Against a backdrop of a rising treatment workload and equipment modernisation programmes, marked by extremely rapid development of new technologies, ASN aims to extend the scope of its inspections in 2007 to cover human and organisational factors, in order to check compliance with the safety requirements applicable to radiotherapy installations.

In addition to its own supervisory duties and the powers of inspection recently granted to it, ASN hopes to establish effective cooperation with the organisations in charge of supervising health care establishments, to examine the practicalities of increasing the material resources allocated to radiation protection when necessary, and of course to alert them if patient safety were to be threatened. To ensure improved patient radiation protection, ASN has also set itself the goal of developing close ties with all health safety stakeholders, whether in charge of resource planning (regional hospitalisation agencies, National Cancer Institute), of assessing medical practices (High Health Authority) or of specific supervisory actions (AFSSAPS).

The ASN report on improving the safety of radiotherapy treatment, requested by the Minister for Health and Solidarity, will be particularly keenly awaited in 2007.

In 2006, with the hindsight of several years of supervision of medical installations, ASN observed considerable heterogeneity of radiation protection practices in the medical field. As in 2005, it underlines the wide range of situations encountered between purely administrative radiation protection, the purpose of which is to declare the use of a radiology installation or obtain a license, and a true radiation protection culture integral to a structured organisation designed to boost the awareness and accountability of all players concerned in use of sources. The entire radiologist community therefore has to be mobilised concerning assessment of the doses delivered to patients, so that the existing radiology installations can be equipped with the appliances needed for estimating the dose delivered to the patients, particularly children, and that the new regulations concerning patient radiation protection can be effectively implemented.

In 2006, the situation is still not good enough, despite increasing involvement on the part of learned societies and professional labour organisations with respect to training and awareness, with a view to setting up good practices compatible with the principles of justification and optimisation.

This context of gradual improvement in medical radiation protection was however deeply affected in 2006 by ASN declaration of several serious radiotherapy accidents, involving a number of deaths or requiring extensive interventional intervention.

The creation of a system of serious event declarations is among the actions implemented by ASN since 2002 in the field of patient radiation protection which led to a new body of legislative and regulatory texts, to development of inspection with greater resources, and – jointly with the learned societies – to the distribution of guides of good practice and the provision of training. The declarations recorded in 2005 and 2006 were immediately followed by reactive inspections, assessment of the causes with the support of IRSN, distribution of recommendations to the entire community of radiotherapists and information to the public through press releases.