Siting of pathology dept ‘blunder’

Press, 18 November 1981, Page 11

Siting of pathology dept ‘blunder’

The proposed siting of the new pathology department at Christchurch Hospital is a “planning blunder,” according to the hospital’s former director of pathology. Dr D. T. Stewart. Architect’s drawings of hospital development plans, including the placing of the pathology department on the Manse site, which is bounded by St Asaph Street. Antigua Street, Tuam Street, and Hagley Avenue, were approved by the North Canterbury Hospital Board’s works committee this week. A time table for the development has not been finalised but the board expects it to be completed in five to six years. The board’s initial plan to house the pathology department with other related departments in a six-storey building on the main hospital site was scrapped because of a Health Department restriction limiting the height of the building to four storeys. Dr Stewart, who retired as head of the board’s pathology services four years ago, said that the decision to put the department away from the main hospital building spelt “disaster*’ for the hospital. His assertions were contained in a letter to the editor of the “New Zealand Medical Journal” which was not accepted for publication. Dr Stewart said that pathology laboratories formed the largest of Christchurch Hospital's ancillary services. Last year tney had performed about 15

million, "work units” for ward patients, and outpatients. The delivery of test specimens and the return of reports on such a scale needed “the closest association” between patients and the laboratories. ”, Close association was important in activities such as blood transfusion, freezing material during surgery, and in other emergency work such as dealing with cases of poisoning. The present set-up enabled the microbiology section to take an essential role in ward cross-infection control. To establish separate laboratories for such functions within the main hospital would be a - waste of space, staff, and equipment. Pathology laboratories had a close involvement in teaching and there was excellent integration at present, with many pathologists sharing service and academic duties. This was easy because diagnostic laboratories were close to classrooms used for practical work, the museum, lecture rooms, and research laboratories. The development proposal would “wreck” this arrangement. Diagnostic work at Christchurch Hospital last year had cost more than $3 million. It was important that medical students, were encouraged to have easy access to diagnostic laboratories to appreciate the work and cost involved when a test was ordered and to be able to discuss the appropriateness and interpretation of a test.

Dr Stewart said, “most medical students will end up in practice outside the public hospitals, where last year laboratory services cost the taxpayer" more than $23 million. Education in the use of laboratory tests can save a great deal of public money.” Dr Stewart said that the pathology department should have priority in any budding planned for the space between the new ward and clinical services, block and the clinical school. “The Health Department’s recommendation (regarding the height of buildings) and. presumably, the acquiescence of the Hospital Board that the pathology laboratories should be relegated to the Manse site can only be described as a planning blunder . a disaster for Christchurch. Hospital.” The building-height restriction did not apply to other Government departments and he did not think that it should apply to Christchurch Hospital, where there were peculiar limitations of ground space. “The (Health) Department has never had any real interest in, or knowledge of, laboratory requirements. It has been tied by apron strings to the ‘mother country’ rather than accepting Kiwi capability and it appears to have failed to appreciate the ideal arrangements which could have been achieved in Christchurch.” Dr Stewart said that the recommendation was probably based on economy. But

a separate pathology building, divorced from the hospital. would be more expensive to build and the duplication of space, staff, and equipment would increase future capital and maintenance costs. A board source said this week that although it would have been desirable for the pathology department to be in the main building, there was no room there and because the department was a “composite functioning unit” it was the most feasible to shift. After the Medical Journal had rejected Dr Stewart’s letter, he sent it to the

chairman of the North Canterbury Hospital Board, Mr T. C. Grigg, who this week tabled the document along with his written reply to Dr Stewart. Mr Grigg said that the constraints that the Government had placed on the development or new hospital buildings were very rigid. The North Canterbury board was one of only a few tnat had any >big developments taking place. The Christchurch Hospital development and some developments within the Auckland Hospital Board’s area would be the only main projects to go ahead in New

Zealand in the foreseeable future. , ’■ If the arguments put forward by Dr Stewart had continued to be debated the board would still not have the approval to go ahead. Mr Grigg said. “We could argue for. many more years, expending a great deal of time and et»on and achieving very little. ” He was convinced that even though there were some difficulties to overcome, tne board had made “a great stride forward” in obtaining the long-awaited approvals to proceed with stage three of the development.