Labour ponders free tests as Government struggles with slow path to cervical cancer elimination

Minister of Health Simeon Brown is hailing an uptick in cervical cancer screening rates – but Labour says it's the only national screening programme where people are expected to pay for access. Photo / Alex Burton

Health Minister Simeon Brown is trumpeting an uptick in cervical cancer screening rates, which plummeted during the pandemic, particularly among Māori.

However, Labour’s health spokeswoman Ayesha Verrall said the uptick was partly due to work done when she was minister in the last Labour Government, particularly the rollout of self-testing for HPV, the cause of most cervical cancers.

Health officials have told Brown there is no funding to implement a 2023 recommendation from an expert panel to make screening free for most people. Verrall noted Labour campaigned on a policy of free HPV self-tests for ages 25 to 69 at the last election, at a cost of $20 million a year.

Brown said eligibility for free screening was in the hands of officials, who were working on an elimination strategy for the cancer.

“There’s been no changes to that eligibility since they were last adjusted back in 2023,” he said.

A report, obtained by the Herald under the Official Information Act, noted that screening rates had fallen across the board during the pandemic, with the national rate of people up-to-date with their screening falling from 71.2% in October 2019 to 67.4% in October 2023.

Slowly, screening rates have climbed, including among Māori, Pacific and Asian women, whose screening rates have tended to be below the national average. Rates of screening for Māori women only exceeded 2019 levels earlier this year.

The report said that recovering screening rates were largely the result of new HPV self-tests.

Of the 450,000 HPV primary screens completed between the rollout of HPV primary screening in September 2023 and October 2024, 81% were self-tests, the report said.

Every three years, the Health Minister must appoint a Parliamentary Review Committee (which despite the name, does not include MPs) to review the National Cervical Screening Programme (NCSP).

The figures in this story were included in a briefing the previous minister Shane Reti received in October on the progress Health New Zealand Te Whatu Ora was making towards the 31 recommendations made by the 2021-2023 committee.

The briefing warned that the recommendations were “highly ambitious and unfunded” and made during a time of “tight fiscal settings”.

Officials produced a traffic-light chart of all 31 recommendations, charting which ones were tracking to plan and which were not, rating them green to red for their deliverability.

One recommendation that had been “orange – paused” was “considering options for the development of an elimination strategy” for the cancer.

Brown said this had been started again.

“The Ministry of Health is leading the development of a cervical cancer elimination plan in partnership with the Cancer Control Agency,” he said.

The only recommendation to be given a “red – critical” rating was the recommendation to roll out free screening to all populations.

“Funding has not yet been secured for all population to receive free cervical screening in NZ,” the paper said.

In 2023, the then Labour Government rolled out a new HPV test which could be self-administered. HPV causes over 95% of cervical cancers.

This was accompanied by $7.3m to pay for free tests for some populations. The ability to self-test is meant to appeal to people who felt uncomfortable with the likes of a smear test, which are administered by someone else.

Verrall said the cervical cancer screening programme was “the only national screening programme where people are expected to pay for access”.

“Women might well ask, if I’m screening myself now, why do I have to pay?” she said.

While some providers offered the service for free, others did not and required a co-payment or similar charge.

Verrall said the test can be delivered in a diverse range of settings, allowing eligibility for free tests to be widened further.

“People who have the lowest participation and screening are those who sometimes struggle to pay,” she said.