SCILLY'S X-ray facility in the islands' cottage hospital – in place for almost two years – is only being used weekly by a visiting specialist despite initial plans to train island GPs to use it.
It was said that communication between the myriad of health agencies was proving the obstruction.
Dr Adrian Davis, chairman of the island council's health scrutiny committee told members recently that the problem was X-rays were not primary care and Scilly's service was.
He was "deeply concerned that Scilly is not getting what it should be getting".
Council officer Aisling Hick said it was difficult to get local GPs trained to use the machines. The number of different health agencies involved was confusing.
"Legislation has fragmented the health service and made it more complicated. Structures and bits of paper have made it really hard."
They were doing their best to "integrate care better".
There was an ongoing argument about who actually owned the X-ray facility.
Jane Hurd, of the patients' watchdog Healthwatch, said it wasn't that the islands weren't trying for integrated healthcare provision "but lack of mainland awareness".
Governance was the problem, agreed Christine Savill. "It's getting people to actually talk to each other and bringing some common sense into the arena," she said.
The hold-up was all "down to rules and legislation and professionals worried about it being outside their own remit".
Dr Davis said use of the X-ray machine could reduce the number of medical aircraft flights.