Too much asked of too few, say cervical project pioneers

Five weeks of evidence and cross-examination ended at the Gisborne cervical screening inquiry yesterday with two former national coordinators responding to criticism of the national cervical screening programme.

Susan Dahl, national coordinator from January 1993 to September 1994, said comments that there had been little evaluation or monitoring of the programme were "very harsh."

Gillian Grew, national coordinator from June 1990 to July 1992, said the programme's staff of 4.5 people was not adequate and had been given a huge task.

Ms Grew said she was told when she became national coordinator that there was tension with the programme's expert group, but she felt it and the programme's staff worked together "really well."

There was a great sense of urgency about getting the programme "up and alive" from the expert group and the minister, but she did not think the programme was established too quickly.

Inquiry head Ailsa Duffy, QC, wanted to know why the 1991 screening policy timeframe of requiring accreditation within two years with Telarc (a subsidiary of the Testing Laboratory Registration Council) had been removed in 1993.

Ms Dahl said she could not recall exact details but the decision was based on advice that laboratories were working towards accreditation.

The process towards accreditation was a lengthy and expensive one. It was never suggested that there was a need to legislate for mandatory accreditation or that accreditation was a pressing issue.

Ms Dahl said she was surprised when she learned that Dr Michael Bottrill's laboratory was not accredited.

"I consider that inappropriate."

Hugh Rennie, QC, representing the Royal College of Pathologists of Australasia, said the former national coordinators' statements contradicted previous evidence that compulsory accreditation was recommended as early as 1989.

Ms Dahl said compulsory accreditation was never brought to her attention. She was told that a lot of small labs were just starting up and had not been accredited. There was never "major danger" related to it.

Asked if a medical person might have realised the importance of accreditation, Ms Grew said that, with hindsight, yes.

Ms Dahl said she did not remember receiving advice from the Cervical Screening Advisory Committee that appropriate quality assurance was required "as a matter of urgency" to minimise screening failures similar to those that occurred in Britain.

Nor could she recall reading an article on the British smear misreadings in the National Cervical Screening Programme newsletter.

The inquiry is due to sit again for oral submissions for two weeks from September 18.

It is due to report to Health Minister Annette King in December.

The second session of the inquiry was originally due to end the week before last but Ailsa Duffy asked the minister for another week.

The inquiry sat previously for five weeks in April and May.

- NZPA

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