Loss of key staff puts breast-screening at risk, says doctor

'BreastScreen Aotearoa [is] at significant risk in a number of ways, particularly clinical safety.' Photo / Thinkstock

The safety of women has been put at risk by the national breast-screening programme's loss of key, long-serving staff, a leading doctor says in a letter to the Government.

The letter to Health Minister Tony Ryall in January by Dr Sally Urry, the clinical director of the Counties Manukau breast screening programme, prompted the Health Ministry to commission two reviews of the national BreastScreen Aotearoa scheme.

Dr Urry cited the resignation of nine senior staff from the ministry's national screening unit, mainly since 2009.

They included , including Dr Madeleine Wall, a radiologist and clinical leader of the x-ray-based breast screening programme, a public health physician who has not been replaced, and a biostatistician.

"With the resignation of [this] group has gone a large amount of knowledge and skill," wrote Dr Urry, the chairwoman of the clinical directors' group within the national programme.

"Many have not been replaced. This puts BreastScreen Aotearoa at significant risk in a number of ways, particularly clinical safety."

Australian management consultant Dianne Gillis' review report, dated August, was publicised by the ministry yesterday.

It indicates the screening unit became increasingly unstable after a restructuring under the Labour Government in 2007, followed by ministry-imposed "headcount reductions", temporary "recruitment freezes" and more changes under National.

Ms Gillis portrays the unit as becoming more focused on contract management and having difficulty replacing experts in population screening.

Only temporary replacements have been found for Dr Wall, in part because of to the perceived insecurity of the job and a pay rate lower than top radiologists make at DHBs. The current clinical leader is a breast physician, not a radiologist, which has caused some concern in the sector.

The ministry issued an assurance yesterday that the breast screening programme remained "world class" on key measures of quality and safety such as the rates of participation and cancer detection.

Organised screening programmes can save lives, but had a rocky start in New Zealand.

Dozens of women developed cervical cancer and some died after under-reporting of cervical smears during the 1990s by former Gisborne pathologist Dr Michael Bottrill.

After a ministerial inquiry into the Gisborne scandal and shortcomings in the national cervical screening programme, which did not pick up Dr Bottrill's mistakes, 46 recommendations were made to fix the problems.

Labour's deputy leader, Grant Robertson, said the Gillis report confirmed his contention that National's "back-office" health cuts were having a serious effect on the running of services.

Mr Ryall said the review was commissioned as soon as Dr Urry's concerns were raised with him.

The two screening unit reports make 14 recommendations, including shifting antenatal and newborn screening into the ministry, and strengthening the links between the screening unit and the ministry's cancer control team.

The ministry has created a committee to consider the recommendations.