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Thursday, March 25, 1999 Published at 11:04 GMT


Authority appeals against smears ruling

The women who successfully sued East Kent Health Authority

A health authority is to appeal against a high court ruling that a hospital was negligent in screeening smears from three women who later developed cancer.

East Kent Health Authority and the NHS Litigation Authority fear the ruling could destroy the national screening programme.

Eight women died, 30 needed hysterectomies and more than 90,000 women had their tests re-examined after mistakes at the Kent and Canterbury Hospital between 1989 and 1995

The authority has paid more than a £1m to more than 47 women, but the three women were among 14 cases the authority had disputed.

Helen Palmer, Sandra Penney and Lesley Cannon, who won their case last month, said their lives were destroyed by the blunders.

They developed cervical cancer and had to have hysterectomies while they were in their 30s.

Saving lives

Figures from the Imperial Cancer Research Fund suggest the NHS Cervical Screening Programme prevents up to 3,900 cancers each year.

Doctors accept that no screening process is perfect and there will always be a margin of error - their task is to reduce that margin as much as is possible.

But last month's ruling demands too high a level of accuracy given today's technology, the litigation authority says.

[ image: The errors took place at Kent and Canterbury Hospital]
The errors took place at Kent and Canterbury Hospital
Lawyers for the health authority and the hospital argued at the High Court that the women's smears were borderline. They said the screeners had made excusable errors in passing the slides.

The judge rejected this argument and said the screeners should have sent the samples for further tests.

Stephen Walker is chief executive of the NHS Litigation Authority, which is effectively an insurer for NHS Trusts.

He said: "We have no wish to prolong the suffering of the three women who brought this case against the Kent and Canterbury Hospitals Laboratory, but this judgment puts the whole screening programme at risk.

"It would demand a level of accuracy which present screening techniques cannot deliver. We have therefore taken a decision to proceed with the appeal.

"This appeal is not directed against the three women and we regret the continuing strain it will impose on them.

"The judge himself recognised the difficulties of this judgment when granting leave to appeal - he referred to the public interest which the cases have engendered and the possible effect of the decisions upon other cases."

Julietta Patnick is national co-ordinator of the NHS Cervical Screening Programme.

[ image: Julietta Patnick: More of a seatbelt than a vaccine]
Julietta Patnick: More of a seatbelt than a vaccine
She said: "If this judgement stands, in order to be completely confident about all results, thousands of women would have to be recalled for further tests and probably unnecessary invasive investigations.

"The net result would be that a programme which is designed to help women stay healthy would cause them physical and psychological harm.

"The NHS Cervical Screening Programme aims to reduce incidence and deaths from cervical cancer - it is doing just that.

"However there are clearly limitations to the test and while we want to reassure women about the programme, it is important that they also understand this."

Reduction of risk

Having a smear test every three to five years reduced the risk of developing cancer by 90%, she said.

"We understand that women would like a guarantee about the results they receive," she added.

"However, even with perfect management and 100% coverage, no screening programme could deliver this.

"The screening programme must be viewed more as a seatbelt than a vaccine - if you wear a seatbelt there is no guarantee you won't be killed in a road accident but it lessens the risk."

Dr John Toy, director of clinical research at the Cancer Research Campaign, said: "It is important that unrealistic expectations are not placed upon the screening programme, but women do have a right to a standard of care.

"We also have to accept that women's confidence in the programme has been dented by this scandal. It is a sadness because it is an invaluable service which does save lives."

The Cancer Research Campaign is currently running trials on a new cervical screening test which has initially been shown to be 100% accurate.

The case will now go to the Court of Appeal for further legal arguments, where the NHS Litigation Authority will pay the women's costs.

A spokesman for the Department of Health said: "The appeal is not being taken against the women. It is about protecting the screening programme."

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