A call for proposals by Alberta Health Services to consolidate cervical cancer lab testing in Alberta has Red Deer lab technologists worried about their future and the safety of women.
Red Deer Regional Hospital Centre has seven cytotechnologists who spend most of their time testing pap smears.
“The problem with centralization is you end up increasing the volume wherever it goes and the higher the volume, the greater the possibility for mistakes in any step along the way — transportation, reporting, processing them — all of it,” said a Red Deer cytotechnologist on Tuesday who did not want to be identified, for fear of repercussions.
Removing the cytology lab would also separate biopsy testing, which would continue to be done in Red Deer, from pap smears so pathologists can’t immediately compare the results side by side for better analysis, she said.
“It’s like all tests, you need to see the whole picture to have a final diagnosis.”
On Feb. 6, Red Deer updated service with liquid-based cytology equipment funded through the David Thompson Health Region Foundation.
“We’ve got the latest technology. (Alberta Health Services) wants us to have a 72-hour turnaround time. Right now, we’re two or three days and that’s really unusual for a cytology lab because it’s not uncommon to run two weeks to a month behind,” she said.
Three years ago, David Thompson Health Region recruited staff and beefed up its cytology lab to cover its growing region.
Under the rules of the proposal competition, David Thompson could compete to provide service to rural Alberta either in the south or in the north.
But either way, it would lose part of David Thompson, despite being set up to serve the entire region.
“They’ve broken up the rural services so that our region is cut in half. We can only compete for the northern half, without Red Deer city, or the southern half with Red Deer city,” said pathologist Dr. Tony Morris, a longtime Red Deer lab employee, who was not speaking for the lab.
“Without any consultation. Without any evidence of expertise. Without any fiscal or financial arguments, Alberta Health Services asks us to play in this competition for outcomes that don’t make any sense.”
Morris said Red Deer did submit a proposal, but believes it’s a forgone conclusion that labs in Calgary and Edmonton will win.
“I honestly think Alberta Health Services is trying to do its best with its mandate. I’m quite sure of that. However, if they want to make change they need to consult. They need to be accountable for the cost of change and for the results of change.”
“They haven’t demonstrated the expertise or any kind of research or basis that this is the way to go, that the people of Central Alberta will be better served to have their work go to Edmonton or Calgary,” Morris said.
The Calgary and Edmonton labs are the largest. Red Deer is the third largest at 43,000 pap smears per year.
Alberta Health Services spokesman Rob Stevenson said Tuesday it’s premature to even say cytology will be consolidated.
“We’re talking about a maybe. There’s no concrete decision one way or the other about the consolidation of services. There’s simply a request for proposals to look at all of the benefits and recognizing, if there even are benefits, if there would be a direct cost saving through consolidation.”
And it if does go ahead, Red Deer’s hospital could be one of the sites chosen, he said.
Concentrating testing at fewer sites would reduce the duplication of expensive equipment and opens up the possibility of using more of the latest technology, he said.
Existing labs with liquid-based cytology would retain their equipment for nongynecologic cancer testing.