HSE fails to audit on protecting patients from X-rays

THE Health Service Executive (HSE) has breached regulations designed to protect patients and practitioners from radiological exposure by failing to meet the deadline to audit its own radiological installations.

Under a European directive transposed into Irish law in October 2002, the first clinical audit of all radiological equipment, including that used in mammography, should have taken place two months ago.

Instead, a questionnaire is today being sent out to all public hospitals to effectively self-audit their own diagnostic radiology equipment.

In addition, an audit of radiology equipment used in dentistry will not start before February of next year.

Yesterday, the HSE blamed the Dental Council’s delay in producing the necessary criteria for clinical audit for the failure to meet the audit deadline. Both the Medical Council and the Dental Council were required by the regulations to produce criteria by 2004, which the Dental Council failed to do.

However, a taskforce set up by the HSE in April to report on progress in implementing the regulations warned the council’s tardiness was an unacceptable excuse. The interim report said it “could not be relied on as a reason for not keeping to the timetable to carry out the first audit within the timeframe specified in the regulations”.

This was according to legal advice obtained by the taskforce. Any breach of the regulations carries a €3,000 fine.

The taskforce report also highlighted difficulties “concerning the independence of the HSE in carrying out audits and setting standards not only for itself but also all holders of radiological installations, including private”.

It said the legislation would need to be amended to transfer responsibility for regulatory audits to the Health Information and Quality Authority (HIQA) and that it would be “well into 2009” before this transfer was complete.

The taskforce said that for meeting obligations under the legislation “there is a significant shortfall in relation to medical physicists’ requirements”.

Yesterday, a spokesperson for the HSE said a number of things had been done since the taskforce met in April. These included the commencement today of a baseline audit to establish practices on clinical audit in the form of a questionnaire circulated to hospitals. A register of all medical ionising radiation installations has also been drawn up as per the regulation and discussions on the recommendations for proposed amendments to the regulations have taken place between the HSE and HIQA and the Department of Health.

When completed, the final report of the taskforce will issue to the department, which will then consider what legislative amendments will be required.

In addition, a National Radiation Safety Committee has been established to meet legal requirements and its first meeting took place this month. A review of standards in ionising radiation is under way and “staffing issues are being pursued through the HSE framework on workforce planning and are still being considered”.