WOULD Dennis Napthine deliberately compromise his personal health to save a few lousy dollars?  Almost certainly not. Why, then, would the Premier allow the health and welfare of thousands of other Victorians to be jeopardised for the sake of saving a bit of cash?

The question arises in the wake of alarming news that Mr Napthine’s Government is pushing ahead with plans to expand the use of nurses — instead of qualified radiographers — to conduct X-rays on patients in regional Victoria.

What began as a pilot program at Lorne Community Hospital is now set to be rolled out across the regions. The Victorian Department of Health is finalising guidelines for rural hospitals to apply for permits to train nurses to perform X-rays. Hospitals in Nathalia, Kilmore and Camperdown are reported to have expressed interest.

The plan has worrying implications for patient welfare. The experiment at Lorne produced numerous reports of botched X-rays, which resulted in patients being forced to undergo repeat procedures – and additional exposure to radiation. Given the accumulative effects of radiation are associated with cancer this is a major public safety concern.

The implications for professional radiographers are also disturbingly clear. There are already more qualified radiographers in Australia than jobs available, and the Victorian plan to use nurses to conduct X-rays can only worsen the employment situation.

On the evidence available from Lorne, it is hard to see how any government, in all conscience, could decide to expand such a program.

The nurses involved initially undertook a ten-week course by correspondence, as with two days of practical training, before being granted limited licences to perform X-rays. Radiographers, by contrast, must study for four years to become qualified. 

Quality control issues at Lorne were apparent soon after the launch of pilot program involving three nurses in 2009. Staff of Barwon Medical Imaging at Geelong Hospital, where the X-ray images were sent, complained repeatedly to their managers about the quality of the work and called in the Health Services Union for support.

The problems included specific examples of unacceptable radiographs requiring repeat X-rays and additional radiation exposure for patients. Nurses were also reported to have taken images of more radio-sensitive central body parts when they were meant to stick to outer areas like hands and feet, except in cases of medical emergency.

The issues, which were reported to Barwon Health management and the Department of Health, led to additional expert training of the Lorne nurses and an independent review of the program. The review found that the quality of the X-rays being produced by the nurses had improved significantly to a ‘’satisfactory’’ level after their extra training.

But this should provide no comfort to other Victorian communities to which the program is being rolled out. The Lorne nurses only managed to improve their performance after receiving intensive tutelage from Bruce Harvey, a senior Geelong radiographer, who was at the time the president of the Australian Institute of Radiography. It is highly unlikely that other centres where the project is rolled out would be able to offer the same level of tutelage.

The ten-week correspondence course is, of itself, manifestly inadequate and an insult to professional radiographers.

Mr Harvey, the immediate past president of the Australian Institute of Radiography, who provided specialist training to the Lorne nurses, said this month that he supported the training of non-radiographers to do X-rays in genuinely remote areas of Australia. But he said there was no real need for it in Victoria, where most people lived within an hour’s drive of a hospital with radiographers on site.

He said a suggestion that patients be given informed consent forms outlining the differences in training seemed to have been rejected by the Government. Given radiation can cause cancer, he said this was important, especially for children, who might face increased doses of radiation if they received inadequate scans and needed them to be repeated.

Importantly, in the same article in The Age, the Australian Nursing Federation’s Lisa Fitzpatrick was quoted saying nurses respected radiographers’ expertise and were not seeking to take on their work in inappropriate circumstances. She said the scheme should operate only in genuinely remote areas.
The Health Services Union Victorian Branch 3, which represents radiographers, could not agree more. We are working hard to persuade the Government to rethink this unconscionable plan and will keep you informed of further developments.