Former staffer damns attitude

By FIONA BARBER

High rates of cervical cancer in Northland and the Eastern Bay of Plenty are set to come under scrutiny at the Gisborne inquiry.

News that the inquiry panel wants to extend its statistical focus to other regions with potential problems came on a day that a former national cervical screening coordinator lambasted senior officialdom at the Ministry of Health for "inherent antipathy" towards the programme.

Inquiry head Ailsa Duffy, QC, yesterday indicated that she would order a subpoena to capture Gisborne statistics from the cancer and cervical screening registries needed for an audit of 61 cases in the region.

But she said the committee also wanted figures from both the Eastern Bay of Plenty and Northland to determine whether audits should be carried out on those regions.

Panel member and pathologist Professor Maire Duggan could analyse the statistics and decide whether more scrutiny was needed, Ms Duffy said.

According to documents provided by the Health Funding Authority and the ministry, the three regions had "significantly high rates" between 1994 and 1997.

Under the inquiry's terms of reference, the committee has the power to canvass not only under-reporting of cervical smears in Gisborne but also wider systemic issues.

Ms Duffy said she believed the committee had jurisdiction to subpoena witnesses to gather information for the audit, which would be carried out by Otago epidemiologist Professor David Skegg.

He wants to scrutinise the records of 61 Gisborne women to ascertain whether they had developed cancer despite smears reported as normal.

Late yesterday, former screening coordinator Teenah Handiside delivered a roasting to the ministry over its treatment of the programme.

In her written evidence, she said the inquiry highlighted the consequences of inherent antipathy towards the programme and expert advice at the ministry's senior levels.

Teenah Handiside, national coordinator from September 1994 to August 1996, said repeated health sector restructuring in the 1990s had harmed the programme.

The most crucial factor "was a lack of commitment to implement a suitable monitoring and evaluation regime."

One of the reasons behind that apathy, she said, was a Cartwright Inquiry recommendation that non-medically qualified women be included in key decisionmaking affecting their health.

"A women-centred approach ... was foreign thinking to the health sector and this attitude appeared to have currency in the ministry."

Teenah Handiside's evidence will continue today, including cross-examination by ministry lawyers.

The Director-General of Health, Dr Karen Poutasi, is also expected to give evidence tomorrow on the future of the programme when it moves back to the ministry.