Have you ever wondered what would happen if lab equipment at the King Edward VII Memorial Hospital broke down? It is not the sort of question that bothers most people and it need not be uppermost on their minds. There are other medical laboratories in Bermuda that carry out much of the same tests done at KEMH. Central Diagnostics Laboratories is in its 20th year of business. Starting out as a single operation it now boasts three locations, a mobile service and is showing signs of further expansion.

Founder Quinton Butterfield is a trained laboratory technician who is still enthusiastic about his work. ?I?ve always wanted to be convenient and that is one of our hallmarks,? he said.

The company does haemotology (blood testing), clinical chemistry, which includes urine testing, and serology which tests for a variety of conditions like hepatitis, mononucleosis and rheumatoid arthritis. Through liaisons with overseas labs, paternity and fertility testing are services that are also offered.

Patients may deal with Central Diagnostics directly or indirectly. Mr. Butterfield said the approach depends largely on the doctor. ?Some doctors schedule their patients to come to us and have their testing done, others take the samples in their office and we collect them,? he said.

Patient confidentiality is paramount to Mr. Butterfield. ?We want to keep tight control on our services and, while I cannot say that there is anything wrong with the courier services available locally, I feel I need to have as much control as possible over the service we operate so I employ my own courier who hand delivers our lab reports to the doctors and who picks up patient samples from the doctors? offices.?

Mr. Butterfield?s courier makes her rounds daily as he tries to get all test results back to doctors in 24 hours. He is able to achieve this for tests actually conducted in his lab but where tests have to be sent to one of Central Diagnostic?s reference labs overseas the turn-around time lengthens.

On a typical day about 600 blood tests are processed by Central Diagnostics. All the actual testing is carried out in the lab at the head office on Union Street in Hamilton. A lab at The Arches doctors? offices on Berry Hill Road is part Central Diagnostics. Fertility and many pregnancy related tests are carried out there by lab technician McLee Gibbons. A lab in Somerset is convenient for patients in the west end of the Island and has proved very popular, Mr. Butterfield said. He said the Somerset location is ideal for people who can go there first thing in the morning before getting to their jobs in Hamilton.

?I know that having a blood test is not a good experience for most people so I try to make is as comfortable and as convenient as possible,? Mr. Butterfield said.

And what could be more convenient and comfortable than having the test done in your own home? So, at no extra charge to most patients, Central Diagnostics offers that service for non-ambulatory patients and seniors. Wanda Butterfield, who is office manager, accountant and Mr. Butterfield?s wife, said the company has over 30 regular patients who utilise this service. Additionally, she said some doctors like the service for their patients who are recuperating at home and need a lot of rest or have difficulty getting out.

The company also regularly attends Lefroy and Packwood nursing homes for testing needs of residents there.

Due to improvements in Government?s Hospital Insurance Plan coverage, more seniors are now eligible to take advantage of the convenient service Central Diagnostics offers.

?The Government HIP now pays for lab services outside the hospital,? said Mr. Butterfield. ?I?m not sure that Government understand how fantastic the change they made in the HIP Plan is for seniors,? Mr. Butterfield said. ?I know that we personally benefit, but for many seniors it means they can now have the test done at home at no cost to them. Previously they had to go to the hospital in order for their HIP insurance to cover it.?

For sceptics who may feel that testing is best done at the hospital, it is important to note that the hospital often use Central Diagnostics to carry out some of their lab work.

The move is not unusual and Mr. Butterfield readily admitted that any testing that cannot be done in his office is sent to other local labs that can conduct the necessary test. ?We do refer samples locally. My philosophy is that Bermuda needs to be self sufficient,? he said. ? We don?t need babysitting by overseas labs.?

And to this end Mr. Butterfield is in the midst of having his facility and services accredited. ?We are in the process of writing quality assurance manuals. It?s quite a big process and within the next year we should be accredited,? he said.

He added: ?I need to make it clear that we do and have always done internal and external quality control tests. Every test we do we measure against a standard. And we also have unknown samples sent to us regularly by the College of American Pathologists (CAP). We send our results back to them and they are checked against our peers throughout the world and against what CAP know the value to be.?

At the moment Central Diagnostics does not collect or swab patients (except in paternity testing). Samples collected in this manner typically require a microbiology lab ? a facility the company does not have. Mr. Butterfield said: ?We don?t do microbiology at the moment but we are interested in doing that and will probably be doing that soon.?