Pathology services are to be overhauled

BMJ 2006; 333 doi: (Published 10 August 2006) Cite this as: BMJ 2006;333:318
  1. Michael Day
  1. London

    The government has announced a complete overhaul of England's pathology services.

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    A candidate for privatisation?


    The move was prompted by last week's publication of a report of a review of pathology services chaired by Patrick Carter, a Labour member of the House of Lords. It concluded that pathology services were “fragmented and inefficient.” Lord Carter called for better transportation of samples and greater efficiency in notifying patients of results.

    To achieve this, his report says, much better computer links between doctors and pathologists are needed, and pathology laboratories need to be freestanding organisations akin to NHS trusts.

    The health minister Norman Warner said that the report's key recommendations would be piloted in 12 hospitals around the country from January next year. Lord Warner said: “We need to look for substantial efficiency gains through new ways of working that can be fully implemented in 2008-9. I am looking for at least a 10% gain.”

    The Royal College of Pathologists backed the report's recommendations. It said, “If we don't modernise pathology—for example, cervical smears, blood tests, biopsies for cancer, diabetes testing—as this report says then patients in the United Kingdom won't benefit from the same standard of diagnosis that other countries in Europe and the West offer. This means that doctors will find out what's wrong with patients later and less accurately.”

    Lord Warner also raised the possibility of greater involvement of the private sector in pathology services. He told the Government News Network (, which provides communications expertise to the civil service and government, that plans to reform pathology services included “bringing in new providers of pathology services, especially in regard to routine tests.”

    This proposal brought a less enthusiastic response from the college, which said that Lord Warner was clearly going further than Lord Carter's recommendations. “The report is very cautious about privatisation. The Royal College of Pathologists welcomes that caution,” said the college's vice president, Peter Furness, professor of renal pathology at Leicester University.


    Review of NHS Pathology Services in England is at

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