Doctor 'read smears at home'

By FRANCESCA MOLD

A friend of former Gisborne pathologist Dr Michael Bottrill took trays of cervical smears home to screen while he was waiting for his wife to cook his dinner, a ministerial inquiry was told.

The revelation that Dr Alan Padwell, a former pathologist at Gisborne Hospital, "moonlighted" for Dr Bottrill for at least several months during the time thousands of smear slides were misread horrified women at the inquiry yesterday.

Gisborne Hospital laboratory manager Brian Morris said Dr Padwell, who was employed at the hospital from June 1993 until February 1997, had a private arrangement to take a tray of 20 of Dr Bottrill's slides home to read each night.

"He would take home a tray of slides and read them while he waited for his wife to cook tea," said Mr Morris.

Inquiry panel member Maire Duggan said: "So he was doing primary screening while he was waiting for his supper?"

"Yes," replied Mr Morris.

Asked if the reports recording the results of the slide readings were put out under Dr Bottrill's name or Dr Padwell's, Mr Morris said he did not know what the arrangement was.

The deal between the friends continued until they had a falling-out, he said.

Dr Padwell left Gisborne in 1997 and now lives in Britain.

Women at the hearing yesterday told the Herald they were shocked by the news their slides might have been read in such a casual way.

They were also concerned about issues of cultural sensitivity involved in the reading of slides from Maori women.

The inquiry has heard this month that up to 3000 slides may have been read by locum pathologists employed by Dr Bottrill when he was away on holiday or ill.

It was not known whether the slides read by Dr Padwell were among these.

Yesterday, Mr Morris also described Dr Bottrill's laboratory as small and cramped, with poor lighting and ventilation.

"I wouldn't have wanted to work in that physical environment ...

"In the histology area, it was unsafe because of an absence of decent ventilation in an area where people worked with solvents," he said.

Mr Morris said the laboratory had ancient textbooks and broken benchtops.

A domestic pressure cooker was used to sterilise instruments rather than a proper autoclave.

Dr Bottrill was also forced to use equipment at the hospital at least twice a year when his own broke down, said Mr Morris.

The inquiry, which has been extended for another week this month, will continue hearing witnesses today.

It will hear evidence from five women who were affected by the misreadings.

This week The inquiry has heard:

Concerns have been raised about the performance of six laboratories which had problems such as coding errors or undercalling slides.

A complaint has been laid with the Health Funding Authority about another laboratory which allegedly misread slides from one woman. The laboratory's identity is suppressed.

The Director-General of Health has forwarded a Crown Law Office opinion to the inquiry recommending it use a legal loophole to bypass regulations which have prevented an audit of cervical cancer cases going ahead.

Public health expert Professor David Skegg told the hearing that at least 100 women had died of cervical cancer in the past 10 years because there had been no research, evaluation or monitoring.

Another expert, Dr Brian Cox, made a plea for a cancer control agency to be set up to run national cervical and breast screening programmes, as well as to house the programme's databases and the Cancer Registry.

Australian pathologist Dr Gabrielle Medley, who advised the Health Funding Authority during its review of 17 laboratories, admitted that the study could not reassure the inquiry that there were no major concerns with other laboratories.

Women's health and consumer advocate Sandra Coney revealed a series of concerns about the way the Ministry of Health and politicians, including former Health Minister Jenny Shipley, ignored numerous recommendations from advisory groups in relation to the programme.

She accused the former Department of Health of sabotaging the programme and resenting the fact that it was recommended by the 1988 Cartwright Inquiry rather than emerging from its own advice.

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