Attacks on NHS Staff

Justin Madders Excerpts

Monday 27th February 2017 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate the hon. Member for Hertsmere (Oliver Dowden) on the eloquent and powerful way he introduced the debate on behalf of not only the Petitions Committee but the more than 115,000 people who signed this extremely important petition. He took us through some of the many figures and gave us a clear overview of the issue. I also found some of the stories he told us compelling, such as that of the NHS worker who had been spat on, punched, kicked and verbally abused, and the other who said they could not recall a day going by without police or security being called to their department. Such personal tales add weight to the plethora of figures, which I will repeat, to some extent.

The hon. Member for Hertsmere correctly identified the fact that sentencing guidelines acknowledge that it is an aggravating factor when assaults are made on public servants in the course of their duty. It is right that that is so, but the general thrust of his speech was that the Government should consider a specific offence, and he identified the fact that there is such a specific offence for other public sector servants as a discrepancy. Clearly, the speeches today suggest support for tackling that discrepancy.

It is to the credit of my hon. Friend the Member for Halifax (Holly Lynch) that, despite the many demands on her time, she took a considerable period of her own time to shadow many frontline public servants in her constituency. It is telling that her experiences led her to introduce her ten-minute rule Bill. I congratulate her on her work on that Bill to make it an offence to assault emergency workers. It is due for Second Reading on 24 March. I hope the Government will find time to support it, although I think my hon. Friend was realistic enough to acknowledge that it may not make it and become legislation. However, that does not mean the campaign will end there. She clearly set out some of the ways in which current legislation falls short and why she believes her Bill should make it on to the statute book. I hope the Minister will be encouraging about it.

The Scottish National party spokesperson, the hon. Member for Central Ayrshire (Dr Whitford), clearly set out, from her own experience, the immense challenge that healthcare professionals face in balancing the need to give patients the right advice against the need to de-escalate highly charged situations. It is interesting that she said it was not only legislation that led to improvement in Scotland; it was also the sending out of a clear message that there would be zero tolerance of assaults on staff. I think that is something that we can all agree on and do our bit to deliver.

As always, it was a pleasure to hear from my hon. Friend the Member for Heywood and Middleton (Liz McInnes), who brings many years of experience of working in the NHS. As she rightly said, many assaults are occasioned by patients with mental health issues, and she made the important point that those factors make it difficult to come up with a blanket sentencing policy. We certainly need to reflect upon how we balance those sensitive issues with the need to send out a clear and strong message, as most hon. Members have said. She also made a pertinent point about the risks that NHS staff will face in enforcing a blanket no-smoking policy. I think we can all envisage the difficulties that asking our frontline staff to enforce that will bring.

I am pleased that we had time to hear from the hon. Member for Cheltenham (Alex Chalk). He made the important point that NHS staff need to see us taking this seriously, and that we need to follow that through with resources. There is an awful lot we can do that does not require the statute book. I will return to that later.

We are all rightly proud of everyone who works in the NHS—not only the doctors and nurses, but the midwives, porters, healthcare assistants, cleaners, receptionists, care workers, paramedics and many others who make up our national health service. None of us could have missed the many troubling reports over recent months about the pressure that the health service is under. I have said it many times before, but I do not think this is something we can ever say too much: each and every Member of the House recognises and values the incredible commitment our health service staff give to their job. I have no doubt that the current difficulties that we have all heard about would be even more significant were our wonderful staff not continually prepared to go the extra mile.

The petition relates specifically to NHS medical staff. If I was to make one slight amendment to it—this was also suggested by my hon. Friend the Member for Heywood and Middleton—I would broaden its definition to include non-medical NHS frontline staff. Like many Members from across the House, I have heard worrying reports of attacks not only on medical staff but on reception staff in both hospitals and primary care settings. We need to take firm action on that. All our frontline NHS staff are public servants. They work long hours, often in very difficult circumstances, and they help and treat our loved ones as if they were their own. They are the reason why we are so proud of our health service, and they deserve our respect, admiration and gratitude.

However, it is not enough for us to simply state our support for NHS staff in these debates; as the hon. Member for Cheltenham said, we have to demonstrate it in a meaningful way. Those staff dedicate their lives to caring for us, so it is right that we should also care for them. Sadly, the warm words that we hear are not always reflected in reality. The truth is that NHS staff are working longer hours in a system facing much greater pressure, they are being paid less in real terms and, most worryingly of all, as the subject of the debate shows, they are more and more likely to be attacked while simply doing their job. The impact of attacks on individual members of staff cannot be overstated. Violence and aggression can leave staff traumatised both emotionally and physically. Many need to have a significant amount of time off work, and sadly some have to leave their profession altogether.

I draw hon. Members’ attention to one example I was given of a 35-year-old ambulance technician from Cornwall, who was punched in the face while at work by a drunk and aggressive woman. She sustained a broken jaw. She has had at least 12 surgical procedures since and is still suffering from symptoms. She had a titanium jaw implant put back in in September 2016, but has had to have two further procedures since and cannot open her mouth wider than finger width at the moment. She was attacked in 2006; that is more than a decade of agony and suffering. We owe it to people like her—and everyone else who has been attacked while just doing their job—to stand up and send a message: that attacks on NHS staff are contemptible and we will do everything in our power to stop them.

While the incredible human cost is all too apparent from such examples and others we have heard today, we should also be mindful that, in addition to the individual impact on staff and their families, those incidents have a significant financial impact as well. The Royal College of Nursing reports that the estimated cost to the NHS of healthcare-related violence exceeds £69 million a year, which is equivalent to the salaries of an additional 4,500 nurses.

We have heard from hon. Members about the indisputable rise in attacks, but it is also important to note that the increasing likelihood of attacks on staff is not a long-term, gradual rise, but seems to have increased markedly for the worse over the past six years. Looking back at some of the figures we have heard, a decade ago, in 2005-06, there were 43 attacks per 1,000 staff, while in 2009-10, it was at a similar level of 44 attacks per 1,000 staff. However, as we have heard, by 2011-12 there were 47 attacks per 1,000 staff, which rose again to 53 attacks per 1,000 staff by 2015-16.

As alarming as those figures are, they may actually understate the position. As we heard from the hon. Member for Hertsmere, a Royal College of Nursing survey found that 56% of its members had experienced physical or verbal abuse from patients, with 63% experiencing that from relatives of patients or members of the public. The most recent figures show that there are 193 physical assaults on NHS staff each and every day. When we hear figures like that and of some of the experiences of staff, it is no wonder that every day someone is called to the department. Will the Minister indicate whether he feels there is any particular reason for such a significant increase in recent years? Is he also prepared to undertake a candid and detailed look at the reasons behind that rise and to report back to the House in the near future?

Much of the focus has been on attacks in accident and emergency, but as hon. Members have said, it is clear that assaults occur in every part of the NHS—hospitals, pharmacies, GP surgeries and in the community. One such example I was told about was of an occupational therapist working in Ipswich who was conducting a relaxation therapy session with a service user. We would expect that to be a fairly calm environment, but suddenly and without warning, the service user grabbed the therapist and attempted to strangle her, during which time she fell unconscious. The attacker has now been charged with attempted murder.

That example demonstrates that the risk of physical assault is higher for staff working alone; indeed, the figure for lone workers suffering injury is about 9% higher. Another example is of a paramedic in the East of England Ambulance Service NHS Trust who was instructed to attend a call alone. During the visit, she was physically attacked with a claw hammer. The assailant attempted to strike her on the head, but the paramedic managed to deflect the blow, sustaining serious injuries to her right hand in the process. We do not know what would have happened had she attended with someone else, but there is at least a reasonable chance that, had she not been alone, the attack would not have occurred.

The Minister will also be aware that, along with the medical factors that we have discussed today, such as mental health issues and substance abuse, the acute shortage of staff across departments and lengthening waiting times has been cited as a common factor behind many assaults. I appreciate that he is not a Health Minister, but I would welcome any comments on what the Government are doing to ensure safe staffing levels in the NHS, and that lone working is kept to a minimum. Having considered the rise in attacks and their impact, the Opposition support new, specific criminal sanctions for assaults on NHS staff. I am prepared to give an undertaking that we will assist the Government in ensuring that any legislation of that nature receives a swift passage through Parliament and on to the statute book. I would appreciate it if the Minister could indicate whether the Government have any plans to bring forward such a Bill in Government time.

While we support the introduction of new criminal sanctions, the creation of a new offence alone is not a panacea, as the hon. Member for Hertsmere said. He suggested many improvements that could be introduced alongside new legislation, including lone-worker alarms, well-designed environments and conflict resolution training, all of which have been called for by the Royal College of Nursing. Again, I would be grateful if the Minister indicated what steps the Government are taking to follow up such initiatives. Until such legislation is introduced, we need to use all the tools available to improve safety. I know that NHS staff find it to be a particular injustice that just 10% of assaults not related to a medical condition result in criminal sanctions. I would welcome the Minister’s comments on why he believes that figure is so low and whether any steps can be taken to increase it.

I would like to press the Minister on the worrying reports about the future of NHS Protect, which other Members have mentioned. Various media reports have suggested that the security and violence function will cease to exist on 31 March 2017. That would be a retrograde step and would send out totally the wrong message about the value of NHS staff and our commitment to protecting them. Can the Minister confirm today whether the Government will be making any changes to the vital role of NHS Protect?

In conclusion, there is no doubt that the NHS is one of the country’s greatest assets and that the people who work within it are by far the single most important component of its success. If we want to ensure that that asset continues to be a source of great pride for the people of this country, we have to value the staff who work within it, respect them and, above all, protect them.