Cancer check overhaul imperative, says report

By FRANCESCA MOLD and FIONA BARBER

More women risk developing invasive cervical cancer if the national screening programme is not overhauled, says a health authority report that surfaced at the Gisborne inquiry.

The damning document revealed there had been no national quality standards developed and little monitoring or evaluation of the programme since its inception in 1991.

The April 1999 report, written by the Health Funding Authority team running the programme to secure future funding, said it did not have adequate procedures and structures in place to ensure the safety of women.

"This has been evidenced recently in the very public cancer crisis in a North Island town."

The report said that if changes were not carried out, there was a likelihood that more women would develop invasive cancer because of a lack of quality standards and monitoring.

There would also be a risk of further public criticism aimed at the programme, causing women to drop out. The project proposed by the screening team is to address its "inability to perform core business."

The head of the screening programme, Dr Julia Peters, said the document was a fair statement.

The inquiry panel also found that about 3000 of the 23,000 cervical slides from Dr Michael Bottrill's laboratory, sent to Sydney for rescreening, were read by other pathologists.

The inquiry heard that the 3000 slides had been initialled by pathologists working as locums in the laboratory in Dr Bottrill's absence. Panel chairwoman Ailsa Duffy, QC, asked Health Funding Authority witness Tracy Mellor if it was possible the locums' slides were among those deemed by Sydney to have been misread.

"Theoretically, that may be just about possible," Ms Mellor replied.

Ms Duffy asked on what basis the HFA had decided to hold Dr Bottrill responsible for all the slides in the rescreening exercise. Ms Mellor said Dr Bottrill was the sole pathologist and owned the laboratory under investigation.

Ms Mellor told the inquiry it would take several days to compare the locums' slide reading results with Dr Bottrill's. But an HFA lawyer later told the Herald there were no plans to carry out such a comparison.

Ms Mellor also conceded yesterday that had it not been for a High Court case against Dr Bottrill, fears over Gisborne would have been unlikely to have come to the HFA's attention.

Meanwhile, a top pathologist has replied to charges levelled at him during the inquiry.

Dr Andrew Tie, chairman of the New Zealand branch of the Royal College of Pathologists, and colleague Dr Clint Teague, were criticised for failing to act when they learned there could be more than one woman whose smear slides had been misread.

Dr Tie yesterday told National Radio that a few months after the original court case was publicised, Dr Teague told him he had been contacted by a GP concerned about a slide misread by Dr Bottrill.

Dr Teague had advised the GP to contact the Medical Council or Health and Disability Commissioner with the concern. Dr Tie said he believed the GP had not done so.

Asked whether the pathologists were at fault for failing to act when they heard of another potential misreading, Dr Tie said Dr Teague had acted correctly.

"The College ... has no statutory powers to act and no power to regulate and it cannot certainly take action on the basis of a telephone call from one practitioner without some further evidence."