It took one of the biggest scandals in the history of New Zealand healthcare to set women on the path to greater patient rights and better treatment.

The changes came about in 1988 following an inquiry into the 'Unfortunate Experiment', where some women died as a result of a trial on thousands of patients at National Women's Hospital from the 1960s to the 1980s to not treat early stage cervical cancer in the belief it did not develop into invasive cancer.

At that time in many hospitals in New Zealand anaesthetised women were used to train groups of medical students in vaginal examination without the women's prior consent or even knowledge.

Led by Dame Silvia Cartwright, the inquiry changed the doctor-patient relationship so that patients must now provide informed consent.


Auckland District Health Board finally apologised for the experiment last month, 50 years after it began, but one legacy of the experiment by Associate Professor Herbert Green was that a generation of doctors believed cervical screening was pointless.

A National Cervical Screening Programme was rolled out in 1990 but it's believed the human papillomavirus [HPV] vaccine, introduced in 2008 to pre-teen girls to target the virus that causes cervical, oral and now penile cancer, will be what wipes them out.

Breast cancer also remains a challenge. Rates in the Western world have increased as a direct result of women's fertility, because pregnancy and breastfeeding are "protective features" but they are being delayed to the age of 28 to 30.

Another contributing factor is that each generation is a little heavier than the last, by three to five kilograms, and that is largely down to the types of food women are consuming and a lack of exercise.

One in nine Kiwi women will get breast cancer now and 650 will die each year, compared with 25 men.

But in some ways women's health is looking positive. A Kiwi women's life expectancy has always been higher than for New Zealand men. In 1892 it was 57 compared to 52 for men and now it is around 83, compared to 78 for men.

This is a result of better medications, advancing treatments and technology, and more education and prevention.

Specialist obstetrician and gynaecologist Dr Emma Parry said the rate of teenage pregnancies in New Zealand, which used to be one of the worst in the OECD countries, had fallen significantly in recent years.


Parry believes that is in part to full funding of an implantable progesterone contraceptive.

Jadelle is made up of two small rods, inserted by a doctor or nurse, that sit under the skin on the upper arm and release progesterone into a woman's body for five years.

That and intra uterine devices [IUDs], the emergency contraceptive pill and teenagers delaying their first sexual encounter have all been credited with helping to halve teenage pregnancies from 2008 to last year, from 33 births per 1000 to 16 for age 15-19, according to Statistics New Zealand.

"This speaks to women's rights and what's changed in 125 years because we know that when you look around the world, if you have good contraception that's easily available to women then you change so many of the outcomes for women," Parry said.

Last ditch effort to make treatment publicly available

When Megan Banks turned 45 she was called up as part of the national breast screening programme for a mammogram – which found she had cancer.

The Orewa project manager was diagnosed with stage two breast cancer and had a partial mastectomy to remove the tumour.

She paid $6000, half the normal cost, to have all the radiation therapy she needed administered in one hit during the surgery.

The Intrabeam intraoperative radiotherapy [IORT], which is not yet publicly funded, saved Banks from having the radiation once a day, five days a week for six weeks after the surgery.

That Banks was even diagnosed with the disc-shaped lump that was undetectable from the outside, is light years ahead of the diagnosis of breast cancer even 50 years ago.

But she says in 2018 the one-shot breast radiation, a technology estimated to be clinically suited to 700 women per year, should be publicly funded and Banks supports a petition to the Health Select Committee by breast cancer surgeon Dr Erica Whineray Kelly.

Whineray Kelly's 3116-signature petition is a last-ditch effort by her after a five year campaign to get the IORT machine funded.

But while treatment for early stage breast cancer in New Zealand was world class, advanced breast cancer treatment left women dying faster than in other countries according to new research.

The I'm Still Here report commissioned by the New Zealand Breast Cancer Foundation found women, and men, whose breast cancer had spread to other parts of the body died faster than their counterparts in Australia, France and Germany.

And the five-year survival rate for Māori was just five per cent, compared with 15 per cent for non-Māori.

Whineray Kelly said it was very hard to get patients with metastatic breast cancer to have more treatment.

Reasons for that included access to drugs, financial implications, that clinicians were competing with alternative medicines and cultural barriers.