HC Deb 01 February 1989 vol 146 cc270-4W
Mr. Cousins

To ask the Secretary of State for Health (1) whether he has asked the National Radiological Protection Board, or any other agency, to prepare scientific standards for the calibration of radiation machines;

(2) on what dates within the last five years his Department circulated health authorities with advice on the calibration and dose standards of radiation machines; and if he will place the texts of such advice in the Library.

Mr. Mellor

In December 1985 we issued to health authorities health circular HC(85)31 which informed them of their responsibilities as employers for ensuring compliance with the Ionising Radiation Regulations 1985 (SI 1985 No. 1333). In May 1988 executive letter EL(88)P/64 was issued covering a more detailed and technical document; "Guidance Notes for the Protection of Persons against Ionising Radiations arising from Medical and Dental Use", prepared under the joint auspices of the National Radiological Protection Board, the Health and Safety Executive and the health Departments. This replaces a code of practice first published in 1957 and most recently revised in 1972. Pages 29 and 30 of the guidance notes deal specifically with calibration and maintenance. The executive letter indicated that the guidance notes provided a guide to good practice and asked managers to bring them to the attention of all relevant staff. All these documents have been placed in the Library.

In December 1988 the Institute of Physical Sciences in Medicine (IPSM) issued to its members further advice augmenting that in the guidance notes. Having consulted relevant professional bodies on the content of the IPSM advice, we shall shortly include it in consolidated guidance to health authorities on the use of ionising radiations.

1988. Mr. Cousins

To ask the Secretary of State for Health how many consultant radiotherapist posts were funded within the National Health Service; and in which hospitals these posts are or were located in(a) 1983 and (b)

Mr. Mellor

Information about medical staffing is collected by employing authority and not in relation to the hospital in which a doctor is working. The employing autorities for consultants are regional health authorities, district health authorities designated for teaching purposes and special health authorities for the London postgraduate teaching hospitals. The latest available informantion about consultant radiotherapists by employing authority is set out in the table.

Table: permanent paid consultants in radiotherapy: by regional health authority and teaching district health at 30 September each year
1983 1986
number WTE number WTE
England 182 177.7 181 175.2
Northern RHA 9 8.0 10 8.8
Newcastle upon Tyne DHA 6 4.4 6 4.3
Yorkshire RHA 14 10.4 12 9.4
Leeds Western DHA 8 6.0 8 6.3
Trent RHA 15 14.5 17 15.4
Leicestershire DHA 3 3.0 3 3.0
Nottingham DHA 4 3.0 4 3.0
Sheffield DHA 5 4.4 6 5.4
East Anglian RHA 8 8.0 10 10.0
Cambridge DHA 4 3.0 5 3.9
North West Thames RHA 15 11.6 11 9.1
Paddington and North Kensington DHA 3 1.6 1 0.5

1983 1986
number WTE number WTE
Riverside DHA 6 5.0 4 3.8
North East Thames RHA 26 22.9 21 19.4
Hampstead DHA 2 1.8 1 0.5
Bloomsbury DHA 6 3.5 5 3.7
City and Hackney DHA 4 3.1 3 2.8
Tower Hamlets DHA 3 2.8 3 2.9
South East Thames RHA 17 15.1 18 17.1
West Lambeth DHA 4 3.4 3 3.0
Camberwell DHA 2 2.0 2 2.0
Lewisham and North Southwark DHA 3 2.1 3 2.3
South West Thames RHA 10 6.5 9 6.5
Wandsworth DHA 4 2.1 3 2.1
Wessex RHA 9 8.6 12 9.9
Southampton and South West Hants DHA 4 4.0 4 4.0
Oxford RHA 12 9.9 12 10.7
Oxfordshire DHA 4 3.8 5 4.7
South Western RHA 16 14.8 16 14.1
Bristol and Weston DHA 7 5.7 7 5.1
West Midlands RHA 15 14.0 15 13.9
Central Birmingham DHA 5 3.9 6 4.7
Mersey RHA 8 7.1 7 6.5
Liverpool Central DHA 8 1.0 7 1.7
North Western RHA 17 15.6 17 15.6
Central Manchester DHA 0 0.0 0 0.0
South Manchester DHA 16 15.4 16 15.5
Salford DHA 0 0.0 0 0.0
Special Health Authorities (LPGTHs)
Hospital for Sick Children 0 0.0 1 0.2
Hospitals for Nervous Diseases 0 0.0 0 0.0
Moorfields Eye Hospital 0 0.0 0 0.0
Bethlem and Maudsley 0 0.0 0 0.0
National Heart and Chest 1 0.1 1 0.1
Royal Marsden 5 3.9 5 4.0
Hammersmith and Queen Charlottes 7 5.4 5 3.9
Eastman Dental 0 0.0 0 0.0

Notes:

1.Regional health authority figures include all consultant staff employed within the region including the numbers for individual authorities cited.

2.For the England total, staff holding two or more appointments whether with the same or different regions are counted once only. Differences in the sum of numbers of staff for all regions are due to the duplication of staff holding appointments in more than one region. Such are included in each region. This duplication does not occur in the WTE component.

Mr. Cousins

To ask the Secretary of State for Health what steps he has taken to ensure that each radiaion machines has(a) a calibration logbook, (b) a maintenance logbook and (c) a patient logbook; and on what dates such steps were taken.

Mr. Mellor

This is for individual health authorities to decide. Recommendations for record keeping are given in "Guidance Notes for the Protection of Persons against Ionising Radiations arising from Medical and Dental Use", which we drew to the attention of all health authorities in executive letter EL(88)P/64 in May 1988. This replaced "Code of Practice for the Protection of Persons against Ionizing Radiations arising from Medical and Dental Use" which, originally printed in 1957, and subsequently revised in 1968 and 1972, similarly advised health authorities.

Mr. Cousins

To ask the Secretary of State for Health what are the sources of guidance for the maintenance standards of radiation machines he expects health authorities to adopt; on what dates such standards were drawn to the authorities' attention within the last five years; and if he will place the text of letters drawing attention to such standards in the Library.

Mr. Mellor

Existing departmental guidance to health authorities, bearing on the safe use and maintenance of equipment delivering radiation doses, is in the form of:

  1. (a) Health Circular HC(85)31, issued in December 1985, which informs authorities of their responsibilities as employers for ensuring compliance with the Ionising Radiations Regulations 1985.
  2. (b)Health Equipment Information Booklet HE1 98, updated in August 1984, on management of equipment;
  3. (c)Health Notice HN(87)22, issued in 1987, which sets out advice on decontamination procedures, where necessary for inspection or maintenance purposes;
  4. (d)Executive Letter EL(88)P/64, issued in May 1988, covered issued of a detailed document, "Guidance Notes for the Protection of Persons Against Ionising Radiations Arising from Medical and Dental Use";
  5. (e)Health Circular HC(88)29, issued in June 1988, which informed authorities of their responsibilities under the Ionising Radiation (Protection of Persons Undergoing Medical Examination or Treatment) Regulations 1988;
  6. (f) Executive Letter EL(88)P/127, issued to Regional General Managers in December 1988, which reminded authorities of their responsibility to ensure that they and their staff observe their obligations to protect people against any harmful effect from ionising radiations and to ensure safe and effective operation of all their departments.

I have arranged for copies of the guidance specified to be placed in the Library.

Mr. Cousins

To ask the Secretary of State for Health what are the sources of guidance for the calibration and dose control standards of radiation medicines which he expects health authorities to implement, and the particular sections of such sources which particularly refer to calibration and dose standards; and if he will place all such guidance in the Library.

Mr. Mellor

In May 1988 executive letter EL(88)P/64 was issued to all health authorities, covering the guidance notes for the protection of persons against ionising radiations arising from medical and dental use, which replaced a code of practice first published in 1957, and most recently revised in 1972. Section 10.46 et seq of the guidance notes deal specifically with calibration and dose standards regarding radioactive substances, (which includes what you refer to as radiation medicines).

The executive letter indicated that the guidance notes provided a guide to good practice and asked managers to bring them to the attention of all relevant staff. All these documents have been placed in the Library.

Mr. Cousins

To ask the Secretary of State for Health when he has asked for all the incidents of radiation overdosage within the National Health Service to be reported to him; and on what dates such a request was issued to regions or districts.

Mr. Mellor

In 1972 we contributed to a revision of the code of practice for the protection of persons against ionising radiations arising from medical and dental use, which was issued to all health authorities. That code called for reporting of instances in which patients had received in excess of a prescribed dose of radiation.

The Ionising Radiations Regulations 1985 sent to all health authorities along with health circular HC(85)31, made it mandatory for the Health and Safety Executive to be notified, by the employer, of any incident in which a person undergoing a medical exposure was exposed to ionising radiation, to an ex tent much greater than that intended. The guidance notes for the protection of persons against ionising radiations arising from medical and dental use published in 1988, to replace the code of practice, gave further guidance on the interpretation of the Ionising Radiations Regulations 1985, and made it clear that all radiation accidents or serious defects involving equipment should be notified immediately to the Department. This document, under cover of executive letter EL(86)P/64, was also distributed to all health authorities.

Mr. Cousins

To ask the Secretary of State for Health how many consultant radiotherapists are actually working in the National Health Service in each of the last five years; and what percentage of such consultants are full time within the National Health Service.

Mr. Mellor

The available information is set out in the table. Consultants with whole-time NHS contracts are not required to spend the whole of their professional time on NHS work. The number of consultant staff working exclusively in the NHS is not known and, therefore, the percentage given is that for consultants holding whole-time contracts.

Table: Consultants in Radiotherapy (at 30 September each year)
England Numbers
Year All staff1 Whole-time Percentage

whole-time
1983 199 115 57.8
1984 195 107 54.9
1985 199 106 53.3
1986 202 104 51.5
1987 204 100 49.0
1 Includes permanent paid and honorary staff, but excludes locum staff.

Mr. Cousins

To ask the Secretary of State for Health (1) what support he has given, or proposes to give, to the nationwide survey of the quality of radiation dosimetry being carried out by the Institute of Physical Sciences in Medicine;

(2) why he has refused financial support to the Institute of Physical Sciences in Medicine's nationwide survey of the quality of radiation dosimetry.

Mr. Mellor

In 1984 a decision was taken not to support this project from central research and development funds. In terms of its research and development merits it was not of as high priority as competing projects. However, its merits as a quality assurance aid to NHS management was full recognised and the Institute of Physical Sciences in Medicine was advised to seek support from health authorities on this basis.

A number of hospitals have subsequently participated in the survey, including the Royal Devon and Exeter hospital where, in 1988, it played a role in revealing an error in the radiotherapy department.

Any further proposals for central funding will be considered on their merits.