Women’s health advocates are demanding urgent accountability after an independent review uncovered serious problems with New Zealand’s new National Cervical Screening Programme Register, including nearly one million screening notifications that were never sent.
The findings come 38 years after the landmark Cartwright Inquiry, which transformed women’s health protections in Aotearoa and helped lead to the establishment of the National Cervical Screening Programme.
The Auckland Women’s Health Council, Cartwright Collective and Federation of Women’s Health Councils Aotearoa say the latest failures risk repeating lessons New Zealand should have learned decades ago.
Nearly one million notifications missing
An independent expert review commissioned by Health New Zealand Te Whatu Ora found the new register, introduced alongside HPV primary screening in September 2023, went live with limited functionality and known problems.
The review found more than 800,000 notifications had not been triggered by June 2025, while another approximately 160,000 were triggered but never sent.
The register is intended to provide a national safety net by managing eligibility, invitations, recalls and follow-up for people aged between 25 and 69 who are eligible for cervical screening.
But the review found screening histories had not been completely migrated from the previous system, while weaknesses in notifications, data quality and clinical recommendations created potential risks for patients.
Health advocates say that strikes at the very purpose of having a national register.
Cartwright legacy hangs over controversy
The timing carries particular significance.
August marks 38 years since Judge Silvia Cartwright delivered her landmark report following an inquiry into the treatment of women with cervical abnormalities at National Women’s Hospital.
The inquiry became a defining moment in New Zealand healthcare, driving major changes around patient rights, informed consent and cervical cancer screening.
Women’s health organisations say the creation of a reliable central register was one of the safeguards intended to prevent women falling through gaps in the system.
They argue the latest problems therefore represent far more than an IT failure.
Māori and Pacific women particularly important
The reliability of cervical screening is also an equity issue.
Health New Zealand says the shift to HPV primary screening has increased screening across all ethnic groups, with more than one million people screened since the new system was introduced.
But ensuring Māori, Pacific and underscreened communities are reached remains critical if Aotearoa is to eliminate cervical cancer.
One of the register’s important intended functions was identifying people who were unscreened or underscreened, yet the independent review found this functionality was among the significant elements not delivered when the system launched.
For wāhine Māori, any failure to reliably identify and contact people requiring screening risks adding another barrier to a health system already confronting persistent inequities.
Health NZ promises action
Health New Zealand has accepted the review findings and established an action plan responding to its 48 recommendations.
The priorities include improving clinical safety, strengthening data quality, fixing notification problems and ensuring people with abnormal results receive appropriate follow-up.
Health NZ says around 13,000 clinical cases have been reviewed, with no harm identified so far as resulting from the register problems.
That provides some reassurance, but women’s health organisations say continued independent oversight and transparent public reporting are essential.
Their concern is straightforward: a screening programme designed to prevent cancer depends on people being identified, contacted and followed through the system.
Thirty-eight years after Cartwright forced Aotearoa to confront what happens when women are failed by health systems, advocates say the country cannot afford to learn the same lesson twice.
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