A government report published yesterday said laboratories across the country were facing increasing difficulties recruiting staff because of poor pay and "adverse publicity" arising from the scandals that have beset the service. It said the position had deteriorated over the past year.
Sarah May, of the Institute of Biomedical Science, said that A-level school-leavers joining a management course at Marks & Spencer were paid pounds 14,000 a year compared to pounds 7,000 a year for those that went into cervical screening. "Attracting people is a challenge," she said.
After two years' training, the pay of screeners, who check smears under the microscope for signs of abnormal cells, rises to pounds 9,437 and then in steps to pounds 13,849 a year.
Sir Kenneth Calman, the chief medical officer, said that he was concerned about the difficulties and urged NHS managers to be flexible on pay to ensure the programme was adequately staffed. The job carried a heavy responsibility, the training was arduous and the staff faced heavy criticism when things went wrong. "The disincentives to becoming a screener are very high," he said.
Despite the difficulties, the programme was preventing up to 3,900 cases of cervical cancer, and saving 800 lives a year, he said. He described it as a "world-renowned life-saver" whose image had been unfairly damaged by a handful of isolated problems.
Sir Kenneth said that cervical screening was not a test for cancer but aimed to detect abnormalities that might lead to cancer if not treated.
As with any screening programme, it was impossible to achieve 100 per cent accuracy, so checks to ensure that high standards were being met were essential. These were bound to pick up problems.
The report, by the Cervical Screening Action Team, showed that 9 of the 180 laboratories were seeing significantly fewer than 15,000 smears a year - the minimum judged necessary to maintain their expertise.
Sir Kenneth said their future would be decided later this year. All but four of the laboratories had sought accreditation which required them to meet certain quality standards.
The action team was set up in 1997, following concerns raised by failures in the management of the screening service at Kent and Canterbury NHS Hospitals Trust in which at least eight women died and 90,000 were recalled for re-screening.
The team found "strong preliminary evidence" that abnormal smears had been underdiagnosed nationally between 1990 and 1994, falsely reassuring women who were at risk of cancer.
Yesterday's report said that better training was being given to laboratory staff. It also said that laboratories were more open about their standards, and that all were being kept under stringent review.
Dr Mary Buchanan, of the Women's Nationwide Cancer Control Campaign, said: "It is so important for women to continue to go for screening because it is saving lives."