After her departure to go as chief executive at the Reading hospital, the chief executive of the Dorset County Hospital. Jean O'Callaghan wrote a letter to the Dorset Echo on 25 July 2014 making certain statements about the Dorchester Pathology Laboratory tendering process. The letter is reproduced here with answers to each point by the Dorset Health Campaign.
Letter from Jean O'Callaghan, Dorchester Hospital Chief Executive
In light of the ongoing publicity surrounding Dorset County Hospital’s pathology services tendering project I thought it would be helpful to give your readers some further background information.
J O'C - The most important thing to emphasise is that pathology services will not close at Dorset County Hospital, whatever option is taken after the tendering process.
DHC - We do realise that a small part of the pathology lab will remain in Dorchester hospital whatever happens. However when we asked a question at the DCH hospital board meeting in May, we were told that this would be the testing services to maintain infection control. That surely will be only a very small percentage of the 103 posts in the current pathology laboratory.
J O'C - It is also important to understand why we are looking at options.
We have experienced a number of issues recently, which highlight the increasing difficulties of providing high quality and sustainable pathology services:
An inspection of blood services by the Medicines and Healthcare products Regulatory Agency resulted in us being under special measures for a number of non-compliances and the threat of a ‘cease and desist’ order, which would prevent all surgery from taking place. We have worked hard to improve this position including reallocating funds to mitigate the risks;
We have struggled to consistently meet turnaround times;
DHC - As for non-compliances in recent quality inspections, we noted that at the same hospital meeting it was stated that excellent progress had been made to put this right. Moreover none of the many staff we have spoken to at all levels within and without the hospital have complained about any of the services provided, including turnaround time. They have all been very happy with the service, although some did not wish to be quoted. It is notable that a group of twenty five GPs in West Dorset have recently written to the Dorset Echo saying how happy they are with the pathology laboratory service, including its rapid turnaround times; They certainly would not like to see such major changes to the pathology services.
J O'C - We have difficulty recruiting to highly specialised roles such as histopathologists;
DHC - It is not surprising that there have been difficulties in recruiting staff given that path lab staff were told a year ago about the very likely run-down of the lab.
J O'C - Increasing competition from other lab services providers;
DHC - Regarding competition from other lab service providers, presumably Jean O'Callaghan is referring to the effect on business from GPs in West Dorset. Well as readers might have seen from the local GPs letter to the Dorset Echo, they do not want the Dorchester Path lab service to go elsewhere. One reason is perhaps that this would surely mean less competition with likely higher prices for the GPs.
J O'C - Ongoing capital investment will be required but capital is limited and the board needs to prioritise this expenditure.
DHC - It would be interesting to know how much extra capital expenditure is foreseen for the pathology lab and in what areas. When a private company took over the pathology laboratory at the Bedford Hospital when Jean O'Callaghan was chief executive it ran into financial difficulties plus there were many quality problems.
J O'C - In addition, The Lord Carter reports of 2006 and 2008 recommended pathology services be consolidated to improve quality and highlight the impossibility of every hospital in England maintaining a stand-alone pathology service. The regulatory quality pathology standards rise incrementally each year and these standards, and the increasing level of technology, are becoming more challenging for the hospital to meet.
DHC - The Lord Carter report recommending centralisation of pathology services can only be a generalisation and may not apply well to the Dorset road transport topology. This Carter report was dragged out in Essex last year to justify a plan to move the pathology services some distance to the Bedford hospital. The plan was eventually ditched after 20,000 signatures from the public via the Essex Echo and letters from GPs and consultants to the health secretary. The Essex pathology lab did not seem to have a problem with rising standards and from what we hear from speaking with the Dorchester pathology lab staff, they are more than happy to take up the challenge of meeting these standards.
J O'C - The trust is using a tender process to see if the existing pathology service is providing best value. We have the option of going with a bid or leaving our service as it is.
DHC - At the hospital board meeting in June we asked why the pathology lab was not being allowed to put in a bid against the private companies. Jean O'Callaghan’s answer was that the pathology lab service was not good enough to meet the requirements of the tender specification so they could not join the competition. Given that answer, it seems rather unlikely that the bidders could be told that none of them could provide a service as good as the current hospital pathology lab and therefore their bids would be rejected.
J O'C - The outcome of this process will not be finalised before the end of September 2014 and it will be the trust board that takes the decision. The trust is following a procurement process governed by European Union Directives. The project team has been rigorous in adhering to best practice and the core principles of procurement, one of which is transparency.
DHC - We asked for a copy of the tender specification to see, among other things, what in this specification the current hospital pathology lab might not meet. Our request was rejected on the grounds of confidentiality. At the last hospital board meeting in July we asked what were these points of confidentiality. After several questions there were no satisfactory answers provided. Finally “EU regulations” were mentioned but there was no answer as to which EU regulations. Finally the board hid behind the statement that they were following legal advice; we were told that it was open to us take legal action to challenge the board’s refusal to reveal the contents of the document.
J O'C The specification has been written by trust pathology and support service staff. Tenders submitted by potential providers are being evaluated by 16 panel members representing the key disciplines.
It is incumbent on the board to look at all possibilities and it would be negligent in its duties to ignore a service that we will struggle to maintain at the standards expected and where guidance points to a number of alternative sustainable models of care.
DHC - In reply to the need “to look at guidance pointing to other alternative sustainable models of care”, well we must say that these particular models did not work very well when the path labs at Bedford and in London were privatised resulting in major quality and financial problems.
Jean O’Callaghan, Chief Executive Dorset County Hospital, NHS Foundation Trust