient …”

I repeat it like a mantra, so that amid the relentless workload we don’t lose sight of who we work for. We say it as we navigate crumbling floors – in one of our labs, a hole in the lino flooring has been patched up with heavy-duty gaffer tape.

In my work, I see only names, not faces. But every sample is a patient, and every patient has hopes, fears, family and friends. Doctors and nurses get to see their charges in the flesh, whereas I see only the flesh. Paramedics and porters see the blood spilt, I see only the blood. Some names become familiar – a premature baby on the neonatal unit, a 90-year-old with a broken hip – but we never see them recover, never witness the reunions and taxi rides home. Not that my colleagues and I need it, but we never hear their thanks. When we stop receiving their samples, we can but hope for the best.

I work in a pathology laboratory and they are involved in 70% of all diagnoses within the NHS, but very little of what we do is known to the public, or indeed, to many of our healthcare colleagues. We are the definition of behind the scenes, providing doctors with the vital information they need to assess and treat patients.

We are the definition of behind the scenes, providing doctors with the vital information they need to assess and treat

The inner-city microbiology lab where I work as a technician processes thousands of samples a week, from A&E departments, GP surgeries, intensive care, maternity units, and everywhere in-between. We run a full seven-day service (including bank holidays), and with biomedical scientists covering the lab throughout the night, I’m happy to say that we make a mockery of Jeremy Hunt’s calls for a 24/7 NHS.

Sadly, and as with the NHS as a whole, we are short-staffed, under-funded and often ill-equipped. I’m often expected to attempt the workload of two members of staff. What little morale remains is nurtured from the ground up, an esprit de corps forged in a shared adversity, and in taking inspiration from colleagues going about their duties with a quiet efficiency.

Throughout the day porters and couriers deliver a constant stream of samples that are immediately triaged. Urgent specimens are processed within a matter of minutes. What might seem to the untrained eye to be an overwhelming mound of bloods, swabs, tissues and every bodily fluid imaginable is swiftly organised; well-rehearsed procedures are carried out so that every diagnostic test is performed with the minimum of delay.

The sheer amount of equipment and consumables necessary for the lab to function often surprises visitors and those new to the job. The NHS is truly a system, with every part reliant on the other. The labs do not stand alone, and indeed, would be worthless if they did so. Just as the pen is of little use without the paper, so the NHS cannot treat its patients without laboratories. The staff themselves are of course any lab’s greatest asset, a biomedical scientist needs years of education and training to become qualified.

Even though it can be difficult to find a moment in which to draw breath, we are forced to confront our fears about the future. The vital ancillary services of estates, cleaning, security and portering (to name but a few) have been tendered out to the private sector within the trust where I am employed, as they have been across the wider NHS.

Financial pressures are causing more and more laboratories to merge, and it is now the case that many individual trusts no longer directly own their pathology services – instead there are “joint ventures” and “partnerships” forced to bid against one another for customers and business.

While efficiency savings are possible, fewer labs equal longer transport times, and longer transport times equal potentially life-threatening delays. At night, our (private) courier company sometimes has to send a driver from 30 miles away to bring an urgent sample to the lab from a hospital five miles from us.

Given how behind the scenes we are, and how fragmented the NHS is becoming, there is an acute dread that pathology is ripe for the picking in terms of
the work we do being tendered-out to private contractors, or the joint ventures themselves morphing into entities no longer under the control of NHS trusts.

We want to cooperate with our colleagues, not compete against them, even if not many realise what we really do. We want to use the best diagnostic tools, not the cheapest ones. We want the time to treat every sample we receive as a patient, not a commodity. Help us to help you.

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NHS pathology labs are ripe for privatisation and cuts