Health: New national checks after breast cancer screening `disgrace'

Tougher checks on breast and cervical cancer screening were ordered by Frank Dobson yesterday after the Health Secretary condemned the programmes in Kent and Devon as a `disgrace'. Jeremy Laurance, Health Editor, reports on the latest government moves to improve the quality of a service that has been beset by scandal.

The faith of women in cancer screening has been undermined by serious failures affecting the programmes and reforms are now necessary to restore public confidence, Frank Dobson, the Secretary of State for Health, told the Commons yesterday.

Speaking after publication of a report on the East Devon breast screening service which found that 229 women out of 1,920 were misdiagnosed, Mr Dobson blamed the NHS internal market for the failure of those in charge to pick up the problem and act on it earlier.

The report, by Sir Kenneth Calman, the Government's Chief Medical Officer, said the two radiologists running the Exeter service, Dr John Brennan and Dr Graham Urquhart, had failed to provide care of the standard that could reasonably be expected. They are understood to have failed to send women with evidence of microcalcification - tiny deposits of calcium in the breast which can signal the start of cancer - for further tests.

Dr Brennan, who was in charge of the breast unit, mounted a legal challenge last week to try to prevent publication of the report. He has been suspended and disciplinary proceedings have been started against him. Dr Urquhart has been moved from breast screening and all his radiological work is being checked.

In a statement to the Commons, Mr Dobson said the failures in the East Devon service paralleled those identified in last month's inquiry into the cervical screening scandal at Canterbury hospital in which five women died and 90,000 smears had to be re-checked.

He blamed the internal market for the absence of arrangements to secure national standards and legal obstacles which prevented interference in the affairs of trusts even when they were falling down on the job.

"The breast cancer screening service in Exeter and the cervical cancer screening service in Canterbury ... were a disgrace. And the failure to have in place a system which could identify promptly things that were going wrong and then put them right was also a disgrace," he said.

All health authorities and trusts have been ordered to institute a new programme by next February to ensure all screening programmes meet national standards. All breast units have been told to review their arrangements for securing a high quality service and submit reports by next January.

Historically, the cervical screening service has had the greatest problems because it grew slowly from the 1960s with each local service operating its own system. The breast screening service began in 1988 and operated to national standards from the start.