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Nhs: Violence Against Staff

Volume 622: debated on Wednesday 14 February 2001

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What steps they plan to take in response to rising violence against National Health Service staff.

My Lords, the Government are determined to ensure that NHS staff, who spend their lives caring for others, do not suffer from intimidation and violence. That is why the NHS zero tolerance campaign was launched in October 1999. As part of the campaign, staff working in the NHS are expected to report all incidents of violence and employers are required to implement strategies for reducing such incidents.

My Lords, I am sure that the Minister will be aware that four-fifths of the NHS trusts surveyed were doubtful whether the 2001 target of a reduction of 20 per cent in violent incidents would be met by this April. Two-thirds were doubtful whether the 2003 target of a reduction of 30 per cent in violent incidents would be met. What does the Department of Health plan to do to make the zero tolerance campaign more effective?

My Lords, it was an interesting survey but there was confusion about the target. The baseline set is based on 2000–01 so the targets start from 1st April 2001. I believe that overall the effect of the Government's programme—it is to ensure that NHS trusts are wholly aware of the need to have proper strategies in place—is beginning to bear fruit. The survey found that there had been an increase in the number of violent incidents reported by staff over the past year. Somewhat perversely, I think that that can be seen as positive: it suggests that staff now feel better able to report such incidents. The more information we have about violent incidents the more we can focus on dealing with them.

My Lords, clearly the Government are taking the matter seriously. Is it now normal practice for those responsible for violence—I refer in particular to drunken violent hooligans late at night—to be prosecuted? Have people been prosecuted for such offences in recent months in order to gain publicity to deter further practices?

My Lords, these are matters for the police and the Crown Prosecution Service. We do not have figures centrally for specific prosecutions in relation to violent attacks against NHS staff. I agree with my noble friend that it is important, as part of a deterrent effect, that the public know that if they indulge in violent attacks on staff the NHS will have proper systems in place to respond immediately, and that when it is appropriate prosecutions will take place.

The noble and learned Lord the Lord Chancellor is the President of the Magistrates' Association. He has made it clear that it is entirely legitimate for magistrates to respond decisively to a particular form of criminal behaviour such as assaults on NHS staff and to impose a sentence which has a deterrent component.

My Lords, does the Minister appreciate that not only are trusts at risk but also primary care services, and general practitioners in particular? Was the noble Lord present in the Chamber when a similar inquiry was made about violence in courts? The reply was that one should have a panic button. The noble and learned Lord, Lord Ackner, said that that is all very well but someone must be available to answer the panic button. Is advice given to general practitioners about not being in a surgery alone with a patient without another member of staff being present to help?

My Lords, I accept the noble Baroness's point. General practitioners, community staff and ambulance staff are vulnerable. The survey by the department in September 1998 found that, while there were three reported incidents per 1,000 staff per month in acute trusts, there were seven reported incidents in ambulance trusts, 14 in community trusts and 24 in mental health and learning disability trusts.

Panic buttons have their place. Equally, it is important that a proper training programme offers advice to all staff on how they should behave, with back-up so that staff who feel threatened can call upon other staff to help them. I believe that we are getting into a more robust situation than in the past. I recall some years ago that staff affected found that they were not receiving support from management. I believe that that has changed.

My Lords, today being St Valentine's Day, would the Minister agree that all noble Lords in this House would like to send Valentine messages to all nurses and doctors working in the National Health Service?

My Lords, I think that that is a really splendid suggestion. It would do wonders for the morale of staff in the health service.

My Lords, I am sure the Minister is aware that this problem relates not only to the National Health Service but also to the public service generally. For example, 11 per cent of those convicted of assaults on police were given custodial sentences. Until custodial sentences are the rule rather than the exception for assaults on public servants, I am afraid that there will not be a deterrent.

My Lords, as I intimated, I believe that there must be a deterrent effect and that members of the public who carry out violent attacks must expect the full force of the law to come down on them. We shall do everything we can to encourage NHS authorities to report such actions to the police.

There has been close liaison between some trusts and the police forces. There are some very good practice initiatives taking place, including sub-police stations being centred within NHS hospitals. I am sure that my noble friend is right: it is tragic that members of staff—I think in particular of ambulance staff who have to deal with difficult, stressful situations—now have also to pay attention to potential violence against them by members of the public. I think that that is disgraceful.

My Lords, does the Minister agree that a decade or more ago, people would have found it unbelievable that attacks would be made on nurses in hospitals? The situation that he has disclosed is very disturbing. Is he aware that, as a result of Mrs Bottomley's ill-advised decision to close the accident and emergency department at Bart's, the Royal London accident department has become grossly overcrowded? That makes it difficult to manage, particularly when there is violence in the department.

My Lords, I agree that accident and emergency departments are particularly difficult. They are often vulnerable areas of NHS hospitals. There are a number of points to make. First, the expansion in A&E services and facilities over the past year or two will have a positive effect. While there can never be any excuse for physical or verbal violence, there is no doubt that a better environment can help to calm some people down. Secondly, liaison with the police has been very helpful. One trust that I visited earlier this week has an arrangement whereby special constables are present in the A&E department on Friday and Saturday nights. That is an excellent scheme and we wish to encourage similar ones.