Rooting for refurbished CT scanner machines

Som Panicker

We all need to agree with the fact that any X-ray generating machine, no matter small or big, old or new, makes for a radiation risk if it is not maintained or monitored for radiation safety. 

But at the same time, we cannot agree with the propaganda that all the radiation hazards are mainly caused by imported, used X-ray tubes and CT machines brought from US, Europe or Japan to India, and conveniently forget that there are thousands of old X-ray equipment which are more than 10-years old, both in government sector and private hospitals in India, which are neither monitored nor maintained due to various reasons. 

We should not forget that many of these high end equipment like CT scanners are not fully manufactured in India till date and the cost of new medical equipment are extremely high, making it very unreasonable to charge the patients for these high end services. 

There is a very acute shortage of qualified personnel for making quality assurance and test reports in this field. Very often the diagnostic medical centres and hospitals have to wait for several months to get approvals, and also bear the brunt of certain officials who are hand in glove with agents to demand bribes and favours for providing licenses. 

Under such prevailing circumstances, Atomic Energy Regulation Board (AERB) has authorised and issued licenses to qualified and trained personnel to do Q/A tests for X-ray equipment which is a great relief to the medical centres and frees the system from the monopolistic attitude of the state DRS officials. 

As a qualified person working with diagnostic imaging equipment for many years, I would like to highlight few important aspects that justify the import of refurbished or used CT scanners in India. They are as follows: 

1. Government of India permits import of any used medical equipment with residual life of more than eight years.
2. Medical equipment do not have an expiry date and these equipment can be used as long as it is serviced and maintained efficiently to produce good quality images and performance within specifications
3. Due to very high costs of new and imported medical equipment, the cost-effective but used medical equipment are the only feasible solution to provide high-end diagnostic services at low costs in remote and rural areas of the country.
4. X-rays are produced by secondary emission. Their use is very effectively controlled by electronic circuits and mechanical devices which limit the spread and scatter of X-rays. As these X-ray tubes get older, the radiation emitted keeps reducing and ultimately the tubes get fused after which they need to be replaced.
5. AERB is a regulatory body which provides training, testing and inspection for all types of radiation equipment at site. They also approve sites for installation of equipment and guide the doctors and hospitals on the specific use of such equipment.
6. Unlike radiation produced from nuclear isotopes and other materials used in nuclear medicine as well as cancer treatment equipment like Gamma camera, Linear Accelerator, Cobalt Therapy etc, X-ray radiation is much safer and less harmful when used for diagnosis under controlled situations.
7. X-rays are the main source of diagnostic medical imaging of patients, and the effective use of these equipment (old or new) by trained professionals are safe and harmless to the patients when used as per the allowed radiation limits and dosage.
8. The use of latest technology in developed nations has become a trend, and most of them replace equipment within a span of four to five years. The cost of such upgrade to technologically advanced equipment do not hinder their services to patients, as most of the patients are covered by medical insurances or government policies.
9. As these replaced equipment have a large percentage of residual life left over, it is wise to make good use of it in other countries where they lack such facilities greatly. Hence these imported used equipment play a great role in the development of rural clinics and medical centres. They also facilitate rapid growth of high-end medical services by providing economical solutions to the needy patients.
10. Indian engineers use their skills and intellectual ability to make excellent use of these medical equipment for safe and effective patient diagnosis therapy, saving a lot of foreign exchange for the nation. They also provide alternative solutions to the dictum of some vendors who overcharge the customers and make huge profits from services and sales of new medical equipment.
11. Average life expectancy of good medical equipment is approximately 15 years with proper service and maintenance conducted at regular intervals. All X-ray equipment are calibrated at regular intervals to ensure production of good quality diagnostic images.
12. Even in countries like US, Japan, Korea etc., the use of second hand medical equipment are permitted and is considered as a viable alternative to new equipment. Most of the high-end medical equipment have CE/FDA/TUV certification thus proving to be safer for use in medical diagnosis.
13. Radiation hazards are caused only due to misuse or abuse of equipment and not because it new or old or imported. To ensure that good quality diagnostic images are produced, all X-ray based medical equipment need to undergo similar tests and periodic maintenance, irrespective of whether it is a used machine, a brand new one, locally manufactured or imported.
14. Finally, we should work towards encouraging local manufacturing of high-end medical equipment like CT, MRI etc by offering tax cuts, incentives, subsidies etc. It is our government’s lack of policy, and illogical as well as difficult tax structures that make investments in medical equipment manufacturing an unattractive idea. China has gone a long way ahead in this arena and we should learn from their manufacturer-friendly policies. It is better to encourage more investors to start manufacturing these high-end medical equipment in India, thereby reducing the overall cost of such equipment. It would also create an alternative to expensive imports from US, Europe and other foreign countries. 

The author can be reached at [email protected]