There appears to be a lack of acceptance of UK law and its implications,
all Jacquie has said is that there is a law you can't ignore - even if you
think it's stupid!

Under UK law - each request must be 'justified' by
the 'practitioner'. 'Justification' is a technical term and is not the same
as this word's plain English usage, as a referrer - you can't 'justify' the
request (which just adds to the confusion in my opinion).

Keeping on topic - this means that IRMER legislation clashes with the
legislation you mention about police inspectors requesting radiographs. It
clearly states in the new amended IR(ME)(A)R 2006 (ammendment 3, section 2
subsection f) that now referrers have to be a "registered health care
professional" I'm not sure how this will work out... I will ask over in the
medical physics forum, but I guess this is why they are asking you to fill
out the form, cos the radiology 'practitoner' certainly should not carry
out such an exam - it would be ILLEGAL!

On the more general point about relationships under strain between
Radiology and A&E - Australian law has no such technical definition of
a 'justification' step as far as I am aware... So Paul's comparison is not
valid, and 'pay per x-ray' services would not be a panacea in the UK (with
current law their would be a conflict between the patient protection clause
and financial imperative)

Also - one does not need to read Foucault to realise there is also a deal
of micro political activity going on here. Radiographers and, to some
extent radiologists will flex what muscle they have... (as will A&E
staff...)

For example, if radiology practitioners prefer CT (high dose) over US (no
dose) for a particular clinical indication, they just get on and write a
protocol, and all patients have a change in care, with a consequent higher
risk to that patient. Most of the research in radiology is heavily biased
toward new, highly technical modalities away from less costly, less
technical ones. (Something to do with research bias, and a powerful
manufacturer lobby willing to 'sponsor' research on their new 64 slice CT
scanner...) This is happening with the FAST scan I believe, with multislice
CT now seen as 'better'. (All the Evidence Based Practice, just pick the
evidence you want...)

AF's point - that there is more harm in NOT imaging, than in imaging is
well made. There are very few truly high dose (risky) exams (cardiac
interventions like angioplasty and stenting are perhaps the only ones that
could cause deterministic effects) despite this; the focus of most
radiation protection training I have seen is that the BEST radiation
protection is to NOT do the exam in the first place. Please be aware
that 'refusing' radiographers (and prob radiologists) have had this type of
policy drummed into them during their training - and would fail their
assessments if they did not cite this legislation. It is quite a difficult
place to be, what you are piggy in the middle.

Philip