On a hiding to nothing?

It is now more than six months since the external auditors, PriceWaterhouseCoopers, were called in to review over 100,000 files in the breast-screening unit after clerical recall errors were discovered. The findings of that report are due to be published shortly. The audit followed a series of both internal and external inquiries into the imaging department, which manages the breast-screening service.

Speaking exclusively to HSJ, trust chief executive John Cooper revealed that the West of London Breast Screening Service, based at the trust's Charing Cross Hospital and managed by the trust, has been suspended for the past 10 weeks because the breast unit has had serious problems implementing the national protocol for reporting results.

Although all staff had been trained, the procedure was still not being followed properly. 'The service is not functioning at the moment.We suspended the service for three months and it will not come back on line until the regional quality assurance team says so. We will be reviewing this at the beginning of September.'

He says this will not create a backlog, as the trust was already ahead of the three-year standard, and had been recalling women every 34 months.

Mr Cooper says delays publishing the audit are because the trust wanted to avoid adverse publicity until as much as possible had been done to address the problems and so that the women identified could be tracked down.

Previous inquiries into the imaging directorate had investigated claims made by whistleblowers about poor performance and safety issues, and also looked at whether the whistleblowers themselves had been victimised.

And HSJ sources claim that whistleblowers who have recently attempted to raise concerns in confidence have faced difficulties.

It is understood that staff trying to raise issues through procedures outlined in the trust's whistleblowing policy have been encouraged to reveal their identities in order to pursue their concerns.

HSJ sources say changes in the management of the unit still need to be made to address issues raised over the past few years.

Mr Cooper insists that criticisms of the way the unit was being run are being addressed: 'In terms of whistleblowing, we have done all we can to reassure people. I personally wrote to every member of imaging department staff [saying] that if they felt they had a problem anybody could come and see me.'

He says the trust has now decided to appoint a superintendent radiographer, after it was found that Hammersmith's breast unit was the only one in the country without this position.

Commenting on his role in the problems the trust has had, he says: 'Ultimately, I am responsible for this service.'But he says that he had not been criticised by any of the inquiries and that neither had Professor Shaw.

Of the Commission for Health Improvement investigation - expected to be published in the spring, months after Mr Cooper takes early retirement in October - he says: 'If there is some fault in what we have done, we have the most independent organisation in the NHS and they will not hesitate to say so.'

Does he feel he could have done more? 'If I criticise myself, I could have paid more attention to the breast-screening unit.'

Nor will Professor Shaw be drawn into guessing whether the CHI investigation will criticise his own role. He says: 'I do not think I could anticipate the future.'

Radiologist Professor Peter Dawson, who resigned from the trust in 1999, after raising concerns about a backlog of unreported images, says there is a huge task ahead for the new clinical director of the imaging directorate, Dr Philip Gischen.

'I hope for radical and sensible change, but the culture historically has not been open. This has to change. People should speak openly and without fear.'