This proportionately low volume, combined with the significantly different characteristics of paediatric specimens compared to those of adults, means that a highly sophisticated expertise and specialized knowledge base is required to support the investigation of the many rare and more widespread diseases that primarily affect young children. In Toronto, this is especially true for childhood cancers, where virtually all the molecular testing done on solid tumours is at The Hospital for Sick Children. Because of the urgent need to develop new diagnostic tests for such diseases, special Ministry of Health recognition and funding must be forthcoming. Ignoring young children ignores the impact of their diseases on the years of life lost. If the child has a cancer that suggests a familial trait, then the extended family and future children will benefit from this knowledge.
Children have unique illnesses, illnesses that are virtually always diagnosed early in life.
Leukemia, cystic fibrosis, and genetic disorders of the metabolism such as Tay Sachs disease are common examples. Those who work in an adult hospital lab or private lab do not see enough of these illnesses to become competent in either the routine detection and monitoring of childhood problems, nor in the testing requirements of small children. At The Hospital for Sick Children we have received no acknowledgement from the Ministry of Health that paediatric laboratory medicine is providing an essential, critical service to the children of Ontario and requires special consideration when examining models of regionalization. We still await a response to our proposal that existing centres of excellence in paediatric laboratory medicine in London, Ottawa, Kingston, Hamilton, and Toronto form a network to preserve paediatric expertise. The trend in Ontario is to move laboratory testing to factories located in one or two designated areas.