'It's created a monopoly': MLA calls on province to ensure Dynacare has competition for lab services

Liberal health critic Jon Gerrard will table a petition in the Manitoba Legislature Thursday, urging the provincial government to address Dynacare's monopoly of lab collection service in Winnipeg.

American-owned Dynacare bought out Unicity Labs in December and now owns 62 diagnostic labs across the city — all of the labs in Winnipeg that do blood and urine work, except for those in hospitals. Forty lab sites were closed in the buyout; 19 of them were Unicity labs; 21 were Dynacare. 

The petition has garnered more than 500 signatures from patients, doctors and clinic owners — primarily from clinics in Winnipeg that lost their labs — who say the results of the buyout are affecting patient care and patients' ability to get their lab work done.

"It's really inconveniencing a lot of people. It's created a monopoly of laboratory services in medical clinics," said Gerrard, the MLA for River Heights. 

He said while many patients needing blood work used to have a one-stop shop, those at clinics that no longer have a lab must trek first to the clinic, and then often wait for their lab work at one of the remaining Dynacare labs. 

The community of La Salle, just south of Winnipeg, has been drastically affected, Gerrard said, as people now have to travel to Winnipeg, Morris or Carman for blood work. 

"We've got people who are sick, we've got seniors, and we've got people who are going to see their doctor who may not be easily able to jump in a car," he said.

"Or we've got people who have very busy schedules and have lined up just a certain amount of time to go see their doctor.… They're being forced to spend another hour or two or three in running around and getting the blood work done that they thought they were going to be able to get done at the clinic."

The petition will urge the province to either create opportunity for competing private businesses to set up labs in city, urge Dynacare to reopen labs, or mandate Diagnostic Services Manitoba, which only does hospital lab work, to set up labs in some of the vacated private-clinic lab spaces.

Competition best for patients: physician

Gerrard said he recently met with the owners of seven clinics in the city who are concerned about Dynacare's buyout.

"I think that competition in this area would ultimately be best for the consumer, the client, or the patient in this case," said Dr. Tim Ross, medical director for Bison Family Medical Clinic in Winnipeg.

"So that people have more choice, but also so there's greater access to services, and also so that there's more accessibility."

He said he's not seen much change in the service that Dynacare has provided at his two locations since the buyout, but his clinics are not directly affected because they retained their labs. 

"They have a monopoly of lab services, and even though we've historically been well served by them, I have my doubts that Winnipeg will be well served going into the future with one provider," said Ross.

Health Ministry to meet with Dynacare

Health Minister Kelvin Goertzen said he's aware of some of the concerns raised in the petition and officials from the department will be meeting with Dynacare Thursday to discuss some of the accessibility challenges expressed both publicly in the petition, and privately from within some Dynacare labs. 

While it is not realistic for a lab site to be on every street, he said, he doesn't want the transition to impact patient care.

"We don't want people to be overly inconvenienced," he said.

While there are no immediate plans to mandate Diagnostic Services of Manitoba to operate out of some of the vacant lab spaces in clinics, he said the government may step in down the road to encourage a more open market, and he wants more public discussion and input on the issue.

"We'll work with Dynacare at this point," said Goertzen, when questioned about concern over their monopoly of lab services in Manitoba. "This is a relatively new environment."

Expanding company

Dynacare is owned by Lab Corp, an American company based out of Burlington, North Carolina. Its Canadian locations are operated out of Brampton, Ont. with 200 locations in Saskatchewan, Manitoba, Quebec and Ontario.

According to its website, it offers blood collection, urinalysis and electrocardiography, or ECG, services. It bills Manitoba Health when services are not covered by insurance. 

"We take it very seriously. We're very sorry that people have been inconvenienced by the transition," said Scott Hickey, vice-president of communications for Dynacare, adding that 'most patients' are happy with the service.

"We will be meeting with the ministry," he said. "We've developed a strong reputation. Our mission is to support healthy lives and commitment to care." 

Dr. Jenisa Naidoo, medical director for Dynacare in Manitoba, said the La Salle clinic has been identified as a site where accessibility to lab services has become an issue, which they're addressing, perhaps by introducing a mobile phlebotomy service to that site.

Both Naidoo and Hickey said they want the public feedback, and are open to making changes to improve, where appropriate. 

"We still feel the pressure to be even better," said Hickey, in response to questions about having no competition in the Winnipeg market.

During the transition phase, they are encouraging patients to go to their website to find one of the 62 locations that are open, and in close proximity. That number may change to streamline care and close some of the low-volume sites.

By comparison,  Saskatoon and Regina have five Dynacare collection sites, and Calgary has  15. Dynacare is the sole service provider in Regina too, according to Hickey.

Although lab services in Manitoba have historically been an open market, Gerrard says the government has some capacity to regulate them. He will have patients and clinic staff with him to present the petition in Question Period Thursday.

"I think the government needs to be very concerned that there should be competition and there should be a level playing field, and I think the government needs to look at this very closely."