Bottrill clues missed says QC

By FRANCESCA MOLD

Doctors and other health professionals should have known that pathologist Dr Michael Bottrill was incompetent, a lawyer told the Gisborne cancer inquiry yesterday.

In his opening address, Stuart Grieve, QC, said questions must be asked about why Dr Bottrill's incompetence was not detected sooner.

However, counsel assisting the inquiry Royden Hindle said the inquiry panel should not assume Dr Bottrill was incompetent. Questions must be asked about what the level of under-reporting really was in Gisborne, compared with the rest of the country and overseas.

Mr Grieve represents eight women appearing at the hearing, including a woman known to Herald readers only as Jane, who sparked the inquiry when she sued Dr Bottrill for gross negligence last year.

Representatives of the Royal College of Pathologists knew about Jane's case in 1995 - four years before she went to court - said Mr Grieve.

"They knew Dr Bottrill was a sole pathologist, practising in an isolated area. They knew of the problems that can arise with sole practitioners in such circumstances, and yet the warning signs were not heeded."

Mr Grieve also attacked health authorities for failing to act on Dr Bottrill's unsatisfactory quality-assurance programmes.

In 1994, Dr Bottrill took part in a quality-assurance survey by the Midland regional health authority, which later became part of the Health Funding Authority.

Mr Grieve said his response was judged "unsatisfactory," but nothing was done.

He also questioned advice by the College of Pathologists to the authority that there was insufficient evidence to warrant retesting slides read by Dr Bottrill.

"The evidence will reveal that, at a very early stage, those who were privy to the preliminary results of the rereading exercise were appalled at the level of misreporting."

Deaths and suffering could have been avoided, as cervical cancer was 100 per cent curable if detected early.

"There are a large number of women who have undergone needless major surgery affecting their ability to have children, who have suffered other hideous consequences which have made their lives utterly miserable.

"There are women who have lost their lives - who are now only memories in the minds of their families and friends. All this human tragedy could have been avoided."

Dr Bottrill, who retired in March 1996, would have read approximately 95 per cent of all cervical smears during his 30 years in Gisborne.

"We must ask for what part of that 30 years was he incompetent," said Mr Grieve.

"Should the medical professionals of Gisborne who worked in this community over that period have concluded from clinically detected cancers that earlier smear results were incorrect?"

Jane was among six women who gave evidence yesterday, and while Dr Bottrill did not appear himself, his lawyer, Christopher Hodson, QC, told each of the women giving evidence that he was sympathetic and expressed regret.

Meanwhile, Prime Minister Helen Clark has indicated that she will tolerate Consumer Affairs Minister Phillida Bunkle having a private role at the inquiry, but wants it kept in check.

Ms Bunkle was in Gisborne yesterday representing the New Zealand Women's Health Information Trust at the inquiry. The trust sprang from the Cartwright inquiry into cervical cancer treatment at National Women's Hospital.

"Providing that Phillida observes an appropriate boundary between advocacy as a member of the trust and her role as a minister, then I don't have a problem," Helen Clark said.

Asked if Ms Bunkle should take an active role, including crossexamining witnesses, she said: "I think I would tend to stand back for that, and I'm sure Phillida has more important things to do. I don't think the Gisborne inquiry will be seeing a lot of Phillida."

Ms Bunkle said last night through a spokeswoman that she had asked a few gentle question of women witnesses yesterday, but was not intending to ask any more.

She planned to be at the inquiry for only three days in April but would try to get back during parliamentary recesses.