Smear-test gaps go back to '92

By FRANCESCA MOLD

Serious problems with the national cervical screening programme should have been obvious to the Ministry of Health as far back as 1992, according to evidence at the Gisborne inquiry.

Under cross-examination, Ministry of Health witness Dr Bob Boyd said that, looking back at quality assurance issues relating to the programme in the past eight years, there were gaps which were not identified.

"There are several things we have learned here and looking through the files which would suggest there were significant problems ... "

However, Dr Boyd said very little data was available in 1992 which would allow health officials to tell whether the national programme was working well.

A Women's Health and Information Resource Trust representative, Neil Kirton, asked Dr Boyd if he believed that the former Department of Health had failed to take action in the face of concern and advice from experts, programme managers and its own staff in the past eight years.

"Certain actions could have been taken along the way. It was not an overall failure to act, but the responses to some things could have been better," said Dr Boyd.

The lawyer assisting the inquiry, Hanne Janes, said there was concern that a wealth of information flowing into the Ministry of Health over the years might never have been correlated so that meaningful conclusions could be reached and action taken.

Dr Boyd said: "This is the first in-depth look at this sort of work I have had to do. It shows the complexity of managing things in this way. I have to agree with you that there were points there that if you were totally involved in the cervical screening programme you would want answers to."

Bruce Corkill, lawyer for women affected by the misreading of slides, took Dr Boyd through a catalogue of problems associated with the programme since 1992. He revealed documents from former programme managers detailing concerns about the "dubious reliability" of laboratory reporting in New Zealand.

In 1992, a programme manager asked experts to give urgent attention to the apparent wide variation of reporting that existed between laboratories involved in the screening programme.

Mr Corkill said concerns about the quality of laboratories continued over the years. Another 1997 report showed there was "no obvious process to reduce persistently and widely disparate reporting." Dr Boyd agreed there had been a consistent theme of concern from managers.

Inquiry chairwoman Ailsa Duffy, QC, asked Dr Boyd what it indicated to him if programme managers were still voicing the same concerns five years later.

"I would be concerned if they were reporting things had not improved and no use was being made of data," he replied.