Legal briefing

The Court of Appeal has upheld a High Court judge's ruling that East Kent health authority was negligent in the case of three women who developed cervical cancer after negative smear test results at Kent and Canterbury Hospital.

The Appeal Court said a competent screener would not have treated the slides as negative but would have referred them to a supervisor. The NHS Litigation Authority, backed by the Department of Health, appealed on the grounds the High Court ruling would threaten the screening programme nationwide.

The Appeal Court judgment raises questions why the DoH thought it worth spending£500,000 to appeal.

The judges point out the High Court judge was concerned only with the slides relating to Sandra Penny, Lesley Cannon and Helen Palmer, and with the standards of screening at the time, 1989-1992.

He decided that they all contained obvious abnormalities. Failure to spot different abnormalities might not have been considered negligent. Nor would negligence be established just because a woman developed cervical cancer after a negative test result.

The publicity generated by the cases will probably lead to more pressure on resources because women will demand more frequent tests.

The legacy of this saga, in which 57 women have received payments totalling more than£1m, will probably be more colposcopies after doubtful smears, and better training for screeners in spotting the difficult early signs of adenocarcinoma.