Details of the approach by Clinpath – SA’s largest private pathology firm – are documented in an increasingly-terse series of emails seen by InDaily, in which the company claims it was responding to a request for assistance from government-owned SA Pathology, but sought some government funds to increase its capabilities.
The first message was sent on March 30, after SA had recorded its highest weekly spike in new COVID-19 cases – adding 162 of its current 427 total in the preceding seven days, although with the rate of increase tapering off.
The message – sent from Clinpath CEO Dr Fergus Whitehead to several recipients including Health Minister Stephen Wade, chief public health officer Dr Nicola Spurrier, Treasurer Rob Lucas and Liberal Party fundraising director Maurice Henderson – is prefaced with a subject header: “Clinpath providing assistance with PCR testing in the current COVID-19 pandemic”.
We watch with our hands tied as… our offers to assist this state, even with other routine tests, have been ignored
PCR [polymerase chain reaction] tests are used to directly detect the presence of an antigen, rather than the presence of the body’s immune response.
Whitehead notes that “all states have private pathology options for testing other than SA”.
“I have been phoned by [SA Pathology Clinical Service Director Dr Tom] Dodd re help for COVID testing or help with other PCR tests so they can concentrate on COVID testing,” he writes.
“The more COVID tests done and the better the turnaround time, the easier it is to isolate the infected patient and trace contacts.”
He explains that “for Clinpath to help we need to set up electronic report delivery and billing with SA Pathology to make the testing seamless”.
“This takes time but it is necessary for us to help,” he says.
“Currently I have been provided no contacts within SA Health to progress these necessary processes.”
He adds that it would “make more sense” to set up two laboratories equipped for COVID-19 testing as “in crisis situations it is important to have redundancy of important services”.
“If one laboratory temporarily goes down through staff sickness and isolation, another can keep testing,” Whitehead notes, adding that because necessary reagents were currently being rationed by federal and state governments, “we would need the State Government to support COVID testing at Clinpath” via an official directive.
“Once a government directive for us to test COVID is achieved we can access help… to access reagents and help to set up testing,” he writes.
“We are in a position to double [testing] capacity over a relatively short time frame.”
Whitehead says it would take four weeks to build additional lab space, “which will require $160k”.
“Currently all private pathology laboratories are seeing significant revenue reduction – up to 40 per cent – which make us all loss making [and] as with all businesses we will have to instigate cost base mitigation activities,” Whitehead continues.
“Cash flow will only get worse if further restrictions are introduced [so] a government grant to help this upgrade and increase testing capacity would be beneficial and would ensure increased testing during this crisis.
“It is small amount of government money compared to what has already been spent during this crisis [and] the more COVID testing that can be undertaken with timely results will help the public health effort and I believe is vital to navigate SA through this crisis as effectively as possible.
“Winter approaches and this is when the health system is most utilised, particularly if COVID exhibits a seasonal resurgence. Usual respiratory viral testing and COVID testing will become paramount at this time to identify and isolate COVID-19 cases.
“I hope the Government will give consideration to private pathology involvement in COVID testing in SA as they have in other mainland states…
“I understand that the recent reduction in COVID positive numbers shows promise, however, in my opinion in any crisis situation it is better ‘not to put all your eggs in one basket’ and [instead] to ‘hope for the best and prepare for the worst’.
“I hope you are all getting enough sleep and looking after yourselves at this very difficult time.”
The initial correspondence was also addressed to Premier Steven Marshall, although there is some doubt as to whether he would have received it as there was a typo in his email address.
However, he was a CC recipient of a subsequent email and attached letter – addressed to Wade and dated three weeks later, on April 20 – that shows the Clinpath CEO’s patience wearing thin.
Your lack of a response is bewildering and shows a complete lack of respect
“Dear Stephen, I have written a few times now (3 including this correspondence) with no response. I wonder if you could respond anytime soon. Fergus,” the email reads.
The attached letter notes “this is the third letter/email I have sent to you and the second to the premier and the treasurer… You have not dignified me with a response.”
“I am a senior medical specialist in anatomic pathology and the CEO of the largest private pathology provider in SA, Clinpath Pathology which is a subsidiary of ASX-listed Sonic Healthcare,” the missive continues.
“Your lack of a response is bewildering and shows a complete lack of respect as to the intent of my previous correspondence.”
Whitehead goes on to detail Clinpath’s expertise before reiterating that a sharp reduction in testing volumes – “and hence revenue” – caused by social distancing measures and elective surgery bans has forced “cost mitigation [to] preserve cash flow”.
“Meanwhile we watch SA Pathology recruit an anatomic pathologist, phlebotomists and scientists – and we have been approached by SA Pathology to temporally [sic] employ our staff who have reduced hours at Clinpath,” he writes.
“It was only six months ago when in the press you were asserting that SA Pathology was inefficient, needed to reduce its budget and raised the possibility of privatisation, and now you are espousing its virtue and bloating its staffing levels and cost base even further… all this extra resource and expense to test for one virus without emphasising the importance private pathology plays in the maintenance of the health of the South Australian community.”
Whitehead asserts “we watch with our hands tied as our interstate pathology laboratory partners in Sonic Healthcare all support with their local state health departments, and yet our offers to assist this state, even with other routine tests, have been ignored”.
“I would have thought redundancy and capacity for COVID testing was important to sustain or increase testing during this winter, especially if COVID exhibits a seasonal resurgence,” he adds.
He also notes that through mediation from Australian Medical Association SA president Dr Chris Moy, Clinpath was allowed to assist with “some Enteric PCR testing and were told to expect 200 samples per day”, however the samples never arrived in sufficient volume and “have subsequently stopped being sent without explanation”.
“To process an additional 200 specimens required planning in our microbiology department, including bringing in extra staff… this is lack of communication is completely unprofessional and shows a complete lack of respect for our organisation and our staff,” Whitehead writes.
“Your lack of response suggests to me that the state Liberal Government has no interest in South Australian private pathology and don’t view it as an essential service.
“Moreover, your actions lead me to believe that you have changed your view of SA Pathology and now believe it to be highly efficient and the only pathology service worthy of your support.
“I appreciate your time is valuable and you have many pressing issues and challenges to face. However, I am a senior pathologist managing a pathology practice under significant duress that is essential for medical management of disease in the South Australian community.
“I have tried to communicate with you and to be completely frank you have completely ignored me and what Clinpath currently provides to SA and what we could provide during this pandemic.
“Please behave in a respectful manner as a privileged representative of the South Australian public and allow me to meet with you so I can discuss these issues with you further.”
Another week later, on April 27, Whitehead took a different tack, writing to Marshall and Wade about a forthcoming “federal announcement in regard to increased testing capacity for COVID testing across all states and territories”.
“I noticed in the news the Premier was considering sentinel testing and the testing criteria have now been relaxed by the national cabinet… can I please discuss this with you so as to co-ordinate our efforts as a matter of urgency?” he writes.
He followed up with a further email 22 minutes later – adding several other recipients, including SA Health CEO Chris McGowan – pointing out there was “extra capacity for COVID testing… in the private sector [which was] about to come on line in SA at Clinpath”.
“I would like to co-ordinate COVID testing in this state with SA Health and SA Pathology in order to navigate out of the restrictions,” he writes.
“I need to talk to someone of influence in government as no one has yet responded to my previous correspondence.”
In a reply to all recipients, McGowan responds: “I will reply colleagues.”
Whitehead did not wish to comment on the correspondence when contacted by InDaily today, but confirmed he has now spoken to the Health Minister and believes the issues will be “sorted out in the fullness of time”.
“It’s not as dire as it was before,” he said.
InDaily contacted Henderson, the director of the Liberal Party’s fundraising arm FutureSA, who confirmed he had received some of the correspondence but had not followed up on it.
“I receive lots of emails from lots of people, because I’m connected to the Liberal Party,” he said.
Asked if Clinpath’s parent company, Sonic, was a Liberal donor, Henderson said: “It could be.”
Sydney-based Sonic has reportedly previously contributed $200,000 to the federal Liberals in both 2010 and 2013. It has since donated to both Labor and Liberal parties, backing Labor’s “save Medicare” campaign.
The Marshall Government was contacted for comment, with a response coming via SA Health, which said SA Pathology “approached Clinpath in mid-March to discuss COVID-19 testing availability, however we were informed Clinpath did not have capacity at this time”.
“South Australia is in a fortunate position of being close to eliminating current COVID infections, but a high level of testing and contact tracing will be required moving forward,” the agency said in a statement.
“SA Health is pleased to discuss how the additional capacity through Clinpath can be optimised.”
Just yesterday, in a Facebook post on his official account, the Premier identified “further community testing” as one of three critical things needed before restrictions can be eased.
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