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Irish government offers an apology to victims of child abuse
30 000 smear-test results re-examined in New Zealand
T
he New Zealand Health Funding Authority (HFA) ordered a review of 30 000 cervical smear slides in Gisborne, New Zealand, on May 13. The review follows a controversial High Court case in March where a woman with cervical cancer failed to get exemplary damages against a pathologist—doctors cannot be sued for ordinary negligence in New Zealand—who had misread or misreported a series of smear tests between 1990 and 1994. The pathologist, Michael Bottrill, who retired in 1996, was working by himself, had few quality standards in place, and had failed an attempt to get accreditation. He was also rereading his own smear tests. The HFA’s announcement came
after weeks of criticism from the media and politicians who said that the HFA was acting too slowly. HFA said it was hampered by a court order suppressing the pathologist’s name and workplace. A month after the case, Alliance MP Phillida Bunkle, using parliamentary privilege, revealed that Bottrill was based in Gisborne. Bunkle and the Cancer Society of New Zealand added that they knew of other cases involving Bottrill. On May 13, HFA announced that it would provide free smear tests for women in Gisborne and establish counselling and support services, in addition to the review of slides. This was followed the next day by a NZ$1·4 million injection into the
National Cervical Screening Programme. The events in Gisborne have led to some soul-searching about screening and professional self-regulation. A screening programme was instituted in 1990 but has never been formally evaluated, despite requests from successive government advisory-groups. The Minister of Health, Wyatt Creech, has also asked why neither the Medical Practitioners Disciplinary Committee nor the Medical Council of New Zealand had alerted health authorities after they found Bottrill guilty of conduct unbecoming in 1997. Sandra Coney
Canadian blood-donation prohibition for UK visitors
O
n May 5, the Canadian Blood Services and Hema-Quebec announced that they will forbid donations from people who have travelled to the UK since 1980—about 500 000 people per year—until “deferral policies” for such donors are established. The agencies have reversed an assertion made in October, 1998, that stated that they would never impose such a ban because it would decimate the blood services. Consideration of a partial prohibition is being driven by a Laboratory
Centre for Disease Control report commissioned from CreutzfeldtJakob disease (CJD) expert Neil Cashman (University of Toronto, Canada) who concluded that Health Canada should avoid blood from persons incubating variant CJD because it poses a higher risk than classic CJD. Although it is believed that classic CJD cannot be transmitted through the blood system, it is not known whether variant CJD is transmissible. An advisory committee has been set up to establish criteria for deferring
donations and will report by June. The committee is expected to create a system under which donors are rejected depending upon the duration of their visit to the UK. Surveys indicate that 22% of existing donors have visited Britain, so a total ban would probably cause severe blood shortages. But among the options under review is a ban on donors who visited the UK for a cumulative period of more than 1 month since 1980, which is about 12% of all donors. The blood agencies say they must be wary of contaminated blood given Justice Horace Krever’s 1997 recommendations (see Lancet 1997; 3 5 0 : 1688) that safety be placed ahead of definitive scientific proof. Wayne Kondro
Irish go vernment offers an apology to victims of child abuse
A
“truth commission” on child abuse that occurred in publiclyfunded institutions over the past 50 years will be set up, announced the Irish government on May 11. Taoiseach (prime minister) Bertie Ahern said that the establishment of a three-person commission will give victims of childhood abuse a chance to tell their stories in a “healing forum”. The commission will be charged with establishing the causes, nature, and extent of physical and sexual abuse in institutions. It will also have powers to compel child-care personnel, including health boards, to appear.
THE LANCET • Vol 353 • May 22, 1999
Ahern made an unprecedented apology, saying sorry to all those who were abused as children. “On behalf of the State and of all citizens of the State, the Government wishes to make a sincere and long overdue apology to the victims of childhood abuse for our collective failure to intervene, to detect their pain, to come to their rescue . . . what the government has decided to do today is not a break with the past; it is a facing up to the past [and] all that this involves.” The government is also changing the statute of limitations for seeking compensation for abuse, raising
the spectre of hundreds, if not thousands, of claims against religious orders. 42 000 children went through the Irish industrial school system, orphanages, and residential homes which were run by religious orders but paid for by the State. The government action was taken a few hours before the third part of a television documentary on childhood abuse was aired on RTE, the state broadcasting network. The series, States of Fear, has shocked and angered the public. Karen Birchard
1775
T
he New Zealand Health Funding Authority (HFA) ordered a review of 30 000 cervical smear slides in Gisborne, New Zealand, on May 13. The review follows a controversial High Court case in March where a woman with cervical cancer failed to get exemplary damages against a pathologist—doctors cannot be sued for ordinary negligence in New Zealand—who had misread or misreported a series of smear tests between 1990 and 1994. The pathologist, Michael Bottrill, who retired in 1996, was working by himself, had few quality standards in place, and had failed an attempt to get accreditation. He was also rereading his own smear tests. The HFA’s announcement came
after weeks of criticism from the media and politicians who said that the HFA was acting too slowly. HFA said it was hampered by a court order suppressing the pathologist’s name and workplace. A month after the case, Alliance MP Phillida Bunkle, using parliamentary privilege, revealed that Bottrill was based in Gisborne. Bunkle and the Cancer Society of New Zealand added that they knew of other cases involving Bottrill. On May 13, HFA announced that it would provide free smear tests for women in Gisborne and establish counselling and support services, in addition to the review of slides. This was followed the next day by a NZ$1·4 million injection into the
National Cervical Screening Programme. The events in Gisborne have led to some soul-searching about screening and professional self-regulation. A screening programme was instituted in 1990 but has never been formally evaluated, despite requests from successive government advisory-groups. The Minister of Health, Wyatt Creech, has also asked why neither the Medical Practitioners Disciplinary Committee nor the Medical Council of New Zealand had alerted health authorities after they found Bottrill guilty of conduct unbecoming in 1997. Sandra Coney
Canadian blood-donation prohibition for UK visitors
O
n May 5, the Canadian Blood Services and Hema-Quebec announced that they will forbid donations from people who have travelled to the UK since 1980—about 500 000 people per year—until “deferral policies” for such donors are established. The agencies have reversed an assertion made in October, 1998, that stated that they would never impose such a ban because it would decimate the blood services. Consideration of a partial prohibition is being driven by a Laboratory
Centre for Disease Control report commissioned from CreutzfeldtJakob disease (CJD) expert Neil Cashman (University of Toronto, Canada) who concluded that Health Canada should avoid blood from persons incubating variant CJD because it poses a higher risk than classic CJD. Although it is believed that classic CJD cannot be transmitted through the blood system, it is not known whether variant CJD is transmissible. An advisory committee has been set up to establish criteria for deferring
donations and will report by June. The committee is expected to create a system under which donors are rejected depending upon the duration of their visit to the UK. Surveys indicate that 22% of existing donors have visited Britain, so a total ban would probably cause severe blood shortages. But among the options under review is a ban on donors who visited the UK for a cumulative period of more than 1 month since 1980, which is about 12% of all donors. The blood agencies say they must be wary of contaminated blood given Justice Horace Krever’s 1997 recommendations (see Lancet 1997; 3 5 0 : 1688) that safety be placed ahead of definitive scientific proof. Wayne Kondro
Irish go vernment offers an apology to victims of child abuse
A
“truth commission” on child abuse that occurred in publiclyfunded institutions over the past 50 years will be set up, announced the Irish government on May 11. Taoiseach (prime minister) Bertie Ahern said that the establishment of a three-person commission will give victims of childhood abuse a chance to tell their stories in a “healing forum”. The commission will be charged with establishing the causes, nature, and extent of physical and sexual abuse in institutions. It will also have powers to compel child-care personnel, including health boards, to appear.
THE LANCET • Vol 353 • May 22, 1999
Ahern made an unprecedented apology, saying sorry to all those who were abused as children. “On behalf of the State and of all citizens of the State, the Government wishes to make a sincere and long overdue apology to the victims of childhood abuse for our collective failure to intervene, to detect their pain, to come to their rescue . . . what the government has decided to do today is not a break with the past; it is a facing up to the past [and] all that this involves.” The government is also changing the statute of limitations for seeking compensation for abuse, raising
the spectre of hundreds, if not thousands, of claims against religious orders. 42 000 children went through the Irish industrial school system, orphanages, and residential homes which were run by religious orders but paid for by the State. The government action was taken a few hours before the third part of a television documentary on childhood abuse was aired on RTE, the state broadcasting network. The series, States of Fear, has shocked and angered the public. Karen Birchard
1775