KEY POINTS:
The number of women opting off the National Cervical Screening Programme more than doubled in the year after access to women's medical records for monitoring was freed up.
Figures obtained by the Herald under the Official Information Act show that in the year from March 2005, 1224 women withdrew from the programme or, if having a first smear test, told the programme not to register them.
While they were just a tiny fraction of the 1.3 million women enrolled on the programme at that time, the sharp, although temporary, increase was in line with predictions by the doctors and women's health groups, who objected to the changes in access to records.
Women's groups said letting Government-appointed evaluators see primary-care records compromised patient privacy and provided access even to details of sensitive matters such as mental health and abortions.
But cancer researchers argued that comprehensive access to records was essential to enable reliable monitoring of the programme.
Auckland Women's Health Council co-ordinator Lynda Williams said yesterday she withdrew from the programme because of the changes and she knew of others who had done likewise. "The women who supported the establishment of the programme in 1990 and had stayed involved as a kind of watchdog were very upset with the changes that were introduced and then they opted off."
The legislative changes in March 2005 provided for the Ministry of Health to appoint evaluators to monitor the programme.
In line with the recommendations of the Gisborne cervical screening inquiry, they were given access to women's hospital, laboratory and primary care records.
They also have access to the screening programme's records, although when a woman opts out, her electronic records must be deleted and paper records destroyed or returned to her.
The legislation also gives evaluators access to the same material for non-enrolled women if a woman develops cervical cancer.
The ministry says smear-takers can oversee the evaluators, a measure introduced "to assure women and their smear takers that evaluation poses no threat to doctor-patient relationships or a woman's privacy".
Ms Williams said women should be consulted before copies of their records were given to evaluators and an audit of the programme had shown that most women, once asked, gave permission to access their records.
"It's just common courtesy [to ask] where something as personal and emotionally-charged as your GP and hospital records is involved," Ms Williams said.
The programme's clinical leader, Dr Hazel Lewis, said an increase in the number of women opting out was expected in 2005 following the sending of a letter explaining the changes to more than a million women.
The reasons why women withdrew were unknown, but the number opting out was insignificant when compared with the number on the programme and was now less than 400 a year.
She said the first evaluation of the programme under the 2005 changes - separate from the ongoing monitoring reports by Massey University - would be done this year.
* SAYING NO
A March 2005 law change provided for Government-appointed evaluators to obtain GP records to check on the cervical screening programme.
463 women opted off the programme in the 12 months before March 2005.
1224 opted off during the corresponding period in 2005-06.
406 in 2006-07.
Currently, 71 per cent of eligible women have had a smear within the last three years.
