A German pathology provider, synlab, is attempting to establish itself in the UK. Here, Hugh Risebrow provides an overview of European pathology provision, and how this could inform UK thinking on the subject.
All developed economies are currently facing similar challenges to contain spending in the face of the bottomless pit of demand. Rightly or wrongly, pathology is often a soft target for budget cuts in all health economies. This is possibly because pathology cuts are less likely to be noticed by patients/voters, and possibly because pathologists are less vociferous than other groups.
At the same time, there is a shortage of scientific and medical staff working in pathology across Europe, with some NHS laboratories already struggling to fill out-of-hours rotas. Sadly, pathology is not seen as attractive by many scientists, when in reality it can offer a varied and challenging career, with the satisfaction of being a vital component of the treatment pathway of most patients. Long, drawn out consultation and reorganisation processes do little to attract more into the profession.
The Audit Commission first called for pathology reform in 1993, followed by two reports by Lord Carter of Coles in the past seven years. Carter conservatively suggested potential savings of over £500million per annum from the creation of a hub-and-spoke model. However, despite many inter-hospital reviews of pathology services, very few NHS laboratories have been merged. The old NHS East and Midlands region is tendering GP direct access pathology as a lever to persuade laboratories to rationalise, and possibly as a market entry route for private sector competition. Currently, synlab is bidding on two of the Midland’s regions in partnership with NHS organisations.
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