The image represents a closed-loop ecosystem of money circulation in the name of accreditation and quality—where public money flows upward, while quality never flows back to the patient.
At the very beginning of this cycle is the patient. Patients pay medical laboratories with the expectation of accurate results, safety, and competence. This payment is public money, often coming directly from individuals or indirectly through insurance, public health programs, or employers.
Stage 1: From Patient to Medical Laboratories
Medical laboratories collect money from patients for diagnostic services. In theory, this money should support:
• Competent manpower
• Robust quality control
• Reliable testing systems
• Continuous improvement
In practice, a significant portion of this money is diverted toward maintaining certificates, not improving competence.
Stage 2: From Laboratories to Accreditation Bodies
Laboratories are compelled—commercially and regulatorily—to obtain accreditation. As a result, large sums are paid to accreditation bodies, many of which operate as private, revenue-driven entities.
For private accreditation boards, this money directly becomes:
• Corporate profit
• Business expansion capital
• Market capture tools
Quality becomes a sales promise, not a measurable outcome.
Stage 3: From Accreditation Bodies to Regional Cooperation Bodies
Accreditation bodies, in turn, pay fees to regional cooperation organizations such as APAC and EA to gain legitimacy, peer recognition, and pathway access to global arrangements.
At this level:
• Money is spent on international meetings
• Conferences are organized in premium locations
• Delegates travel frequently under the banner of “harmonization” and “peer evaluation”
The discussion is about numbers:
• Number of accreditation bodies
• Number of accredited CABs
• Number of economies covered
Not about actual quality outcomes.
Stage 4: From Regional Cooperation to ILAC
The cycle culminates at ILAC, the global face of laboratory accreditation.
Here, public money—originating from patients—finances:
• International travel
• Global conferences
• Luxury venues and hospitality
• Closed-door meetings
Professionals within this system enjoy:
• Foreign travel
• Conference privileges
• Institutional prestige
All funded indirectly by patients who still receive unsafe, unreliable, or inconsistent laboratory results.
The Silent Consensus
At every level of this chain:
• Money is distributed among stakeholders
• Each stakeholder benefits financially or institutionally
• No one asks uncomfortable questions
There is a collective silence on real quality, because questioning quality would threaten:
• Revenue streams
• Membership numbers
• Expansion models
• Survival of the ecosystem itself
Big Talk on Quality, Promotion of Commercialisation
Publicly, the same organizations:
• Deliver speeches on “quality culture”
• Publish statements on “competence and trust”
• Promote slogans like “global confidence”
Privately, the system is driven by:
• Growth targets
• Accreditation counts
• Market penetration
• Commercial sustainability
Quality is spoken, not measured.
Quality is promoted, not verified.
The Final Outcome: ZERO Quality for the Patient
The image ends where it began—with the patient.
Despite paying at every stage of the chain, the patient receives:
• No assurance of technical competence
• No guarantee of result accuracy
• No accountability when errors occur
The cycle is complete:
Public money is fully consumed.
Quality output is ZERO.
Conclusion
This is not a failure of one laboratory or one accreditation body.
It is a designed ecosystem, sustained by:
• Commercialisation
• Mutual silence
• Numbers-driven success metrics
As long as this cycle remains unquestioned, the system will survive beautifully—while quality quietly dies.
About the Author
Dr. Sambhu Chakraborty is a distinguished consultant in quality accreditation for laboratories and hospitals. With a leadership portfolio that includes directorial roles in two laboratory organizations and a consulting firm, as well as chairman of International Organization of Laboratories ( An ILAC stakeholder organisation), Dr. Chakraborty is a respected voice in the field. For further engagement or inquiries, Dr. Chakraborty can be contacted through email at info@sambhuchakraborty.com and contact information are available on his websites,https://www.quality-pathshala.com and https://www.sambhuchakraborty.com , or via WhatsApp at +919830051583