§ Mr. AshleyTo ask the Secretary of State for Health (1) what is his estimate of the amount of damage to patients, and the number affected, that has occurred as a result of excessive medical radiation;
(2) if he will conduct an inquiry into the amount of radiation hospitals are giving their patients by X-rays;
(3) if he will make it his policy to identify hospitals which, according to the National Radiological Protection Board, might be giving their patients too much radiation.
§ Mr. DorrellNo current estimates are available; the figures mentioned in the National Radiological Protection Board/Royal College of Radiologists report "Patient Dose Reduction in Diagnostic Radiology", a copy of which is available in the Library, are based on data from 1983, and since then, the more widespread adoption of rare earth screens, where appropriate, will have reduced the amount of medical radiation that patients receive when undergoing diagnostic examinations. The Department of Health is currently funding a project with the National Radiological Protection Board which will provide an up-to-date benchmark which can then be updated on a yearly basis.
In the survey of radiation doses to patients undertaken by the National Radiological Protection Board, the 1983 data from hospitals were anonymised. It would be misleading to publish data on individual hospitals without detailed information on the type of examinations carried out, case mix and so on.
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§ Mr. AshleyTo ask the Secretary of State for Health (1) if he intends to take any steps to minimise radiation exposure from X-rays;
(2) if there are any constraints on doctors exercising clinical judgment when ordering X-rays for patients; and if any changes are being considered.
§ Mr. DorrellThe Ionising Radiation (Protection of Persons undergoing Medical Examination or Treatment) Regulations 1988 lay down that all medical exposures that take place using ionising radiation must be conducted under the responsibility of a person clinically directing, in accordance with accepted clinical practice, and with procedures to ensure a dose as low as reasonably practicable. An inspectorate has been set up within the Department of Health to enforce these regulations.
A range of advice is available to help clinicians fulfil their obligations including the National Radiological Protection Board/Royal College of Radiologists report "Patient Dose Reduction in Diagnostic Radiology", issued in 1990, and the recently issued health service guidelines from the medical devices directorate entitled "Patient Dose Reduction". These guidelines give advice to health authorities on the purchase of equipment for diagnostic X-ray examinations, with particular emphasis on the equipment aspects of minimising radiation exposure from X-rays. Copies of the guidelines are available in the Library.
The Department of Health and the King's Fund have been funding a project to evaluate the Royal College of Radiologists' guidelines on "Making the best use of a Department of Radiology" and the final report is due at the end of January 1992. This project assesses the guidelines necessary to assist clinicians in deciding the appropriateness of X-ray examinations to be ordered for their patients.
Finally at local level radiologists in charge of X-ray departments set out protocols for their departments to determine when an X-ray examination is appropriate following an X-ray request from their clinical colleagues.
§ Mr. AshleyTo ask the Secretary of State for Health (1) when he last discussed safe medical radiation levels with the National Radiological Protection Board; and if any changes in medical practice have been, or are to be, recommended;
(2) what discussions he has had with the Royal College of Radiologists; and if any changes in medical practice have been, or are to be, recommended.
§ Mr. DorrellThe Department of Health has an observer at board meetings of the National Radiological Protection Board and is fully aware of the board's views on the establishment of accepted normal values for the dose involved in diagnostic X-ray examinations. Regular liaison meetings are held between the Royal College of Radiologists and the Department of Health. The NRPB and RCR advice on changes in medical practice is set out in the recommendations of their joint report "Patient Dose Reduction in Diagnostic Radiology", a copy of which is available in the Library.