Dr. Niall Sheehy:

I would like to clarify some points that have arisen. A comment was made about iRefer. For the information of the committee, iRefer is a set of guidelines issued by the Royal College of Radiologists in the UK with regard to efficient and safe referral for radiology. We endorse iRefer, which is an international gold standard.

A number of comments made by members, including what Senator Burke said about insurance, come back to the issue of statutory regulation. As radiologists and other doctors are legally registered with the Medical Council, they need to have insurance. Doctors who are not part of the Medical Council can be prosecuted. Issues with poor performance by radiologists, which have arisen in the past, are remediable to the Medical Council. Doctors can and do have their licences to practice removed or restrained by Medical Council practitioners. We are not a self-regulating body.

The question of the referrers' clause has been clarified by the chief medical officer. As we said in our submission, there is a huge amount of confusion about the terminology used when someone is doing a referral, doing a prescription or doing a test. Essentially, in radiology terms, in most cases it is a radiographer who takes an X-ray of one's spine. A radiographer is not legally permitted to do this unless he or she has received a referral from someone who is allowed to refer under the legislation. At present, this can be a medical doctor or a nurse referrer. If a chiropractor sends in a request to a radiology department, the radiologist or the practitioner in charge can look at that request and say that it is justified. In such circumstances, that radiologist is legally deemed to be giving the referral to the radiographer that permits him or her to perform the examination. Our understanding is that this will continue under the new legislation. This practice should not change, as we understand it, but perhaps that can be clarified further.

The final question that was asked related to competing practitioners. This is not the issue for us. As we heard in previous testimony, most of the radiology examinations referred by chiropractors are being done in the radiology system. A small volume of studies is being done outside of that. I do not think my colleagues have anything else they would like to say.