Bureaucrats plotted over 'deficiencies'

By FRANCESCA MOLD

An internal health authority document has revealed that bureaucrats hoped work undertaken to improve the cervical screening programme before the Gisborne cancer scandal emerged would be a "mitigating factor" in the eyes of the ministerial inquiry.

Inquiry panel chairwoman Ailsa Duffy, QC, yesterday asked a series of questions about a February 2000 report from the head of the cervical screening programme, Dr Julia Peters, to the "executive management team" of the Health Funding Authority.

The report discussed future contracting issues for the programme, saying the inquiry and media interest meant it was a "high-risk" area which required significant support from the management team.

The document said a review undertaken in late 1998 had found there was no comprehensive set of national quality standards for the programme and no processes for ongoing monitoring and quality improvement.

The report said: "The current ministerial inquiry is likely to highlight these deficiencies and so the HFA's decision to undertake this work prior to the Gisborne problem being identified will hopefully be a mitigating factor."

Ms Duffy asked if there was a concern at the HFA about how the inquiry would view what had happened within the programme.

Dr Peters said she had not noticed that particular comment in the report before, as although she had signed the document it had been written for her by a member of her staff.

"But we did believe these deficiencies existed and presumed they would be looked at."

Ms Duffy: "In view of the comment that work already undertaken may be mitigating, can the inquiry rely on what you said yesterday that work in terms of policy, quality standards, statistical reports, evaluation and monitoring will in fact be implemented?"

Dr Peters: "That is my intention and I see no obstacle to it being implemented."

She said the only problem she could envisage might be issues resulting from the new Government's restructuring of the health system, which could make "things more complex."

Ms Duffy said it appeared the HFA had put more resources and money into the programme than the Ministry of Health had when it had control of the programme.

She asked whether it was a concern that the programme might find itself once again with insufficient resources to carry out proposed improvements when the HFA and the ministry merged.

Dr Peters said the ministry had in the past been a policy body which might not have had the budget available for the level of work undertaken by the HFA, but under the planned changes it would take on a funding role as well.

Dr Peters also revealed that a legal opinion was being sought about section 74a of the Health Act, which prevents researchers from accessing identifying information about women needed for audits of their care.

Ms Duffy asked Dr Peters whether provisions should be built into the programme so that it would always be possible to access this data in the future for the purposes of monitoring and evaluation.

Dr Peters replied: "I'm aware that women have concerns about the confidentiality of their information, but to do the detailed audits of invasive cancer to ensure the programme is safe for women that ability is absolutely fundamental."

Ms Duffy said information warning women that their details might be used for audits could be included in educational material so they could decide whether they wanted to stay on the register.