Reshuffle to increase breast tests

By MARTIN JOHNSTON

The Government is trying to boost Auckland's breast screening rate by taking much of the service back from the private sector.

The Auckland-Northland region has the country's lowest coverage.

Last year, just over half of the 200,000 women in the region eligible for state-funded mammograms had them.

On July 1, the age of eligibility for free screening was extended to 45 to 69, from 50 to 64.

National screening unit group manager Karen Mitchell said yesterday that women in the region also faced the country's longest waits for assessment if a mammogram detected an abnormality.

She said the Auckland service, provided by the privately run BreastScreen Auckland & North, was fragmented because it was the largest of the country's six breast screening lead providers.


The screening unit proposes shrinking BreastScreen's base to the Auckland District Health Board area.

The Northland-Waitemata area will be handled jointly by their health boards, and the Counties Manukau board, which now provides the service as a subcontractor, will become a lead provider.

Ms Mitchell said breaking the service into three lead providers would allow each to focus more on boosting coverage by forging closer ties with community health workers.

The number of assessment centres would increase to four - from one in Remuera now - and they would be spread around the region.

But the plan was criticised by two groups yesterday.

Auckland City Hospital's clinical director of general surgery, Dr Wayne Jones, said central Auckland patients would get a worse deal than those in the rest of the region and Northland.

He and Dr Jeremy Whitlock, a radiologist and the hospital's head of breast imaging, said the international best practice was to integrate screening and treatment.

This boosted the expertise of staff involved by exposing them to a greater variety and volume of cases.


Dr Whitlock said women diagnosed with cancer were more likely to end up paying for private surgery if they were screened at a private clinic.

But BreastScreen's medical director, Dr John Harman, said he and his staff avoided helping women decide whether to go public or private.

And he rejected the assertion that integrated clinics were the international trend, saying that the best practice was to have community-based screening centres, which were what women wanted, rather than going to multi-storey hospitals.

He said the real reason for the changes was the Government's opposition to private involvement in healthcare.

But Ms Mitchell said major parts of the screening system would continue to be run by private providers.