Radiologists Raise Alarm Over Patient Scans Reviewed by Unregistered Doctors Abroad
Irish radiologists have raised serious concerns about the practice of sending patient scans to be reviewed by doctors who are not registered with the Medical Council of Ireland, warning that the practice poses significant risks to patient safety and undermines the regulatory framework designed to protect Irish patients, as hospitals seek to address a chronic shortage of radiologists through outsourcing arrangements that bypass normal registration requirements.
Background
Radiology is one of the most critical specialties in modern medicine, providing the diagnostic imaging that underpins clinical decision-making across virtually every area of healthcare. CT scans, MRI scans, X-rays, and ultrasounds are reviewed by radiologists who provide reports that guide treatment decisions for patients with conditions ranging from cancer and cardiac disease to trauma and neurological disorders. The accuracy and timeliness of these reports is directly linked to patient outcomes, and the quality of the radiologist reviewing the scan is therefore a matter of patient safety, not merely professional standards.
Ireland has faced a chronic shortage of radiologists for many years, a problem that has been exacerbated by the growth in demand for diagnostic imaging driven by an ageing population, advances in medical technology, and the expansion of cancer screening programmes. The HSE has struggled to recruit and retain sufficient numbers of radiologists, and hospitals have increasingly turned to outsourcing arrangements — sending scans to be reviewed by radiologists in other countries — as a way of managing the backlog.
The practice of teleradiology — the remote review of medical images — is well established internationally and, when properly regulated, can be an effective way of supplementing domestic radiology capacity. The concern raised by Irish radiologists is not with teleradiology per se, but with the specific practice of using doctors who are not registered with the Medical Council of Ireland to review scans for Irish patients.
Key Developments
The Irish Institute of Radiology and the Faculty of Radiologists at the Royal College of Surgeons in Ireland have both raised concerns about the practice, warning that it creates a regulatory gap that leaves patients without the protections that Medical Council registration is designed to provide. A doctor who is not registered with the Medical Council cannot be held accountable through the council's fitness-to-practise process if a patient is harmed by an incorrect or delayed report.
The concerns have been raised with the HSE and with the Department of Health, and the issue is expected to be discussed at the Oireachtas Health Committee in the coming weeks. The Medical Council has indicated that it is examining the legal and regulatory framework governing teleradiology services provided to Irish patients by doctors based abroad, and that it will publish guidance on the issue before the end of the year.
Hospital management teams have defended the outsourcing arrangements, arguing that they are necessary to manage the backlog of scans and that the quality of the reports produced by the overseas providers is consistently high. However, radiologists have pointed out that quality assurance is difficult to maintain when the reviewing doctors are not subject to Irish regulatory oversight.
Why It Matters
The radiology outsourcing controversy is a specific manifestation of a broader challenge facing the Irish healthcare system: the tension between the need to manage demand within constrained resources and the imperative to maintain the regulatory standards that protect patient safety. The Medical Council's registration requirements exist for good reasons — they ensure that doctors practising in Ireland meet defined standards of training, competence, and professional conduct, and they provide a mechanism for accountability when things go wrong.
Bypassing these requirements, even in the context of a genuine staffing shortage, creates risks that are difficult to quantify but potentially serious. A missed diagnosis or an incorrect report from an unregistered overseas radiologist could have devastating consequences for a patient, and the absence of Medical Council oversight means that the normal accountability mechanisms would not apply in such a case.
Local Impact
Across Ireland's hospital network — from the major academic teaching hospitals in Dublin, Cork, and Galway to the regional hospitals in Letterkenny, Sligo, and Waterford — the radiology backlog is a daily reality that affects patient care. Patients waiting for scan reports face anxiety and uncertainty, and delays in diagnosis can have direct clinical consequences. The outsourcing arrangements that have been put in place to address the backlog are a pragmatic response to a genuine problem, but the regulatory concerns raised by Irish radiologists need to be addressed if those arrangements are to be sustainable and safe.
What's Next
The Medical Council is expected to publish guidance on the regulatory framework for teleradiology services before the end of 2026. The HSE has indicated that it will review its outsourcing arrangements in light of the concerns raised and will engage with the Medical Council and the professional bodies to develop a framework that addresses the staffing shortage while maintaining appropriate regulatory oversight. A recruitment drive for radiologists, including targeted international recruitment, is also expected to be announced as part of the HSE's workforce planning for 2027.
