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ORIGINAL FRENCH ARTICLE: La mort sur ordonnance des labos de proximité

by Alexandra Chaignon

Death on Prescription for Local Analysis Laboratories

Translated Monday 27 June 2011, by Isabelle Métral

By 2013 at the earliest, or 2016 at the latest, most of our small medical analysis laboratories will have been driven out of business by monstrous juice collectors. And so for instance on January 1rst, the laboratory in Penmarc’h (5,600 inhabitants), the second largest borough in the Bigouden country in Brittany, was definitively closing down...

Patients have now to drive seven miles to Pont-l’Abbé. The same thing happened in Bourg-sur-Gironde (2,209 inhabitants) where the laboratory shut up shop on March 1st. In both cases the teams were transferred to a group into which several structures were integrated.

The origin of that devastating overhaul was a reform of the branch of medical biology. following an edict published on January 10, 2010 aimed at restructuring the sector. Under the pretext of “improving the quality and security of medical tests”” the edict recommends the regrouping of analysis centres by 2016, after a period of transition from November 1, 2013 when the laboratories will have to prove they have prepared themselves for the change. The deadline might be put off by two years. The edict also submits the laboratories to a compulsory process of accreditation, failing which they must close down.

The idea was for France (where small structures coexist) to evolve towards large medical analysis poles as in Northern European countries. Whereas Germany, with 80 million inhabitants, numbers 150 laboratories, France by comparison has 4,000 for 65 million inhabitants.

Under the pressure and lobbying of financial groups

Secretly concocted under the pressure and lobbying of financial groups hungry for new opportunities [1], the decision was made after the European Commission put in a claim against France before the Court of Justice. It is clear that the Commission criticized the prohibition to non-professionals from investing capital in more than two medical analysis companies. In theory, under the 1990 Sel law on professional companies, a non-professional cannot own more than 25% of a laboratory. But in practice the limit has largely been outstripped: the Murcef law passed in 2001 allows an investor to bypass the legislation by encouraging the 100% buying out of laboratories through several successive transactions. “This method has always existed, but with this reform it’s going to accelerate,” predicts Patrick Lepreux, president of the “Angry Biologists’Collective”.

In practice, this reform will impose “compulsory regroupings on laboratories together with inordinately, and unnecessarily high, quality standards that are excessively costly”, this Marseille laboratory biologist declares. It will be a blow to him. This threatens to “drive 75% of the 4,000 French laboratories out of business within a short time.(…) There are so many Bourgs-sur-Gironde all over the country.(…) It will cost a lab from 60,000 to 70,000 euro to bring each unit up to the norms (the work surfaces for the dosing of sugar, or for urine tests etc.). It’s next to impossible to meet the costs,” the biologist explains.

The avowed aim of the reform is the closing down of the 3,000 small laboratories with turnovers of under 500,000 euro. These are to be turned into mere sampling centres and to make way for two or three laboratory chains where patients will be considered as mere bar codes and their blood samples as industrial products. And yet, as the Communist deputy Marie-George Buffet observes, “analysis laboratories play a major part for being the first stage before the patient is fully taken in charge by the health system, (notably) in the rural areas.” Which is why Marie-George Buffet ultimately denounces this evolution as being the very opposite of the approach to the health system for men and women that prioritizes proximity.” [2]
Officially the Ballerau edict defends the quality of tests within a European framework and the rationalization of pubic health expenditure. But, as Patrick Lepreux points out, “the profession represents 2% of the total medical insurance outlay, namely 3 billion euro. The cost is far from being heavy.” And in the end it is the patients that will bear the consequences by losing a local medical service, but then only 80% of diagnoses result from medical analysis tests!

[1Four international groups -Unilabs, Labco, Novescia or Bionmis - are ready to pounce on this juicy market and absorb whatever independent structures that exist in France. They are funded by investment funds. Unilabs resorts to to the practice called "dismemberment oof ownership", which reserves the dividends to the investor and the property without usufruct to te previous owner, who is is thus turned into a salaried partner, with no real economic leverage. See article on the next page (page 3) in l’Humanité for June 27

[2To this must be added the proven fact that tests done by automats to the rate of 1,000 a day are more likely to be faulty: see article on page 3 in l’Humanité for June 27.

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