Hospital hierarchy led to friction

Employees in any field take their job in their hands when they criticise the work of colleagues above them in the hierarchy.

Professor Ron Jones recalls he was the most junior specialist of his clinical team when he co-wrote the 1984 medical article which led to the Cartwright inquiry was published and of which he was a co-author.

One of the things he believes made it possible for him to step outside the rigid academic and medical loyalties at National Women's Hospital in the 1970s and 1980s was that he did not do his postgraduate training there.

"There was very much a medical hierarchy in the hospital, with an academic elite. When one looks back on it, the friction that developed between Green and McIndoe was a David and Goliath exercise."

Dr Bill McIndoe was the lead author of the 1984 paper. Herbert Green was associate professor in the hospital's postgraduate school of obstetrics and gynaecology, headed by Professor Dennis Bonham.

At the time, the hospital was divided into the university department under Bonham - which was responsible for teaching, research and management of cervical cancer - and the non-academic clinical teams, including Jones'.

McIndoe unsuccessfully raised his concerns with hospital authorities over Green's study in the mid-1970s, Jones writes in The Cartwright Papers.

When McIndoe began presenting results at conferences - findings later shaped into the 1984 paper - Bonham warned that "any publication emanating from this hospital must be acceptable to the staff of the hospital before it is submitted for publication". McIndoe proceeded regardless.

Yet despite Jones' criticisms of Green and Bonham, he wants history to judge them fairly.

"... I need to acknowledge that both ... made very significant contributions to the health of New Zealand women and children."