Health: Third of cervical labs fail targets

More than a third of cervical screening laboratories are failing to meet standards set by the health department. Yesterday, the Government's chief medical officer announced an action plan to bring the poor performers up to the mark. Jeremy Laurance reports.

Poorly performing cervical screening laboratories were named for the first time yesterday as the Government warned that failure to meet targets would not be tolerated.

Official figures published yesterday show that 83 of the 181 laboratories checking smears fail to meet the national standard for an inadequate smear, and 33 are too small to guarantee accuracy.

An inadequate smear, which means the woman must be recalled for a repeat test, may arise from a failure to take an adequate sample of cells, or from other problems in the laboratory. One laboratory, at the Royal Albert Edward Infirmary, Wigan, found 34.8 per cent of its smears to be inadequate compared with a target range of 5 to 9 per cent. The laboratory examined 4,247 smears last year, well below the 15,000 smears judged necessary to ensure that screeners have sufficient expertise.

Although guidelines specifying the 15,000 minimum were issued 18 months ago, only one laboratory, at St Cross hospital, Rugby, has closed as a result. The laboratory triggered a scare last month after the smears of 18,000 women had to be re-examined after checks showed some that were abnormal had been missed. The laboratory processed fewer than 7,000 smears a year.

There have been a series of scandals of which the worst occurred at Kent and Canterbury hospital where five women developed cancer after abnormal smears were missed and 90,000 smears had to be re-checked. A report on the incident published in October identified management failures as the cause and Frank Dobson, Secretary of State for Health, announced a national review .

Launching the action plan yesterday, Sir Kenneth Calman, the chief medical officer, said small laboratories could be required to close and staff from others where performance was poor may have to undergo re-training.