Cancer screening advice 'never acted on'

By FRANCESCA MOLD

GISBORNE - Recommendations from a powerful think-tank investigating a cervical screening programme were ignored, a top health official has told the Gisborne cancer inquiry.

Dr Bob Boyd, the Ministry of Health's chief medical adviser (safety and regulatory), told the hearing yesterday that in 1989 a working party had recommended an "executive" body with decision-making and financial powers be formed to run a national screening programme.

However, then Health Minister David Caygill did not follow the group's recommendations and instead set up an advisory group with reduced power.

Inquiry chairwoman Ailsa Duffy, QC, asked Dr Boyd if he could recall why the minister had taken that view.

"No ... but that was the action that was carried out."

Asked what the working group's reaction was to Mr Caygill's decision, Dr Boyd said: "That group never came together again. But a lot of people were not satisfied with that situation and I appreciate why."

"Why?" asked Ms Duffy.

"For two reasons: the first, the recommendations in the Cartwright report [which recommended strong leadership], an important document very much in the minds of the people there, and I believe everybody had a wish to see a cervical screening programme which took into account everybody's views."

Dr Boyd said he had envisaged that a board of directors would be set up, headed by a chief executive who would be held accountable for the success of the programme.

That person would be chosen by the Health Minister for his or her skills and on the recommendation of affected groups, with additional advice and input from organisations representing the users of the service as well as technical people.

"None of what I envisaged was achieved in the programme but it was not my decision," said Dr Boyd.

Ms Duffy asked: "Has anything representing that model ever been put in place?"

"No, it hasn't."

Last night, Prime Minister Helen Clark, a former Minister of Health in 1990, said Dr Boyd's evidence to the inquiry seemed to seriously misrepresent events at the formation of the programme.

She said ministers in the then Labour Government had been far more open to the need for a strong national leadership of the programme and outside medical advice than officials at the ministry.

As minister, "I insisted on there being a national coordinator; I set up a national screening programme. I had about four months in office after the Budget in 1990 and then I went."

A large portion of Dr Boyd's evidence at the hearing yesterday was suppressed by Ms Duffy on the grounds that it might reveal information about the health of women who had earlier given evidence but were not present.

During the past three days, eight women have given harrowing accounts of discovering that their cervical smears had been misread and that they had developed pre-cancerous abnormalities or invasive cancer.

Several, but not all, of the women were in the public gallery to hear evidence from Dr Boyd.

The inquiry panel was expected to review the suppression but postponed that decision until today after ministry lawyers said they had not had time during the lunch break to speak to Dr Boyd about whether he objected to the lifting of the order.

The inquiry today will hear Dr Michael Bottrill, the former Gisborne pathologist whose misreading of cervical slides sparked the probe.