Bottrill's lab not worst says QC

By FRANCESCA MOLD

GISBORNE - Some laboratories may have under-reported cervical smear abnormalities at a greater rate than Dr Michael Bottrill, according to evidence at the Gisborne cancer inquiry yesterday.

The inquiry also heard that Ministry of Health officials had expressed concern about Dr Bottrill as far back as 1989.

In draft notes on the cervical cancer screening programme, they described Dr Bottrill as "laid back to the point of almost falling over."

The retired pathologist's lawyer, Christopher Hodson, QC, said statistics from 1996 showed a number of laboratories reporting fewer slides than his client in all categories, including normal, low and high-grade abnormalities.

Mr Hodson said he had alerted lawyers involved in the inquiry to the statistics last year and recommended to health authority representatives that a group be set up to look at the evidence.

"The figures are not new. I put them on record in December last year. I said then the whole performance of every lab in New Zealand is under question."

Yesterday, Mr Hodson repeatedly asked Ministry of Health witness Judy Glackin what the ministry was doing to chase up those laboratories.

"I would like to know sooner rather than later what is being done to identify and reveal the labs which reported less than Dr Bottrill."

He asked whether Ms Glackin was satisfied that the problems were restricted to Gisborne.

She replied that the statistics related to the year ending 1994, so by the time they were released to laboratories in 1996 they were "historical."

Mr Hodson: I ask you for the third time, did it ever cross your mind as an official, a woman or anything else there might be other women at risk?

Ms Glackin: In my personal opinion and as an official, I was extremely concerned about the potential for harm to other women as this came to light.

Questions were also raised about whether the ministry had concerns about Dr Bottrill in 1989 after members of a cervical screening implementation unit visited Gisborne.

In draft notes, ministry staff described Dr Bottrill as "laid back to the point of almost falling over."

Bruce Corkill, representing the women whose smears were misread, asked Ms Glackin what the ministry made of that observation at the time.

"I can't respond. These were draft notes, not a formal Ministry of Health document. It certainly implies that Dr Bottrill was perhaps less than focused, but I think the point has to be made that I am commenting on text written a long time ago."

Mr Hodson said the notes contained comments "similar in tone and equally offensive" about other medical professionals in Gisborne, including area health board staff and GPs.

"Had that document ever been circulated, everyone referred to would have been furious?"

"I believe so," replied Ms Glackin.

There was also evidence that concerns were raised at a meeting of cervical screening programme managers in June 1997 that Gisborne seemed to have more high-grade abnormalities than elsewhere.

Mr Corkill asked whether those concerns were a "flag" for something that needed to be attended to promptly.

Ms Glackin said the issue was kept under review. Action would have been taken if the increase in high-grade abnormalities had been seen to become a "trend."