Health chief 'should answer questions about screening'

By FIONA BARBER

A lawyer representing women affected by cervical smear misreading has called for the Director-General of Health, Dr Karen Poutasi, to give evidence to the Gisborne cancer inquiry.

Stuart Grieve, QC, told the inquiry committee yesterday that it was Dr Poutasi who should be answering questions about the cervical screening programme.

The request came after inquiry committee chairwoman Ailsa Duffy, QC, asked the head of the cervical screening programme, Dr Julia Peters, whether she had concerns about the future of the programme when it was moved into the Ministry of Health.

The inquiry will discuss the development today but Ms Duffy has already warned that time constraints may prevent other witnesses from being called.

Meanwhile, witnesses and records could be subpoenaed to clear the path for an investigation expected to provide vital insights into the under-reporting of cervical smears in Gisborne.

Yesterday Ms Duffy indicated she would be willing to issue subpoenas to unlock the information needed for an audit by public health specialist Professor David Skegg.

The Otago University epidemiologist wants to scrutinise the cases of 61 women in the Gisborne region to find whether they developed cervical cancer despite having slides read as normal.

He has been stymied by section 74a of the Health Act, which prevents the release of information about cervical cancer cases held by the national register.

Ms Duffy said one solution around the legislation would be to use the inquiry's powers to subpoena witnesses to get the necessary information.

Potential witnesses include officials operating the cervical screening and cancer registries and doctors holding patient information.

The only way to be sure whether misreading of abnormalities was related to Dr Michael Bottrill's laboratory was the clinical audit, said Ms Duffy.

"If there is misreporting by others, the clinical audit will show it up."

Names and identifying information could be suppressed except for use by inquiry panel members, counsel assisting and Professor Skegg, who would need names in order to match information.

Ms Duffy also yesterday granted applications to subpoena two pathologists, Dr Brian Linehan, who has already testified, and Dr Nadir Hasan, to appear before the inquiry tomorrow.

Dr Linehan, whose evidence was cut short last week, is managing director of Gisborne and Hamilton Medlabs. Dr Hasan is a cytopathologist at the Hamilton laboratory.

Mr Grieve wants to find out whether problems with Dr Bottrill's screening could have been identified earlier if the Hamilton laboratory, which took over the reading of Gisborne women's slides in 1996, had reviewed those slides.

And Neil Kirton, representing the Women's Health Information Resource Trust, wants to canvass Dr Bottrill's ethics with Dr Linehan, a former chairman of the Medical Association's ethics committee.