Cervical screening expert sensed disaster and quit programme

By FIONA BARBER

A cervical screening expert quit an official advisory committee because he didn't want a calamity on his hands, the Gisborne cancer inquiry heard yesterday.

During cross-examination Teenah Handiside, a former screening programme national co-ordinator, said that Dr Brian Cox had resigned from a Government-appointed group in the mid-1990s because he could not make any headway in auditing the programme.

Teenah Handiside, co-ordinator between September 1994 and August 1996, said Dr Cox left because he did not want blood on his hands, he did not want a calamity - "and it has happened."

The lack of a clinical audit to evaluate the programme - considered a crucial means of checking safety and effectiveness - was one of the themes running through yesterday's questioning.

In her written evidence Teenah Handiside said repeated restructurings of the health service had a negative impact on the screening programme.

"The most significant in my view was a lack of commitment to implement a suitable monitoring and evaluation regime for the programme."

She later said that some monitoring had been taking place in relation to statistics on the screening register including the numbers of women involved.

Later pathologist Dr Brian Linehan made a return to the inquiry - under subpoena - bringing with him statistics from his laboratories.

Hamilton-based Dr Linehan took over Dr Michael Bottrill's laboratory in 1996 and so took over the reading of Gisborne women's cervical smears.

Under cross-examination it was revealed 10,936 Gisborne slides had been read since the takeover, of which 168 showed high-grade abnormalities.

The rate was significantly higher than the national average, said Stuart Grieve, QC, a lawyer for affected women.

He said that presumably someone had been aware of the rate and in those circumstances should they have been looking back over women's smear histories?

Dr Linehan said that question should be directed to a cytopathologist. He had asked a cytopathologist at his laboratory about the matter but he had been sick and was unable to help out. The inquiry continues today and will possibly run tomorrow .

During the week:

Dr Bottrill conceded he had under-reported cervical slides to an unacceptable level but could offer no reasons apart from ill-health and possibly attention deficit problems.

The inquiry canvassed, using subpoenas to gather statistics from the screening and cancer registers vital for an audit, 61 cases of cervical cancer in Gisborne.

A call was made for the Director-General of Health, Dr Karen Poutasi, to answer questions about the programme's future under the Ministry of Health.

The inquiry sought to widen its statistical scrutiny to include the Eastern Bay of Plenty and Northland.

A former co-ordinator criticised the Ministry of Health for its inherent antipathy towards the programme.