Bottrill's training 'inadequate' to read cervical smears

By FRANCESCA MOLD

GISBORNE - Former Gisborne pathologist Dr Michael Bottrill may have only had three months' specialist training in reading slides containing cervical cells.

His qualifications and experience came under scrutiny from Scottish cervical screening expert Euphemia McGoogan during the Gisborne cervical cancer inquiry yesterday.

Stuart Grieve, QC, representing women affected by misread slides, said that "on the face of it" there was no indication Dr Bottrill's postgraduate training in pathology included cervical cytology (cell reading).

Evidence showed that he might have spent only three months of his four-year training as a pathologist studying gynaecological cytology at a women's hospital in Yorkshire.

"I suggest to you that whatever cytology training Dr Bottrill undertook in the United Kingdom in the late 1950s until 1961 was totally inadequate compared to the sort of training currently required with the reading of cervical smears."

Dr McGoogan told the inquiry: "I would agree the training of pathologists in the 50s and 60s is very different to that of today ... Very few pathologists before 1980 participated in reporting cervical smears."

Mr Grieve also questioned Dr McGoogan about her opinion of a pathologist who worked alone, reading 5000 smears a year, without following a very strict control programme.

"It's not good practice. It is questionable," she said.

Earlier Dr McGoogan had outlined criteria she believed were vital for a pathologist working in these circumstances who wanted to pro-vide a quality cervical screening service for women.

The criteria included interaction with other laboratories, including reviewing slides; internal quality control such as data collection; correlating biopsy and smear results; participation in an external quality control programme; frequent attendance at professional meetings; and achieving accreditation.

"Would you agree his failure to meet the criteria amounted to a breach of his duty of care?" asked Mr Grieve.

"The practice as described to me so far would in my mind have failed to meet the standards of a laboratory with good practice," said Dr McGoogan.

She said pathologists needed to constantly assess their performance, be aware of their weaknesses and consult other health professionals when in doubt.

The inquiry also heard yesterday how a contract with a Sydney laboratory required it to use its best endeavours to "promote and protect" the interests of the Health Funding Authority when rescreening Dr Bottrill's slides.

Dr Bottrill's lawyer, Christopher Hodson, QC, produced the contract and asked Dr McGoogan whether such a clause would cause her to "raise an eyebrow."

She said she was not a legal expert, but it would raise questions only if there was a suggestion that the interests of the funding authority were different from those of the screening programme.

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