Новая система скрининга рака шейки матки в Новой Зеландии признана неэффективной из-за пропущенных уведомлений для миллионов женщин

38 Years After Cartwright Inquiry, Women Are Being Failed By New Cervical Screening Register That's Not Fit For Purpose Last Wednesday, the 5th of August, marked 38 years since Judge Silvia Cartwright released her landmark report into the treatment of cervical cancer at National Women's Hospital. That report led directly to the establishment of the National Cervical Screening Programme (NCSP) — and it explicitly called for the urgent establishment of a central register to guarantee quality control. An independent expert panel review, commissioned by HealthNZ has found myriad flaws with the new Register including: almost one million screening notifications never sent to eligible women; no screening histories properly transitioned onto the new Register; and a concerning level of clinical risk arising from the excessive number of recommendation mismatches between screening laboratories and the Register. For the Auckland Women's Health Council, Cartwright Collective, and the Federation of Women's Health Councils Aotearoa, this is a sickening echo of history. The 2001 Gisborne Cervical Screening Inquiry — itself only eight years after the NCSP began — found the register at the time was in such a sub-optimal state that results were routinely under-reported, with normal or negative readings issued for what were in fact abnormal or precancerous cells. Women were, in the words of that Inquiry, “severely injured” as a result. The entire rationale for a centralised, high-quality register was to make sure this could never happen again. Yet, it has happened again! “It is appalling and beyond belief that 38 years on, and only three years after this Register was implemented, we have learned it went live with known flaws, and that hundreds of thousands of women have not received the notifications the system exists to send them,” says Sue Claridge, spokeswoman for the Auckland Women's Health Council. Reckless implementation, known risks, ignored warnings We are deeply concerned by reports that nurses and other frontline staff have said they tried to raise the alarm about these failings before the system went live. HealthNZ carried on regardless, implementing the new Register to support the major shift to HPV primary screening at the same time it was restructuring the National Public Health Service. The National Screening Unit was disestablished as a stand-alone agency, hollowing out clinical leadership, shifting the data analytics team to HNZ’s Digital Services and creating exactly the kind of workforce churn that our organisations warned would be a recipe for disaster. “This was a world leading change to the cervical screening programme. Why did they risk the Register going live with known issues and missing functionality? This was no accident. The failures were inevitable despite the concerns we had expressed,” says Barbara Robson, Co-convenor of the Federation of Women’s Health Councils. Irrespective of HNZ assurances that there is “not yet any indication that anyone has experienced harm” in the 13,000 case reviews, harm to women may take years to become apparent. Could the multitude of failings identified in this review of the Register be attributed to any subsequent increase that may arise in the incidence of and mortality from cervical cancer? Only time will tell. It may be that wider sector issues such as colposcopy clinic capacity and waiting times will further complicate this. We expect these issues will have been assessed in 2025by the NCSP Parliamentary Review Committee, whose report is yet to be published. It seems unlikely concerns raised by previous committees will have been resolved, another potential for harm. The lack of transparency surrounding this review of the Register is shameful. Why were we not told about the review at its outset in October 2024, or that it was completed in June 2025? “Why has it taken more than a year for the women of NZ to find out about it, courtesy of an investigative journalist who seemingly triggered the public release of the review report and the associated action plan that HNZ had been working on for nearly a year?” asks Ms Claridge. Where is the accountability to the public? Women/wāhine deserve more than a promise that “improvements are underway.” They deserve a full, transparent accounting — in public, and without delay. We were relieved to see the review panel shared our concern that there had been no monitoring report and they recommended that NCSP should publish an independently peer reviewed monitoring report as soon as possible. This would ensure a level of accountability to the sector and the public about the impact of the new HPV programme. But where is the monitoring report? A year has elapsed since the review was completed, how soon is soon? Equally troubling is the near-total silence from Minister of Health Simeon Brown and other health spokespeople across the political spectrum. Director-General of Health Audrey Sonerson has a role in ensuring there is communication between HNZ’s National Public Health Service, the Ministry’s Public Health Agency and the NCSP Parliamentary Review Committee about implementing recommendations from both reviews in line with wider action plans for cervical screening. She has been silent. Our organisations are calling for: - A clinically safe and equitable cervical screening programme. - A commitment to regular, independent, transparent reviews into the performance of the screening programme from the implementation of primary HPV screening, identifying any harm caused by the Register’s failures and other wider sector issues; the findings to be made public in a timely way. - Immediate, direct contact with every person affected by a missed or delayed notification. - A cervical screening programme that is free for all participants, as originally promised. - Public accountability from HNZ, the Director-General of Health and the Minister of Health. - Guaranteed, ring-fenced clinical leadership and resourcing for the National Cervical Screening Programme, protected from further restructuring. - Strengthened collaborative governance, timely and effective monitoring, consumer representation. Cervical cancer is preventable. The cervical screening programme has proven this over the years. New Zealand has even better tools to eliminate cervical cancer. What has been missing, again, is the political will and assured sustainable resourcing to make sure the system meant to protect women actually works.