Loss of key staff puts screening at risk: doctor

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 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 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".

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. A committee will consider the recommendations.

 - Martin Johnston