Attacks on NHS Staff

Richard Drax Excerpts

Monday 27th February 2017 Westminster Hall

[Oliver Dowden]

The right hon. Gentleman makes an apposite point, which I was just about to come on to.

I welcome the progress that has been made as a result of the petition. I understand that the Government have committed to updating the protocol on tackling violence in the health system, which will involve the police and the Crown Prosecution Service, and I would be grateful if the Minister could update us on that in his concluding remarks. Like the right hon. Gentleman, I urge the Government to keep an open mind about creating a new specific offence.

[Richard Drax (South Dorset) (Con)]

My hon. Friend is making an excellent speech on a subject that is close to many of our hearts. I pay tribute to all those who work in the NHS and do a wonderful job. I wish to raise an issue that my police and crime commissioner raised with me, which affects all those who work in the emergency services—that of spit guards. The PCC has written to the Home Office to ask it to research this issue further and to hold a public consultation. What is my hon. Friend’s view on how we can stop people spitting on people, which is just as much of an assault as thumping someone? Perhaps the Minister will inform us how far down the road we are on that issue.

[Oliver Dowden]

My hon. Friend is absolutely right, and hopefully this debate will provide the opportunity not just to discuss a specific new criminal offence but to look at preventive measures. Certainly, spitting at NHS staff is completely unacceptable, and any measures we can take to prevent it would be most welcome. Like him, I would be grateful to hear the Minister’s reflections on that point.

Returning to the argument about why we need a specific offence, I understand the Government’s point that existing measures already prioritise prosecuting and sentencing assaults on NHS workers. All assaults are unacceptable, but the fact that we have created specific offences for police, immigration and prison officers, but not one for NHS workers, might amount to a discrepancy. It is important that we send the strongest possible signal from this place that such assaults are unacceptable, and creating a specific offence is one way to do that.

It is important to stress that a new law is not a panacea. This debate provides an opportunity for a wider examination of safety issues surrounding NHS workers. I have a number of issues to raise, and I would be grateful if the Minister addressed them in his remarks. Concerns have been that only about 10% of physical assaults result in criminal sanctions. I would be grateful if the Minister could confirm whether the Government’s promised review of the protocol will look at how that low level of prosecution can be addressed. In addition, the consultation that the Petitions Committee held on this debate suggests that there is scope for more effectively training security staff at NHS facilities in how to deal with violent behaviour to ensure that difficult situations do not escalate.

Further work can be done on preventive measures. My hon. Friend the Member for South Dorset (Richard Drax) mentioned spit guards. Other possibilities mentioned to me include the provision of lone-worker alarms for NHS staff visiting care homes on their own and better designed environments that make it harder for violent offences to be committed. There is, however, concern about the future of NHS Protect, so will the Minister provide some clarity on that?

A wider question concerns changing attitudes towards NHS staff. The Petitions Committee received evidence that some people have an entitlement attitude—“We’ve paid our taxes”—which is sometimes used to justify aggressive behaviour towards NHS staff. That needs to be stamped out. I rarely cite Wales as a good example of NHS practice, but it has had a campaign on zero tolerance of violence against NHS staff, which I believe has worked well. Perhaps that is something else the Minister will consider.

I am conscious that other Members wish to speak in the debate, so I will conclude. I hope that the NHS staff listening to the debate will be reassured by the seriousness with which Parliament treats the issue of violence against NHS workers. I hope that the debate will provide an opportunity to consider what further measures we may take to protect nurses, doctors, paramedics and all other NHS staff, to whom we all owe a tremendous debt of gratitude.

[Liz McInnes (Heywood and Middleton) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gray. I am grateful to the hon. Member for Hertsmere (Oliver Dowden) for his introduction to the debate, which is on an important issue about which I feel very strongly as an ex-employee of the NHS and a former workplace trade union rep in the NHS.

Hospitals, clinics and health centres, by their nature as public buildings, have to be open to everyone. That brings particular security risks to the staff who work in them. Risks are also encountered by community staff who visit people in their homes. Those risks were clearly explained to the Petitions Committee in its meeting with the safety reps from the Royal College of Nursing. Better liaison and sharing of information between the police and the NHS regarding people who present a risk are clearly needed.

Although I appreciate the spirit of the petition and am sure that no one would argue that our NHS staff do not deserve to be protected while going about their work, there is a degree of confusion over what the petition aims to achieve. First, some clarity is required. The petition should cover all NHS staff, not only medical staff. After working in the NHS for many years, I realise that “doctors and nurses” is used as shorthand for all NHS staff, but given that there are about 400 different job roles in the NHS, it must be made clear that our concerns are for all NHS staff. Among many others, the porters, the cleaners, the healthcare assistants, the allied health professionals and the many volunteers are the unsung heroes of our NHS.

Secondly, the Government’s response to the petition stated:

“The fact that the victim is providing a service to the public is listed as an aggravating factor in sentencing guidelines”.

Therefore, is there a need to toughen up the law? Most people would say that there is in order to send out a clear message that to attack any member of NHS staff is totally unacceptable.

[Richard Drax]

I am listening to the hon. Lady closely, and she is making an excellent speech. Should the Government consider an automatic prison term, with the period of detention obviously depending on the circumstances of the assault?

[Liz McInnes]

I will go on to talk about the special circumstances in which NHS staff work, which include working with patients with mental health issues, so I cannot agree with the hon. Gentleman on a blanket prison sentence. One size does not fit all, I am afraid, and I will expand on that later. However, I thank him for his intervention.

Scotland has a law to protect NHS medical staff. According to the House of Commons Library, that law seems to have reduced the incidence of assaults on staff, although the number is still unacceptably high.

Thirdly, many assaults on staff are committed by patients who have mental health issues such as dementia. The accounts given by the RCN safety reps highlight the problems in dealing with those patients, such as whether they are capable of realising the harm that they have caused. That goes some way towards explaining my response to the hon. Member for South Dorset (Richard Drax). There also seems to be a feeling, certainly among the RCN reps, that the police are rather too ready to dismiss cases in which the assailant has mental health problems. That subject deserves further exploration and I hope the Minister will comment on it.

My constituency is served by the Pennine Acute Hospitals NHS Trust, in which the number of cases of physical violence against staff by patients has, unfortunately, gone up from 169 in 2014-15 to 240 cases in 2015-16. The trust had been doing good work on training staff in conflict resolution and had managed to bring the figure down from 251 assaults in 2012-13. Sadly, reported assaults appear to be on the rise again. A spokeswoman for the trust informed me that the most recent rise was due to increased awareness and reporting, but I remain slightly unconvinced of that. I am informed that many staff are still reluctant to report assaults because they do not feel that any action will be taken as a result. The RCN safety reps highlight that the onus on staff to report attacks can act as an obstacle to reporting, so employers should provide more help and support to staff in such situations.

Assaults do not happen only when staff are on duty. There have been many incidents of assaults and muggings of staff at Pennine when they are in hospital car parks. In my days at Pennine, I can clearly remember that a member of staff suffered a serious assault—she was stabbed —when returning to her car after a shift on the Rochdale site. Fortunately, she survived that serious assault. We must make it clear that assaults on NHS staff are unacceptable at all times, not just when they are on duty.

This weekend it was announced that the Government are calling for a complete smoking ban on all English hospital sites. That is very laudable, but who will police it? In my experience of the NHS, a member of staff telling a patient or visitor that they cannot smoke in a particular area is likely to lead to a flurry of verbal abuse. I therefore hope that if the Government are serious about the move, they back it up with funding for trained security staff and do not simply expect already hard-pressed and stressed NHS staff to take on yet more responsibility for enforcement.

Where do we go from here? Without doubt, this is a serious issue and action on it has the support of a great deal of the public, including 161 of my constituents. Undeniably, our NHS staff are under a great deal of pressure at the moment, with long waiting lists, patients waiting on trolleys in corridors and staff having to deal with angry relatives as a result. The Government’s handling of the NHS appears to be creating a perfect storm of unrest and discontent among patients and relatives, which is likely to exacerbate tension and ill feeling. The Government must take some responsibility for that.

In summing up, I return to the Government response to the petition. It states:

“A protocol to tackle violence and anti-social behaviour in the NHS by shared actions between the Police, Crown Prosecution Service and NHS Protect was signed in 2011”,

which, importantly, sets out steps

“to improve victim and witness support. This protocol is currently being updated”.

This debate is therefore very timely. It is my hope that what is said in this Chamber today will be taken note of and fed into that update to ensure that our wonderful and dedicated NHS staff are afforded the highest standards of safety while they go about their daily, and nightly, duties to us, the British public.