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Women's Health Action has a particular interest in screening issues and women's health.

Below are links to news/articles/resources Women's Health Action has posted on this website about screening issues

Screening news

Breast Screening

see our page on breast screening issues

Cervical Screening

see our page on cervical screening issues

Consent in Screening Programmes

see our page on informed consent in screening programmes

[CHPR] Fact Sheet Released on Cancer Screening Rates Among Asian Ethnic Groups - November 2003

A new fact sheet from the UCLA Center for Health Policy Research, titled "Cancer Screening Rates Among Asian Ethnic Groups," finds that, within the Asian population, ethnic subgroups differ substantially in their receipt of cancer screenings at recommended intervals. In additional, screening rates for cervical and breast cancer are generally lower for members of Asian ethnic groups with limited English proficiency. Using data from the 2001 California Health Interview Survey (CHIS 2001), the fact sheet examines cancer screening rates for cervical cancer (Pap test), breast cancer (mammogram), and colorectal cancer (fecal occult blood test, colonoscopy, or sigmoidoscopy) among Asian ethnic subgroups.
This fact sheet also examines cancer screening rates among adults with limited English proficiency.
Key findings from this fact sheet include:

  • Cambodian and Korean women have rates of screening for breast cancer that are far below the average rate for California.
  • Less than 40% of Cambodian and Korean men and women over the age of 50 report a recent colorectal cancer screening.
  • Among Chinese women, the proportion reporting a Pap test is significantly lower for limited English proficient (LEP) women than for English proficient women.
  • While 63.8% of English proficient Korean women report a mammogram in the past two years, this rate drops to 45.4% among those with limited English proficiency.

A copy of the fact sheet can be downloaded at http://www.healthpolicy.ucla.edu/pubs/publication.asp?pubID=82

Latest information on the progress of the Health (Screening Programmes) Amendment Bill

The Bill is currently with select committee with submissions due in by April 11. Here's the link http://www.clerk.parliament.govt.nz/Programme/Committees/Submissions/hehspb.htm

Consumer Reference Group for the National Cervical Screening Programme and BreastScreen Aotearoa
Recommendations from Women's Health Action Trust's consultation with women's organisations on the establishment of a Consumer Reference Group for the National Cervical Screening Programme and BreastScreen Aotearoa

Recommendations of the Women's Health Action and Te Tapu o te Wahine Reports

The following recommendations to the Ministry of Health national Screening Unit are the combined recommendations arising from the Women's Health Action consultation process and the consultation with Maori women conducted by the Health Promotion Forum of New Zealand.

The recommendations are presented under the following headings which are the same headings that were used in the consultation document.

  1. The purposes of the Consumer Reference Group (CRG)
  2. The principles of the CRG
  3. Criteria for representatives on the CRG
  4. Sector representation on the CRG
  5. Size of the CRG
  6. How representatives will be selected
  7. Who makes the final selection of reference group members
  8. Where and how often the group will meet
  9. How the CRG will communicate with women
  10. Term of appointment
  11. Evaluation of the CRG

1. The purposes of the consumer reference group

Women's Health Action recommendations

  • To provide a voice for consumers in the development, implementation and maintenance of the breast and cervical screening programmes.
  • To provide a voice for priority and under-screened groups of the programmes.(1)
  • To provide an avenue for women's experiences of and concerns about screening to be known to the Ministry of Health.
  • To contribute to the development of government policy for breast and cervical screening programmes.
  • To make recommendations to the Ministry of Health.
  • To receive reports back from the Ministry of Health on action taken regarding recommendations.
  • To inform women's organisations about developments and progress in the programmes.
  • To provide support and advice for women acting as consumer representatives in advisory and other groups associated with screening programmes.

Te Tapu o te Wahine recommendation

  • The concerns about the generic nature of the'proposed purposes' be considered when the purposes of the consumer reference group are redrafted.

2. The principles of the group

Women's Health Action recommendations

  • To recognise Treaty of Waitangi responsibilities and obligations.
  • To have a commitment to equity of outcome for priority and under-screened groups within the programmes.
  • To have a well-women focus.
  • To take an evidence-based approach.
  • To acknowledge women's personal experiences of cervical and breast screening issues.
  • To operate in a way that is consistent with government policy for breast and cervical screening programmes.

Te Tapu o te Wahine recommendations

  • A clear Treaty statement be drafted for the CRG. This Treaty statement would outline the specific commitment of the CRG to the Treaty. The statement would also make explicit related Treaty responsibilities such as those outlined by the NCSP.
  • The Maori Treaty text be used to inform the Treaty statement.
  • The consumer reference group principles clearly reflect a commitment to reducing disparity and to achieving equity of outcome for Maori women.
  • The discussion related to a "rights based approach" and "victim blaming" models being used to inform the consumer reference group purposes be considered when the purposes are redrafted.
  • That the additional principles identified in the consultation be considered when the purposes are redrafted.(2)

3. Criteria for representatives on the consumer reference group

Women's Health Action recommendations

Attributes needed by representatives on the consumer group include:

  • Being able to analyse issues and assess their effects from a consumer perspective.
  • Having a good knowledge of and/or interest in the screening programmes.
  • Being actively involved in a women's health group, women's organisation or other organisation of the group or sector that they are representing.
  • Being able to consult with the group or sector they are representing.
  • Being able to keep the group they are representing informed of the relevant issues.

Specific cultures or sector groups may require criteria additional to those listed above when selecting their representatives.

Te Tapu o te Wahine recommendations

  • The statement requiring representatives to'be actively involved in a women's health group or women's organisation' proposed in the criteria section, be deleted.
  • The criteria for Maori representatives identified during the consultation be included.(3)
  • A term be identified for the review of consumer reference group representatives.

4. Sector representation on the consumer reference group

Women's Health Action recommendation

  • The selection panel for representatives on the consumer reference group will need to take into consideration representation of priority and under-screened groups of women as far as it can within the limits of the group size and resources.

Te Tapu o te Wahine recommendation

  • The consumer reference group reflect an equitable representation of those women most affected by breast and cervical cancer and the issues associated with breast and cervical screening.

5. The size of the reference group

Women's Health Action recommendations

The recommended size of the group is a minimum of eight and maximum of twelve members. Factors to consider in making appointments include:

  • Adequate representation of the identified sector groups (priority and under-screened groups)
  • Support and back-up for representatives
  • Manageable workloads/responsibilities for each representative
  • Optimum size for working effectively, eg, not so large it is cumbersome, not so small that there is insufficient representation
  • Financial considerations

Te Tapu o te Wahine recommendation

  • The membership number of the consumer reference group be a minimum of eight and maximum of twelve.

6. How representatives will be selected

Women's Health Action recommendations

  • In selecting representatives for the consumer reference group, it is recommended that organisations be asked for nominations and that a representative panel make a final decision.

Initial consultation with Pacific key informants identified the need to have a national meeting at which issues relating to the consumer reference group could be discussed and representatives nominated or selected.

Te Tapu o te Wahine recommendations

  • Consideration be given to a selection process where Maori women are able to meet, discuss and support potential nominations for their representation.
  • That the organisations identified by the consultation be considered in the process seeking potiential nominations for the consumer reference group. (Recommendation 10a in the Te Tapu o te Wahine report )(4)

7. Who makes the final selection of reference group members

Women's Health Action recommendations

It is recommended that the panel which will select members for the consumer reference group will include:

  • Maori, Pacific and Pakeha representatives
  • Representation from the National Screening Unit of the Ministry of Health
  • Representation from Women's Health Action
  • The consumer representative on the Public Health Screening Advisory Group
  • Recommendations from the Maori consultation.

If Women's Health Action were to nominate people for the group, or if the consumer representative from the Public Health Screening Advisory Group were to seek nomination, other selection panel members would need to be substituted in their place.

Te Tapu o te Wahine recommendation

  • The final decision to select Maori representatives is made by the Maori women involved in the selection process.

8. Where and how often the group will meet

Women's Health Action recommendations

  • The reference group will meet at various localities throughout New Zealand, alternating between the major cities and provincial centres. It has been suggested that Gisborne be offered the opportunity for having the first meeting of the reference group.
  • The reference group will meet up to twice a year, except for the first year when there may be more meetings.

Te Tapu o te Wahine recommendations

  • The consumer reference group for breast and cervical screening meet quarterly.
  • The frequency of meetings be reviewed after the first year.

9. How the reference group will communicate with women

Women's Health Action recommendation

  • The reference group will utilise a variety of means for communicating with women, including by:
    • newsletter
    • mainstream media (including community newspapers, radio etc)
    • website
    • email list
    • notices having a section of each consumer reference group meeting open to women who wish to attend
    • representatives meeting with their own sector groups as may be needed
    • regional meetings with local representatives as may be needed.

The group will need to be mindful that certain methods of communication will have drawbacks for some groups of women, eg, some may not have access to email notices or a website.

Te Tapu o te Wahine recommendation

  • Opportunities for communication be multidimensional with a priority given to the publication of a newsletter, website development and representative/sector group meetings.

10. Term of appointment

Women's Health Action recommendation

  • It is recommended that the appointments to the consumer reference group be reviewed every two years.

Te Tapu o te Wahine recommendation

  • A term be identified for the review of consumer reference group representatives. (Refer to recommendation 3c in the Te Tapu o te Wahine report.)

11. Evaluation of the reference group

Women's Health Action recommendation

  • It is recommended that the consumer reference group undertake an assessment of the value and the effectiveness of the group after two years of operation. Resourcing for the group would need to take into account assessment and evaluation systems being built into the group's operation.

Footnotes

(1) Maori women, Pacific women, Asian women, women from non-English speaking backgrounds 0(including refugee and migrant women), lesbian women, women from low socio-economic backgrounds and women who have a disability. Women over 40 years of age are a priority group for the cervical screening programme. - National Cervical Screening Programme Interim Operational Policy and Quality Standards, Health Funding Authority, October 20000, P2.8, and BreastScreen Aotearoa, Interim National Operations Manual. Draft 2.0. December 1998. Health Funding Authority Breast Screening Programme. P4.5.

(2) Sexual and reproductive rights

  • A commitment to eliminating Maori/non-Maori disparities in sexual and reproductive health
  • A rejection of'Victim Blaming' and'Deficit Thinking' health policy and service provision
  • The determinants of health
  • The Maori concept of whakama
  • The realities of kuia
  • Use and integrity of te reo.

Refer Te Tapu of te Wahine Report, P.14

(3)

  • be Maori women
  • be identified, nominated and selected by Maori
  • be able to represent, articulate and advocate for the Maori women they represent
  • have the ability and competence to upskill and understand the issues facing the consumer reference group
  • be committed and accountable back to wahine Maori o Aotearoa
  • prioritise the support of Maori women's collective kaupapa and issues as opposed to individual, organisational or tribal interests)

Te Tapu of te Wahine Report, P.14

(4)Nga Maia - Maori Midwives Assn; Maori Women's Welfare League; Women's Health League - Te Ropu o te Ora; Nga Ngaru; Maori Doctors and Nurses Assns; Te Puni Kokori; Ringa Atahai - Taitokerau; iwi; Kohanga Reo Te Tapu of te Wahine report, P.18

3 October 2001 Speech Notes Rt Hon Annette King Minister of Health

Launch of the National Screening Unit

It's a pleasure to be here for the formal launch of the National Screening Unit. I would like to thank Julia Peters, Karen Mitchell and the team for inviting me to say a few words to you all on this important occasion.

Although the Unit came into being earlier this year, things have been somewhat hectic for the team, as you all know, and today is the first opportunity that has been available to mark the launch.

I have had a keen interest in the two national screening programmes since I became Minister. I have been impressed by the commitment of people in the Screening Unit and programme providers who have worked, often under significant pressure, to deliver the two programmes to New Zealand women.

This is my opportunity to acknowledge that commitment and to take stock of the progress of the Unit, and of its predecessor the National Screening Team, in managing and developing the two programmes.

The Unit's foundations lie in the creation of the National Screening Team in 1998. In November that year Dr Julia Peters became the manager of the small team of four-and-a-half staff. The team had just been given responsibility for the National Cervical Screening Programme, and it was about to launch the national breastscreening programme - BreastScreen Aotearoa.

The following two years were hectic, to put it mildly. Not only was there a concerted effort to strengthen the cervical screening programme, as well as to bed in BreastScreen Aotearoa, but a need as well, of course, to participate in the Gisborne Ministerial Inquiry.

Significantly the Gisborne Inquiry Report endorsed the team's focus, commitment and hard work.

The report called for the continuation of the'culture' that had been created under Julia and the then National Screening Team.

I can only endorse that call. That is why it is a pleasure to be sharing today's launch with the team.

The Gisborne panel also strongly endorsed the National Screening Team's two flagship quality improvement projects for the cervical screening programme. These were the Interim Operational Policy and Quality Standards and the monitoring plan, which put in place a routine monitoring arm for the programme.

These two quality mechanisms were the result of more than two years' work. Similar essential systems have been integral components of BreastScreen Aotearoa since its inception.

Although considerable work has been needed to bring about improvements in the cervical screening programme in the past two-and-a-half years, it has still been effective throughout that period and earlier in reducing the incidence of and mortality from cervical cancer.

In the ten years to 1997, cervical cancer rates have dropped by 39 per cent. Over the same period, the death rate from cervical cancer dropped by 44 per cent.

Karen Mitchell took the reins of the newly established National Screening Unit earlier this year. At the same time as seeking to build the Unit to its full strength of 33 personnel, she has also led the Ministry of Health's steering group charged with implementing the Gisborne Inquiry recommendations.

Both Karen and Julia have played a key role in this group. So far 45 of the Inquiry's 46 recommendations are in progress or completed. Several key recommendations, currently in progress, relate to law changes that will support the monitoring, audit and evaluation of the cervical screening programme.

In that respect I wish to announce today that the Government has given the go-ahead to proposed law changes, following the receipt of 101 submissions on proposed changes to Section 74A of the Health Act 1956.

The changes will allow information from the NCSP Register to be available for the purpose of monitoring, auditing and evaluating the effectiveness of the programme, and will also include provision for women to'opt off' the programme completely, ensuring their register information is not used if they so choose.

Under strict security guidelines, selected auditors will be able to access identifiable information held on the Register for auditing the programme. Auditors will be required to keep all personal information confidential and secure.

I believe women will see the benefits of remaining on the programme. With new consent arrangements established, and given the emphasis the Gisborne inquiry placed on the need for monitoring, auditing and evaluation, few women are likely to leave the programme.

The changes will meet several key recommendations of the Gisborne report, but consent will still need to be sought to access clinical records of women. As part of an audit of women with invasive cervical cancer, those who have opted off the programme may also be contacted for consent to clinical records.

The dominant message in the 101 submissions was clear. Three-quarters of submissions (74 percent) were opposed to giving access to clinical records without consent. Accordingly we have developed a process which recognises these concerns while giving us the best possible framework for conducting effective programme monitoring, audit and evaluation. The Cabinet has accepted this process.

The Gisborne report called changes to the legislation 'by far the most important change which is required to make the National Cervical Screening Programme fully effective'. It was also important, however, to take into account the strong views among consumer and women's groups and some health professionals who were against the proposal.

The changes we are making will improve the legislative base on which the programme is built, in turn providing the best programme possible for New Zealand women, taking into account privacy concerns. The changes to section 74A of the Health Act are intended to be included as part of a comprehensive bill which will address a number of safety and quality issues across the health sector.

I must emphasise that the changes will not affect information on the NCSP Register relating to Maori women. Preparations have begun for a consultation process on the Kaitiaki regulations, which will take place with Maori women and their families early in 2002.

Quality and safety throughout the sector are a key focus for this Government. Within the Ministry of Health there are teams working on several key initiatives. These include the Quality Improvement Strategy and work on competency assurance for health professionals. The interest in the recent Quality in Health Week shows that this focus on quality and safety is supported across the health sector.

Next month I will be heading to Gisborne with Dr Euphemia McGoogan. As I am sure you all know, Dr McGoogan, who gave evidence at the Gisborne inquiry, and who is a senior lecturer in pathology at Lothian University Hospitals, is providing me with an independent evaluation, after intervals of six months and one year, on progress in implementing the inquiry's recommendations.

She will be giving that assessment of progress at a public meeting in the city. Keeping Dr McGoogan well briefed has not been as straightforward as you might think. The time difference between Scotland and New Zealand has resulted in several tele-conferences very early in the morning New Zealand time.

Some Gisborne recommendations have implications for BreastScreen Aotearoa. The programme has steadily developed a culture of early breast cancer detection. The coverage rate compares favourably with similar programmes overseas. In its first two years more than 152,000 women were screened, 10,500 women were referred for further assessment, and 1080 breast cancers were detected.

The Ministry is seeking to ensure that the benefit of breast screening, the early detection of breast cancers, is complemented by effective treatment services, with equity of access for all. It is fitting that the launch of this Unit is taking place in Breast Cancer Awareness Month.

Several key initiatives are being put in place to address waiting times for cancer treatment. A recent report to the Ministry on improving cancer services in New Zealand outlines a number of changes to ensure equity of access.

One change means New Zealanders are now entitled to the same cancer drugs no matter where they live. Previously there were variations between regions as to which drugs were provided free. This change represents a $4m increase a year in treatment services.

The Government has also approved purchase of five new linear accelerators, costing more than $3 million each, for hospitals in Waikato, Auckland, Palmerston North and Dunedin, and currently Palmerston North and Auckland are considering one more new machine each.

Funding for radiation therapy treatments increased last year by 14 percent, with a further 4 percent this year. Therapists are training as fast as possible. The number graduating this year has doubled to 28, and up to 40 could be trained next year. As well, several overseas therapists arrive by the end of the year.

Ensuring equity of access is the first step. Beyond that we will be developing a process for evaluating and introducing new cancer drugs, treatments and technologies within the public health system. We are also examining research and workforce development issues.

On a wider level the Government is committed to long-term solutions to controlling the incidence of cancer, through the implementation of a national cancer control strategy, and we are targeting cancer-causing factors such as smoking, poor nutrition and lack of physical exercise.

We haven't had a coordinated cancer control strategy. The approach has often been ad hoc and fragmented, lacking leadership and cooperation. Cancer control has been designated as a Government priority in the New Zealand Health Strategy.

This Unit will play a key role in the cancer control strategy, which will build on the achievements of both national screening programmes. That is something everyone in this Unit wants to happen. You can be proud of what you have achieved already, and I know how committed you all are to continuing quality improvement. Thank you again for inviting me to be with you today. If this Unit represents a better future, then that future is now well and truly launched.

NSU Launch 3 October 2001

NSU Launch Speech Notes: Karen Mitchell

In her presentation Julia reminded us of the very considerable achievements of the past two and a half years. The National Screening Unit began with the aim of building on this work.

The Unit's structure will ensure that we are able to make the most out of the progress that has been achieved in recent years and further improve the national screening programmes for the benefit of New Zealand women.

In approving the new structure Karen Poutasi recognised this potential effectiveness. I would like to thank her for the support she has given to the Unit and the screening programmes and also to Don Matheson, Deputy Director General of Public Health who has been a strong advocate for the Unit.

The NSU represents a new and more effective approach to the management of the two national screening programmes for two key reasons.

Firstly, the Unit has brought together the functions and funding arrangements which were previously spread across several teams, directorates and for that matter agencies.

This centralisation process was as Julia pointed out, a new approach for both screening programmes, and is recognised as'best practice' internationally. The move ensures that responsibility for all of the programme's key relationships rests with the NSU and it received the endorsement of the Gisborne Ministerial Inquiry.

The second reason is the Unit's new structure reflects the unique requirements of screening programmes focusing on improving health outcomes for specific population groups.

The Unit comprises several dedicated teams. These are the BreastScreen Aotearoa and NCSP Operational teams, the Unit's Quality and Monitoring team, the Maori Health team as well as teams responsible for information services and finance.

The two programme operational teams manage the day to day operations of the programmes and the key relationships with programme providers. They have responsibility for financial and contract management with a focus on ensuring effective purchasing and financial and operational performance.

The Quality and monitoring team is tasked with the ongoing monitoring, evaluation and audit of the two programmes. This team, which is currently under Julia's direct authority, is working to build on the successful implementation of quality and policy standards for both programmes.

The Information services team has a key role in the provision of information systems across the Unit and amongst programme providers. These systems are a vital component of both screening programmes. This team is responsible for the National Cervical Screening Programme's key management tool ­ the NCSP Register.

Although we have developed dedicated teams for both programmes the Unit operates in a way as to enable the sharing of skills, expertise and support services across the two programmes. There are many issues in common, and the things we learn in one programme can be used to strengthen the other.

The NSU operates as both a provider and funder of services. With this range of responsibilities, it is important the Unit comprises people with specific skills and expertise needed.

One of our key goals is to accumulate the expertise necessary to ensure that all the complex functions of the two screening programmes can be managed or undertaken by the Unit. A reliance in the past on external contractors is gradually disappearing.

At a public level this is already being recognised with the NSU quickly becoming the first port of call by media when screening issues are raised.

As we build up our team it is important that the Unit retains its emphasis on maintaining strong clinical leadership for the programmes. On a day-to-day basis the Unit has a management approach which combines effective health service management with a strong clinical perspective. The complexity and make up of the two screening programmes necessitates this type of approach.

It is important that both the central leadership and the ultimate responsibility for the programmes rests with the National Screening Unit. There is no other single dedicated team of people tasked with the role and responsibilities of the NSU.

We recognise the very many experts across the screening sector who share our goals, and we will continue to seek their advice. But it is the National Screening Unit that will be making the hard decisions. After all this is our day job. There is no one more passionate and more conscious of what needs to be done to build strong and effective screening programmes as those who work within the NSU. I believe the scrutiny of the screening programmes in recent years has ensured that probably every area of screening has received some degree of attention. I think this puts us in a strong position on which to build.

We know of the challenges ahead and we know that providing high quality screening programmes is a complex business. But solutions will not be developed over night. It takes time, consideration, and a well managed process of implementation, to ensure we get the best results.

This year we will deliver and be measured on a number of key projects and achievements.

These include:

  • A comprehensive audit and review process of BSA lead providers;
  • A project to strengthen BSA Coverage;
  • Ongoing BSA Monitoring Reports.
  • Ongoing NCSP Monitoring Reports.
  • Completion of the first NCSP Statistical Report.
  • The implementation of Contractually binding operational policy and quality standards for both programmes.
  • Implementation of a new Health Promotion, Recruitment and Retention Plan.
  • Publication of an Annual Report for both programmes.
  • The implementation of those CSI Recommendations planned for completion this year, including
  • Phase 2 of the Audit of Invasive Cervical Cancer.
  • Legislative changes to support improvements to the NCSP.
  • And the completion of the Workforce Development Strategy.

Importantly, however we will ultimately measure our success in terms of the reduction of the incidence and mortality of cervical cancer, and in the early detection and reduction of mortality from breast cancer.

It is important that we recognise the significant ongoing public interest in both screening programmes.

External interest can seem an added burden, but it can also be viewed as representing a shared ownership for improving systems and ensuring the programmes are operating at an optimum. This is more clearly evident when one considers that more than 980,000 women are enrolled in the NCSP, while more than 150,000 women have been screened through BreastScreen Aotearoa since its beginning.

With some satisfaction, I say that the quality and monitoring mechanisms that have been put in place for the two screening programmes are very much at the forefront of quality systems within the New Zealand health service.

This certainly does not mean that we can afford to be complacent however. There is still more work to be done to ensure that the quality mechanisms we have put in place help bring about the best screening programmes for New Zealand women.

The Unit has several key objectives for the future. These include:

  • strengthening relationships across the sector and internationally;
  • developing and growing expertise within the unit and beyond;
  • building strong national leadership; and
  • maintaining and building confidence in the screening programmes.

The development and maintenance of effective relationships with the literally thousands of providers tasked with the frontline delivery of the two programmes has taken on a new importance since July when direct funding and contracting duties were transferred to the National Screening Unit.

Both Programmes appear to have some way to go to build positive and effective relationships with primary care providers. They are the people who can work with us to inform women about screening and recruit them to participate in both Programmes.

Huge demands are placed on primary care providers and a majority of them are not fully trained in public health. They are therefore not necessarily going to be aware of the technical intricacies of organised screening programmes. At the national and provider levels it is important we continue to build collaborative relationships with the College of General Practitioners and to extend that to other primary care and nursing organisations and individual practitioners where possible.

It takes a well skilled and developed workforce who understand screening programmes - and in particular their benefits and limitations - in order to develop fully effective national programmes.

Many of the challenges we face are challenges that are faced across the health sector. It is important therefore that the Unit is part of solutions that are being developed at a sector-wide level.

For the two programmes, there are some important challenges ahead. Recruitment and coverage is going to be a major challenge for the breast-screening programme in general and more particularly for Maori and Pacific women. If this is not addressed, it will affect the potential effectiveness of the programme.In addition we do not currently have access to a population database from which we can invite women directly to participate in the Programme.

The challenge for the National Unit and providers in the second screening round of the national programme is to go to work on this area. In the absence of a population database, we need to investigate all other avenues to ensure eligible women hear about the breast-screening programme and have the opportunity to participate.

For the NCSP, coverage is also a challenge. Enrolments are high - at around 90% of women aged 20-69 years - but three-year coverage stands at approximately 70% and is lower for Maori and Pacific women. We also need to continue to develop our quality assurance processes for the Programme and to give urgent attention to some of the more fundamental recommendations of the Gisborne Inquiry report on which the future success of the NCSP is dependent.

These include the need for audit, the ongoing implementation of the programme's operational policy and quality standards and the monitoring plan and also legislative change, not only to ensure that essential monitoring and audit can occur, but also to ensure that the legislation supports the Programme in an effective way.

We must ensure the ongoing support of the women of New Zealand. The Unit will aim to both strengthen and rebuild women's confidence in the screening programmes. This will be achieved in part through the communication of the progress the Unit continues to make in enhancing the effectiveness of the two screening programmes.

It is also very important that women are aware of the commitment the National Screening Unit and programme providers have to delivering them the very best programmes that we can.

This includes our commitment to implementation of the Gisborne Inquiry report recommendations, the ongoing development, implementation and refinement of quality practices and standards, high-quality health education material and on-going monitoring and evaluation activities.

The programmes have made a major difference to date. However we still have a way to go. As the Unit continues to increase the effectiveness of the two national screening programmes many of you will play a role in helping us address the challenges of the future. I am confident that I can count on your continued support.

26 September 2001 Media Statement

Minister welcomes new Maori Health Manager for National Screening Unit

Associate Health Minister Tariana Turia today announced the appointment of Aroha Harris as the new Maori Health Screening Development Manager for the National Screening Unit (NSU).

Mrs Turia said the appointment of Ms Harris was an important milestone which would strengthen the Unit's focus on encouraging Maori women to participate in the two national screening programmes - the National Cervical Screening Programme (NCSP) and BreastScreen Aotearoa.

"The Maori Health Screening Development Manager is a new role within the National Screening Unit responsible for developing specific policies for Maori women enrolled in the screening programmes," Mrs Turia said.

"Although Maori women have been supportive of the cervical screening programme during its ten year history, they are one of the key groups that the NSU and programme providers are focusing on to increase participation. Maori women are also a key focus group for BreastScreen Aotearoa.

Ms Harris draws upon previous experience at a senior level in women's health. She was formerly Maori Health Manager at National Women's Hospital. Prior to that she was with the then Department of Child Youth and Family and was instrumental in establishing the Takapuna Maori Roopu for the Department. She has also worked within the area of children's and adolescent's mental health.

"Ms Harris also has a strong network within the Maori health sector, which will be important in her key role overseeing the Unit's relationship with Maori health providers.

"The Government is committed to ensuring the national screening programmes are well resourced and managed and build on the progress made during the past two and a half years. As part of the implementation of the Gisborne Inquiry recommendations, Cabinet recently approved changes to the Health Act supporting the monitoring, evaluation and audit of the NCSP.

"A consultation process for Maori women and their whanau on the Kaitiaki regulations, which control access to Maori women's data held on the NCSP Register, is currently being planned to take place early next year."

Ms Harris will lead the NSU's Maori Health Screening Development Team. The National Screening Unit is responsible for the management and co-ordination of the two national screening programmes and has been growing to its full size of 33 staff since its inception in March.

Biographical information: Aroha Harris is of Ngati Whatua descent. Aroha is experienced working within the health sector, she has most recently worked in the area of Child and Adolescent Mental Health in South Auckland, before that she was a Maori health manager at National Women's Hospital. Aroha has also worked in the social services field and in the past was Acting Manager for the Takapuna Maori Roopu for the Department of Child Youth and Family.

Screening