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Tuesday, June 16, 1998 Published at 16:48 GMT 17:48 UK

Health: Latest News

GPs 'bully women into smears for cash'

Are smear tests exposing women to risks?

Women are unduly pressured into having smear tests because unscrupulous doctors are not informing them of the real risks of being screened, research shows.

Researchers claim some GPs - motivated by money - vigorously persuade women to have a smear test and only provide details of the benefits of being screened. They fail to tell them the test might be painful, or that it can produce false results.

Considerable pressure

Writing in the Journal of Medical Ethics, the authors call for the system of payments - which rewards GPs for convincing women in their practice to have a smear test - to be modified.

Authors, Stockport GP Dr Mary Anderson and senior lecturer Dr Peggy Foster, from the University of Manchester, say: "Under such circumstances it is hardly surprising if a small minority of GPs put these "refusers" or "defaulters" under considerable pressure to accept a smear."

And they suggest GPs gain payments for refusers who have been counselled and signed a form.

Dr Foster said: "GPs stand to gain £63 million if they reach their targets so of course they are going to use strong arm tactics. But we are not blaming them, the policy needs changing.

"We want women to give their informed consent to having a smear test, at the moment the system we have leads to a lot of women being worried unnecessarily by propoganda."

GPs stand to gain £2, 655 each if they take smears from 80 per cent of the women in their practice but those who only reach 50 per cent get £885.

GP denial

[ image: Journal article condemns doctors]
Journal article condemns doctors
But Dr Anne Rodway, a GP in Sevenoaks in Kent and a member of the committee that advises ministers on cervical screening issues, refused to accept that the problem was significant.

"It is not happening to a serious or significant extent because there is evidence that coverage is increasing and we are seeing more successful outcomes," she said.

"If you come to my practice you will see the leaflets give details of the advantages and disadvantages of undergoing a smear test."

Informed choice

Richard Winder, deputy co-ordinator of the NHS national screening programme, said: "I'm a great believer that women should be as informed as possible in order to help them make their own judgements about their health but we are keen advocates of the system."

In 1993 the cervical screening programme reached its Health of the Nation Target for reducing incidence of cancer by 20 per cent seven years before schedule.

Up to four million women have a smear test in the UK annually but only 200,000 abnormal smears are picked up.

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