Abolish screening programmes for the worried well and start treating the sick

I would like to abolish quotas and targets for the cervical screening programme. Forcing 80% of women to undergo this procedure is an infringement of our civil rights. If you are female you cannot go to your doctor about any other problem without them forcing you to have a smear test, even though the chances of most women getting the disease are nil. Stop throwing money at these programmes which cause so much worry and pain, and let people go to their GP for whatever or whenever they like.

14 Replies

  • If you have been forced in any way to have a a cervical screening test you should make a written complaint to the Practice Manager ...I do not know all the NHS rules but I am 99% sure that no such rule forcing this screening test exists.

  • Thanks for your reply, @Kathyfitz12, and I am sure that you are right, but in practise a great deal of coercion and threats go on to make women comply with the GP's demands. Many women think that they might not get other services or help for other ailments if they don't give in to having a smear. Because, GPs get paid a bonus for screening 50% of women, and they get paid an additional bonus for screening 80% of women, there is now a price on a woman's cervix, and some GP's who put the money before the patient pursue women relentlessly to get it done. The cervical screening programme is a commercial con costing about £132 million, about half of which goes to GPs if they can reach the 80% screening target. I don't think there is any other part of the human body, which GPs can get a financial incentive to treat. I would like to see the money spent on better healthcare generally.

  • If what you says is the position we women should just take a deep breath & say NO WAY!

    If you feel you are being pressurised in any way you really must try to report the fact to your local Health Regulator and ask that they contact your GP with a view to stopping the practice. I know that GP's are now very cash conscious but diligently pursuing women to have smear test to reach a cash target is repugnant!

  • Yes, I find it quite repugnant, but so few women seem to be aware that this is going on, and most I have spoken to have assumed that cervical screening is mandatory, and have never questioned why. In my particular case, my last smear was 16 years ago, and after a battle for some years I was sent a letter to opt out, so I haven't been pestered for a while.

    Some of the things which used to happen were that if my GP couldn't convince me they would get the nurse to give me a "woman to woman" chat where I was asked to think of what I was doing to my children, did I want them to know I might die and leave them as orphans, and how I could do this to them. When that didn't work it was whether to trust our husbands for not sleeping around. It disgusted me to be "worked on" in this way. Finally, I was even telephoned at home, by a woman also trying to convince me to attend. I find it disgraceful that the NHS spends so much money on this and has been so cash-strapped in other areas.

  • Any GP Practice that acts like this is a disgrace to the medical profession! I just cannot believe that such practices are taking place in UK in the 21st a century!

    I urge you to forward this correspondence to your local health authority.

  • I just hope this isn't still happening in the 21st century, as I know the NHS is updating it's propaganda leaflets, but it was certainly the order of the day at my GP's surgery during the late 1990's. I am very surprised that you didn't realise this kind of thing was going on. If a GP's practice is just short of a few women to make the 80% screening target, the practice can stand to lose about £2,000 in bonuses, so they have a good reason to pile the pressure on women, who have made an informed choice not to have it done. Although the new leaflets do say more about the innaccuracy of the cervical screening test, they still fall short of explaining the truth: that this test is painful, has a wide margin of error and causes so much unnecessary treatment and harm to women for very little gain.

  • You're right, it's an abuse of our rights, all cancer screening is elective and legally and ethically requires our informed consent. I only agree with evidence based screening that respects our right to balanced information and informed consent. That doesn't exist here in Australia, women get a one-sided sales pitch and pressure to screen, our GPs also, get target payments. I've never screened, my GP has simply made a note on my file. (i'm mid 50s) I've also, recently declined mammograms, another informed decision.

    I've found doctors will try it on, if you're informed, they back off quickly. Also, most women don't lodge complaints, so the coercion and pressure continues. I've heard of UK women being sacked by their doctor if they don't screen, this should be reported to your Medical Council. It's a serious matter.

    Most countries do not offer evidence based cervical screening, they try and drag in everyone and distress and harm huge numbers and waste a lot of money. Of course, vested interests protect population pap testing, they make a fortune.

    The Dutch have an evidence based program, they're about to scrap their 7 pap test program, 5 yearly from 30 to 60, and offer instead 5 HPV primary tests at ages 30,35,40,50 and 60, or women can self-test, and only the roughly 5% who are HPV+ and at risk will be offered a 5 yearly pap test. (until they clear the virus) This will save more lives and take most women out of pap testing and harms way. Those HPV- and confidently monogamous or no longer sexually active might choose to stop all further testing. So most women cannot benefit from pap testing, but testing risks their health. (false positives are common)

    Here women are given shocking medical advice, urged to have 26 pap tests, 2 yearly from 18 or 2 years after you become sexually active until age 70, awful over-screening that sends risk way up, the lifetime risk of referral here for colposcopy/biopsy is a whopping 77%, now this is the result of outdated population pap testing and over-screening for a cancer with a 0.65% lifetime risk. It's rare, always was and was in natural decline before testing even started.

    It's madness, medical abuse.

    Forwomenseyesonly.com is a great source of real information and lots of interesting discussion between informed women. Your Dr Margaret McCartney also, has a great forum, she's declined pap tests and will also, decline mammograms when she turns 50. Fortunately, the UK has a few amazing advocates for women's rights, informed consent, our right to decline and evidence based screening. We have virtually no one here protecting women.

    Good luck to you...nice chatting.

  • You are quite right @Eliz52 the Dutch have had the guts to scale down their own screening programme. Assuming all are negative, women are sent invitations at age 30, 35, 40, 50, and finally 60. A grand total of only 5 smear tests during a Dutch woman's lifetime, yet have a lower incidence of this disease compared to the UK, where women are expected to endure about 14 of these tests and that's only if all of these are negative.

    The programme is such a waste of public money and so oversold to everyone, that most women just cannot see that this disease is extremely rare and was in decline even before the call-and-recall screening programme began, and yet those behind this scheme are claiming that the programme is the sole reason for the decline in cervical cancer, when it is not.

    Now that the new HPV vaccine has been given to teenage girls, you would think that the programme should be scaled down in the future, but all reports I have read so far, suggest that the scheme will go on just as it is now. So not only will it cost just £132 million but also £350 per girl for each HPV vaccination, just to find the very few elusive needles in the haystack. Supporters of this screening programme, are forever trumpeting about how this scheme saves lives from this rare disease, but how many more lives could be saved, if some of this money was put into other more common diseases, which people get?

  • Adawells

    I couldn't agree more, the focus on this rare cancer is a shocking misuse of health resources, while far more likely risks to our health are shoved in the background. This is what happens when screening tests are introduced without randomized controlled trials (there are none for pap testing) and when bias and self-interest are allowed to influence and control these programs...and when informed consent and consent itself is dismissed for women. I think these programs have been shaped by a very paternalistic medical profession that saw no problem dismissing informed consent, and even consent itself, for women.

    The Nordic Cochrane Institute, an independent, not-for-profit, medical research group, should be given the job of reviewing all screening programs to ensure they're evidence based and these programs must be properly monitored ensuring they respect informed consent. (and consent itself) Coverage at all costs is the motto in women's cancer screening, and that is grossly inappropriate.

  • You are NEVER forced to undergo screening tests, you have right to choose. If your GP pressurises you against your wishes then I would change your GP to one who is more respectful and I would also put a complaint on patient opinion.com website

  • Thank you for your advice about patient opinion, but this website seems to be for events which have happened in the last 3 years, and my experience was a long time ago now. Things might be more relaxed now, but I believe the 80% threshold still stands, and if GPs stand to lose money by not meeting their 80% screening targets, they will almost certainly put the pressure on and use whatever coercion they can to get women screened. I don't see how this 80% target is compatible with women having a real choice about whether to screen or not if the target has to be met.

  • Hello

    For screening you have personal choice

  • Margaret McCartney's book The Patient Paradox: Why sexed-up medicine is bad for your health

    ISBN: 978-1-78066-000-4

    Is a useful read

    ' Welcome to the world of sexed-up medicine, where patients have been turned into customers, and clinics and waiting rooms are jammed with healthy people, lured in to have their blood pressure taken and cholesterol, smear test, bowel or breast screening done.

    In the world of sexed-up medicine pharmaceutical companies gloss over research they don’t like and charities often use dubious science and dodgy PR to 'raise awareness' of their disease, leaving a legacy of misinformation in their wake. Our obsession with screening swallows up the time of NHS staff and the money of healthy people who pay thousands to private companies for tests they don’t need. Meanwhile, the truly sick are left to wrestle with disjointed services and confusing options.

    Explaining the truth behind the screening statistics and investigating the evidence behind the hype, Margaret McCartney, an award-winning writer and doctor, argues that this patient paradox – too much testing of well people and not enough care for the sick – worsens health inequalities and drains professionalism, harming both those who need treatment and those who don't. '

  • Thank you very much NHSatheist for recommending this terrific book, it is an excellent read, and clearly explains the problems associated with screening programmes. More people ought to read this book and think carefully about the actual figures. It shows how cervical cancer has been in decline for many decades, and that the screening programme itself is highly unlikely to have been the sole reason for today's all time low rates, as the pro-screening lobby claims it has been.

    For instance, the numbers of women getting screened for cervical cancer are constantly going down, so if the programme is directly responsible you would expect the death rate to be rising, which it is not.

    Women really must be told the truth about these screening programmes, so that they can make an informed decision about whether to participate or not. The coercion and brainwashing that has gone on to terrorise women into believing that these unreliable and inaccurate tests are a mandatory part of our healthcare is scandalous.

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