Bendigo Health has revealed it is now seeking expert advice about the closure of the hospital’s microbiology lab, amidst widespread disquiet about the move among medical staff.

Senior clinicians this week called urgent meetings with management in the wake of the decision, raising concerns about what they say is a “huge risk” to patient safety.

One senior doctor, who spoke to the Bendigo Advertiser on condition of anonymity due to concerns about their future employment at the hospital, said the lab’s closure could have potentially fatal consequences for the health service’s most vulnerable patients.

“The most impacted patients are likely to be those that are critically ill, children and those with cancer, who have reduced immune systems, because in those people time to treatment with antibiotics, the right antibiotics, is the most critical,” they said.

“So the delay there will have a huge impact on patient care and potentially on their survival.”

The laboratory’s operator, Australian Clinical Labs, told staff last week the company had reviewed its regional sites and made the decision to centralise all routine microbiology testing currently performed in Bendigo at its premises in the Melbourne suburb of Clayton.

A hospital spokeswoman yesterday declined to answer specific questions about the impact of the loss of on-site microbiology services in Bendigo but said the hospital was now seeking “expert third-party advice” on the “proposal by ACL”.

Compounding concern about the changes is what hospital staff say was a lack of consultation with senior medical personnel prior to the decision, by both Bendigo Health and ACL, who they say did not speak to "one single clinician” before laboratory workers were informed of the move last week.

“It wasn't discussed with infection prevention controllers or with the infectious disease consultant that's on a part-time contract here, or any of the hospital staff,” the senior clinician said.

“How you can possibly make decisions that have such a huge clinical impact without discussing it with the clinicians is beyond me.”

The senior doctor said a multi-disciplinary pathology steering committee, convened to guide the management of the transition from publicly-provided pathology to a private model and ensure good clinical governance around the contract between Bendigo Health and ACL, was completely frozen out of the process.

“Not one of the clinicians on that steering group was informed of this decision, there was no discussion with them at all,” they said.

A spokeswoman for ACL said urgent microbiology would continue to be performed on site at Bendigo, while non-urgent microbiology tests would be redirected to the company’s 24-hour laboratory in Melbourne.

“We don’t expect there will be significant changes to turnaround times,” she said.

But the anonymous hospital source said the lab’s closure meant urgent testing would now be the responsibility of general scientists, who lacked the highly-specialised training of microbiologists, which had already resulted in delays.

“It’s the equivalent of a GP being expected to provide a specialist opinion, they're general scientists, they're not specialists, we’re losing all our specialists who are highly trained in microbiology and the already-overworked general scientists are being expected to pick up those extra services,” they said.

“We’ve already seen a number of issues even in the last few days, they’ve been under immense pressure to provide those specialist reports and there’s been a lot of confusion and delay in getting the actual diagnoses because they haven’t been appropriately trained.”

Another clinician, who also wished to remain anonymous, described the closure of the services as “ludicrous”, with doctors often consulting the microbiologists several times a day, even when dealing with a single patient.

“It’s a fundamental part of our toolkit in clinical decision making,” they said.

“It’s sort of up there with X-rays.”

The comments come after former pathology director at Bendigo Health, Vince Murdolo, who now holds the same position at the Royal Hobart Hospital, joined the pathologists union, the Medical Scientists Association of Victoria, in speaking out against the privatisation of the sector last week.

Dr Murdolo warned the lab’s closure was an example of how increased privatisation of pathology services would gradually “shave away” at services, and the senior anonymous source agreed the model was a poor fit for a city the size of Bendigo.

“It’s very hard for microbiology to generate an income, so from a private company perspective it makes sense to get rid of microbiology, but as a public service provision it’s absolutely essential to provide safe patient care,” they said.

“Should a large hospital have a private pathology lab? Probably not, because it doesn’t make patient care sense.”

But the doctor said the financial hit the hospital would take if pathology services were returned in-house would be offset by better outcomes for patients.

“If you look at how private pathology services work, they are looking at their service in isolation, so they’re businesses that need to make a profit and they are only looking at what is the revenue that comes in for those services and the cost of those services, whereas for public hospitals you actually need to look at the overall service provided to the patients and one area might not earn much revenue but that’s offset by other areas that perhaps have greater revenue generation,” they said.

“If you’re looking at it financially, in reducing morbidity, mortality, length of stay, all those things have financial implications for the hospital that offset the cost of those services.”

The ACL spokeswoman said the pathology services that Bendigo Health chose to fund in either an on or off-site capacity was a commercial decision for the hospital.

“Outsourcing to Australian Clinical Labs provides the hospital with access to specialists and leading technologies it would not have access to if pathology was in-sourced,” she said.​

For their part, the senior clinician who spoke to the Bendigo Advertiser believes if the decision is not reversed soon, the opportunity may be lost forever.

“If we lose the microbiologists now it’s going to take about 10 years to get the experience back again,” they said.

“If we lose them now, they’re so highly-skilled, we’re going to have a vacuum of expertise and we all know how difficult it is to get people to regional and rural areas.”