12 Towards a new legal framework for radiotherapy in the EU member states: Is there a scope for harmonisation? Can ESTRO contribute?

Abstract

On 30 June 2997 the official journal of the European Communities published the “Council Directive 97/43/Euratom on health protection of individuals against the dangers of ionising radiation in relation to medical exposure and repealing Directive 84/466/Euratom”. Since radiation protection issues are generally not the concern and responsibility of the clinical radiotherapy community, this directive escaped attention until ESTRO was invited to contribute to a conference scheduled from 28 to 30 April of this year in Luxembourg, on the transposition af the directive into national law, a requirement the member states have to comply with betore 13 May 2000. A quick analysis of the text revealed that, in the context of this directive, the term radiation protection needed to be interpreted in the broadest possible sense: not only the physical conditions preventing occupational hazards and environmental contamination, but the protection of the patient against undue exposure and, as far as radiotherapy is concerned: the delivery of the appropriate dose to the patient. The directive touches upon format education and training requirements, accreditation of individuals and departments, minimal infrastructural requirements, staffing, recommendations for continued medical education and the implementation of quality assurance measures. Is the European Radiation Oncology ready for this? Did we do our homework? Whereas some other medical associations were pressing for European examinations and diplomas ESTRO has chosen for bottom-up approach by patiently and carefully working at a grassroots level on a convergence of European standards through its quality assurance, education, exchange and mobility programmes. Besides, the newly created European Board of Radiotherapy in which the scientific community (ESTRO) and the professional bodies (UEMS) are represented on a parity basis, started tackling the issues the profession needs to face up to in order to provide a solid basis for the guaranteed freedom of movementot of its members within the European space: the harmonisation of basic and continued education, guidelines for the length and content of the practical training in radiotherapy (logbook system), and minimum standards for the accreditation of teaching departments. A European examination and diploma were only envisaged to come at the end of the road. However, with the European directive in mind these long term objectives have now gained momentum and. If ESTRO is to play a role in building a European consensus around the legal framework which will govern the future functioning of Radiation Oncology in Europe, it will have to come up quickly with solid data and creative and thorough discussion documents for entering the debate at the national level.