With 25 private labs serving the public health-care system in Winnipeg set to close in the coming weeks, medical and policy experts fear the four new "super sites" replacing them will be inaccessible for some patients.
"The distances are quite concerning," said Dr. Alan Katz, director of the Manitoba Centre for Health Policy at the University of Manitoba's Rady Faculty of Health Sciences.
It’s the second round of closures announced by Dynacare, the company that bought Unicity Laboratory and X-Ray Services two years ago and subsequently shuttered 21 lab sites.
Except for hospital-based laboratories, Dynacare owns all facilities in Winnipeg that carry out services such as blood collection and urinalysis.
"People are anticipating there's going to be continued and worsening hardships, particularly for seniors," said Liberal MLA Jon Gerrard.
"The 'super sites' are farther from any people," said the longtime River Heights representative who was a practising physician. "Winnipeg is a winter city — you need special consideration when people have to be getting tests at times when temperatures are very cold."
People needing blood or urine tests in the northern part of Winnipeg had nine Dynacare lab locations in the area, including Leila Avenue, Main Street, Mountain Avenue, Keewatin Street and McPhillips Street. Soon, they will have just one — opening later this month at 2211 McPhillips St., at Garden City Shopping Centre.
Katz, who is also a family doctor, is concerned closing labs will make it harder for people to get needed medical tests.
“People are anticipating there's going to be continued and worsening hardships, particularly for seniors.” – Liberal MLA Jon Gerrard
"I have worked at clinics where the lab is in the same site — you go down a floor or two, or to a corridor to have access to a lab. If it's more efficient (to get there), you're more likely to have a test done," he said.
"Saying to a patient, 'You have to travel four kilometres or six kilometres to have a test done' means the likelihood of that test being done is reduced."
Dynacare countered Wednesday, saying the switch to four large sites benefits patients and its employees.
"There will be no changes to the lab services, and our larger, newer sites will have longer hours and more employees — which will help us improve our ability to serve patients," company spokesman Mark Bernhardt said in an email.
In the city's downtown, Dynacare's City Place lab location is closing and will be "integrated" into the Winnipeg Clinic at 425 St. Mary Ave., Berhardt said.
In September, the company issued a "partner update," saying it was investing in the shift to four larger "super sites" to improve "patient experience" and provide a "safe and enjoyable" workplace for its employees.
"These new, larger super sites are conveniently located, have ample free parking, will be open longer hours including weekends, and will have many employees to service the collection needs of patients."
The move won't help people who don't drive and can't easily access transportation, said Katz.
"Not everybody has a car," he said. "Lots of people come to clinics by bus. For them, this is a huge burden."
In central Winnipeg, eight labs — Roblin Boulevard, Stafford Street, Taylor Avenue, Kenaston Boulevard, Scurfield Boulevard, Pan Am Clinic, and two on Corydon Avenue — are being replaced later this month by one lab on Sterling Lyon Parkway (at Seasons of Tuxedo).
In west Winnipeg, two labs are closing and will be replaced by a super site opening next month at 3653 Portage Ave. (Unicity Mall).
In south Winnipeg, six labs — Dakota Street, St. Anne's Road, Autumnwood Drive, and three on St. Mary's Road — will be replaced by a new super site at St. Vital Centre next month, Bernhardt said.
The concern is who the system exists to serve, and who benefits from making lab services more efficient, said Katz.
"Clearly, from a lab perspective, there are efficiencies in closing smaller labs and putting them in a central spot," the Manitoba Centre for Health Policy director said.
"This is something they've been doing in the the public system, as well," Katz said, adding those savings go back into the public system. "When a private provider does it with public funding, the savings go toward the profits of the provider."
The cure, Gerrard said, may be some healthy competition for Dynacare.
"There should be an option. When you have competition, companies work hard to provide better service."
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Updated on Thursday, December 5, 2019 at 9:47 AM CST: Corrects that Jon Gerrard was a practising physician