Expectation Continues To Override Investment In The Medical Laboratory Workforce

When the New Zealand Institute of Medical Laboratory Science (NZIMLS) leadership presented the workforce crisis document on May 12th 2022 to the then health Minister Hon Andrew Little and met with the now Health Minister Dr Ayesha Verrall, we came away confident that we had been heard and the very real crisis facing our medical laboratory sector, and pathology in general, was a priority for the government, and in fact all of Parliament.

Whilst we accept that the health system in its entirety is struggling, the medical laboratory workforce has paid a substantial personal and professional price, both during the height of the pandemic and now into the post-pandemic phase. This vital health workforce had justified expectations towards positive change to their predicament over the past 12 months based on Manatū Hauora directed sector assessment recommendations. Unfortunately for this dedicated health workforce sector no change has eventuated. The total registered workforce numbers for 2023 are expected in the next month and it will be no surprise to the NZIMLS to see another significant drop in national workforce, as was seen last year.

The 2022-2023 report card for progress on the recommendations made by the NZIMLS to the Minister in 2022 would get an ‘E’ grade at best. Is that acceptable for such a critical cog in the health sector?

• Formal Ministerial support for mandating the Medical Laboratory Workforce Training Group with the authority to implement policy directives for addressing staffing shortfalls. Working group set up but no progression transferred to the frontline.
• Workplace conditions (including remuneration), career progression and qualification recognition require urgent attention to address poor staff retention. External professional development funding needs ring-fencing within current laboratory service contracts. No progression.
• Māori and Pacifika recruitment require prioritising and incentivising to address longstanding cultural inequities. Partial progression with initiatives taken up by University input.
• Short term immigration cover for hard to fill positions should be supported, under strict independent oversight. The caveat for NZIMLS support for this, is that a significant funding input into training New Zealanders needs to be mandated and resourced immediately. No significant progression due to sector pay rates being too low to meet thresholds.
• Review the strict division between research facilities and diagnostic services to allow collaboration and potential sharing of staffing and resources. No progression.
• Diagnostic laboratory providers must be open and transparent regarding allocated government funding for training, education, and future proofing. No progression.
• Changing provider workplace culture from the ‘keep them lean and mean’ workforce staffing approach to prioritising staff wellbeing and addressing physical and mental fatigue. Negative progression.

“The reality is that many of our most experienced scientists and technicians continue to leave the profession due to poor remuneration, complete lack of career and education progression intent, inferior work conditions and grim future prospects in the current pathology environment” says Terry Taylor the President of the NZIMLS.

“The inertia and complete lack of action in addressing historic and systemic issues that continue to plague our pathology sector, is making it difficult for practitioners to see any positive future. This is a huge concern for those of us fighting to have the stability of our sector taken seriously” says Taylor.

Pathology and laboratory services are an essential cog in a stable and well-functioning health and disability system. Most clinical decisions and all cancer diagnoses rely on quick accurate and readily available laboratory testing.

The reality facing our creaking health system is visible outwardly for all to see. However not so visible, behind the closed laboratory doors, is a sector in just as much trouble as frontline health services. How this plays out for patients is longer wait times, delays in diagnosis and issues accessing critical services.

The driving force behind the high-quality service provision in the face of these challenges, is the unquestionable dedication of those scientists and technicians who are left doing more with less, and continuing to keep things on track as best they can. It is long overdue that this commitment and dedication be rewarded by ensuring the most basic expectations are met.

I wonder what the report card for 2023 – 2024 will read?

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