Blood disorder test breakthrough to save taxpayer

A GENETIC test for a blood disorder has been developed by a Cork hospital that will save the taxpayer millions of euro in the long-term.

But the development has also been hailed as a perfect example of what health service reconfiguration is all about.

“This is a perfect example of what we are going to achieve on a bigger canvas,” said Professor John Higgins, the director of reconfiguration for the HSE South. “This is the kind of positive outcome you get when you have key individuals working together to devise a better clinical service. This is a key component of reconfiguration.”

The three main hospitals in Cork had been outsourcing thousands of tests for haemochromatosis – an iron storage disorder – to private labs in Britain every year at a cost of up to €125 per test.

As part of the reconfiguration of the health service in the southern region, a better and more comprehensive testing system has been developed in Cork University Hospital (CUH) spelling the end of outsourcing.

Haemochromatosis is a genetic condition that causes people to absorb excessive amounts of dietary iron, which can lead to serious organ damage.

The condition is especially prevalent among the Irish and other Celtic people, and affects more men than women. The genetic test can identify the mutation in the gene responsible for causing the condition.

In 2008 alone, CUH outsourced 2,100 haemochromatosis tests at a total cost of €260,000.

The Mercy University Hospital (MUH) and the South Infirmary Victoria Hospital (SIVH) also outsourced vast numbers of the tests.

The new testing regime at CUH began in August and the results of an analysis of the pilot phase, which were presented to medics yesterday, show huge benefits.

The cost to CUH of haemochromatosis testing over the next 12 months will be just over €70,000 – a €180,000 saving compared to outsourcing. If this saving is repeated across the other hospitals, the overall saving to the taxpayer will be immense.

But the new system has also reduced the number of unnecessary tests thanks to strict new criteria.

CUH received 300 requests for the haemochromotosis tests between August and October 2009 – almost half the number of requests in the same period in 2008.

Of those, only 167 tests were performed because the others did not meet the agreed criteria.

Dr John O’Mullane, the Consultant Clinical Biochemist at CUH, chaired the clinical sub-group which developed the test system.

He praised Caroline Joyce, the principal clinical biochemist at CUH, for her work on the project.

He said the new system, which puts “the patient centre stage”, was developed because the sub-group comprised of medical experts from all three hospitals, GP representatives and Ursula Kiely of Haemochromatosis Society of Ireland, all agreed the way forward.

“This is proof of the benefits of a structured, cohesive and single service across Cork and Kerry and is proof of what reconfiguration can achieve,” he said.

“Reconfiguration is about delivering proper clinical governance and delivering a better quality of service to patients, but it also can also deliver value for money.

“I think this model is valid across the whole expanse of delivery of care in the region.”