Poor leadership and a "watered-down" monitoring process are undermining New Zealand's breast screening programme, University of Otago associate Prof Brian Cox says.
His comments come in the wake of a hard-hitting independent review of BreastScreen Aotearoa, the national breast cancer screening programme.
The review dated August, but released in mid-December, revealed 10,000 women received two-yearly mammogram invitations later than they should have.
Referring to this late recall, Prof Cox, a screening authority, said it was hard to know whether the programme was vulnerable to similar, but more serious errors.
He went on to say long-term improvements would not happen without a fundamental philosophical change within the National Screening Unit, which oversees BreastScreen Aotearoa, and the Ministry of Health.
Without this change from a management-culture approach to a health-service one, any changes which resulted from the review would be a "bit of a temporary fix".
Prof Cox said he was disappointed New Zealand was still not fulfilling its potential to have screening programmes "up there with the best in the world".
The late recall of the 10,000 women was an example of an issue which had lurked "in the dark only to come out later".
The ministry's management culture "which seems to be in vogue" was not very good for delivering complex public health services such as screening programmes, he said.
Leadership from a specialist in public health medicine was necessary - someone who had the expertise to recognise which bits of the service provision were fundamental and which bits could work with was more leeway.
