How safe is Australian radiotherapy?

Many incidents and near-incidents are known to occur in Australian radiation oncology departments. The vast majority of incidents are minor in nature; however, a small percentage represent major threats to good patient care, administrative structures and public confidence. A small, but regular, number of incidents result in ad hoc local and/or state committees of enquiry or tort actions, and inevitably have substantial personal and departmental repercussions. Apart from some local databases on treatment-delivery incidents maintained by radiation therapists, no systematic data collection or analysis of treatment incidents exists for radiation oncology in Australia. The present paper argues the case for a prospective, systematic approach to the recording and analysis of treatment-related incidents and near incidents. Major barriers to such a scheme, including fear of litigation, misuse of information and lack of understanding on the nature of an incident are discussed.