§ Mr. AshleyTo ask the Secretary of State for Health what representations he has received from the Radiotherapy Exposure Action Group; and what was his response.
§ Mrs. Virginia BottomleyNo representations have been received.
§ Mr. AshleyTo ask the Secretary of State for Health if he will require all radiotherapy departments to routinely provide all patients with written information about radiotherapy they are to receive, with the information indicating any likely side effects; and if he will ensure that written consent is requested if the treatment is in any way experimental.
§ Mrs. Virginia BottomleyAll patients have a right to reject or consent to treatment. They are entitled to as much information as they need, on an individual basis, to enable them to make a proper decision. Written consent should be obtained where a proposed procedure, including an experimental one, carries a substantial risk or substantial side effect. Most radiotherapy departments routinely provide patients with information on side effects of their treatment.
§ Mr. AshleyTo ask the Secretary of State for Health approximately how many people develop cancer annually and are treated with radiotherapy.
§ Mrs. Virginia BottomleyIn 1986, the latest year for which figures are available, there were approximately 193,000 registrations of newly diagnosed cases of malignant neoplasms in England. Information on whether radiotherapy forms part of a patient's treatment is not routinely collected.
§ Mr. AshleyTo ask the Secretary of State for Health what is the staff size of the inspectorate set within his Department to enforce the Ionising Radiation Regulations 1988; when it was established; and what changes there have been in the level of radiation doses since 1988.
§ Mrs. Virginia BottomleyThe Department of Health inspectorate to enforce the Ionising Radiation (Protection of Persons undergoing Medical Examination or Treatment) Regulations 1988 was established in 1989 and currently warrants are held by four officials. The inspectorate is supported by the Department of Health (DH) administrative division concerned with ionising radiation.
Currently, the DH inspectorate is concentrating on investigating incidents that have been reported, but since 1988 we have asked health authorities to introduce dose reduction strategies.
DH has endorsed the joint report of the National Radiological Protection Board (NRPB) and the Royal College of Radiologists entitled "Patient Dose Reduction in Diagnostic Radiology" and is currently funding, at NRPB, a national survey of diagnostic radiology doses which will be published in 1993.
All these initiatives are directed towards reducing doses in the diagnostic radiology field.
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§ Mr. AshleyTo ask the Secretary of State for Health which professional bodies advise him on radiotherapy exposure.
§ Mrs. Virginia BottomleyThe Department holds regular meetings with the Royal College of Radiologists and is offered advice on an informal basis by the British Nuclear Medicine Society. Both these professional bodies advise the Department on radiotherapy exposure among other issues.
The Administration of Radioactive Substances Advisory Committee (ARSAC) advises Ministers on the administration of radioactive medicinal products and related scientific and radiological safety matters. The members appointed to this committee are proposed by the relevant professional bodies.
The chief medical officer at the Department is advised by his radiotherapy adviser, Professor Bleehan, on radiotherapy matters relating to the NHS.
§ Mr. AshleyTo ask the Secretary of State for Health from what sources he is provided with information about the extent and nature of damage from exposure to radiotherapy; and if he will establish a research programme to provide comprehensive information and to look at ways of preventing damage from both excess and inadequate exposure.
§ Mrs. Virginia BottomleyInformation about the extent and nature of damage from exposure to radiotherapy is available in the clinical literature, as a result of research carried out by doctors, radiobiologists and related medical scientists.
The Department circulated a document "Quality Assurance in Radiotherapy" to all radiography departments in May 1991, a copy of which is available in the Library. This document was produced by a working party established by the Standing Medical Advisory Committee. A research project to establish the applicability of this approach is being funded at two centres by the Department. The results of the research will be promulgated widely.
§ Mr. AshleyTo ask the Secretary of State for Health if he will require his radiation inspectorate regularly to inspect radiotherapy equipment and its use in all NHS hospitals.
§ Mrs. Virginia BottomleyEmployers in the NHS and private health sector are required by the Ionising Radiation Regulations 1985 to ensure that radiotherapy equipment is designed, constructed, installed and maintained so as to be capable of providing the required treatment with the minimum of exposure. These regulations are enforced by the Health and Safety Executive.
§ Mr. AshleyTo ask the Secretary of State for Health what is his latest estimate of the number of patients damaged by(a) excess radiotherapy and (b) inadequate amounts of radiotherapy.
§ Mrs. Virginia BottomleyThe information on which such an estimate could be based is not available centrally.
§ Mr. AshleyTo ask the Secretary of State for Health if he will require all district health authorities(a) regularly to monitor exposure to radiotherapy, (b) to record every incident of excess or inadequate exposure and (c) to prepare an annual report for him, to include details on the nature, quality and age of its radiotherapy equipment.
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§ Mrs. Virginia BottomleyAll district health authorities are required by the Ionising Radiation (Protection of Persons Undergoing Medical Examination or Treatment) Regulations 1988 (IR(POPUMET) Regs 1988) to ensure their staff are adequately trained and that those who physically direct medical exposures
ensure a dose of ionising radiation to the patient is as low as reasonably practicable in order to achieve the required diagnostic or therapeutic purpose".Every radiotherapy treatment is calculated for a specific patient and involves the regular monitoring of exposures from radiotherapy machines, as well as the regular review and clinical audit of the results of such treatment. All radiotherapy departments are required by the IR(POPUMET) Regs 1988) to keep an inventory of radiotherapy equipment which would include details of the nature, quality and age of that equipment.
We would expect provider units to report any untoward incidents to the Department of Health inspectorate.
§ Mr. AshleyTo ask the Secretary of State for Health how many qualified radiotherapists are in post within his Department.
§ Mrs. Virginia BottomleyThe Department does not employ any radiotherapists.
§ Mr. AshleyTo ask the Secretary of State for Health if he will establish a central fund to provide immediate no fault payments for those damaged by excess or inadequate radiotherapy.
§ Mr. DorrellNo-fault compensation was proposed as part of the National Health Service (Compensation) Bill which was defeated on a free vote by a substantial majority at Second Reading. The Government's position remains that the basis for seeking compensation should be through proof of negligence actions through the courts.