Select Committee on Public Accounts Minutes of Evidence


Examination of Witnesses (Questions 200 - 209)

MONDAY 12 MAY 2003

DEPARTMENT OF HEALTH

  Q200  Mr Steinberg: What is being done to ensure that needles are not left lying around? That is presumably how it happens, they are just left lying around.

  Sir Nigel Crisp: No, I do not think it is.

  Q201  Mr Steinberg: It is more sophisticated than that, is it?

  Sir Nigel Crisp: They are not just left lying around.

  Q202  Mr Steinberg: Do the doctors say, "Hey, you, arrgh!"

  Mr Foster: I do not think that is the most common cause of needlestick injury, where they are just left lying around. Clearly there is a whole process here from when you pick it up in the first place to when you use it, to when you put it down for other staff. I do not think they are just being left lying around.

  Q203  Mr Steinberg: How does the £2,000 per prick work out?

  Mr Foster: I think that is a—

  Q204  Mr Steinberg: Why was it not £1,500 or £2,500?

  Mr Foster: This is not an official sum, this is a sort of going rate which has been emerging.

  Q205  Mr Steinberg: It says here, "UNISON have negotiated a deal with employers whereby claims against NHS trusts for certain needlestick injuries are immediately settled by the trust for £2,000." So somebody gets stuck and goes off to the chief executive and says, "I have been stuck by a needle", and then there is a cheque for £2,000 by the sound of things. It does not work like that?

  Mr Foster: As I say, it is a figure which has emerged through a series of case studies, where there is a demonstrable case of mental stress which has resulted from the needlestick injury. It is not an automatic payment. Clearly the employer has got to balance a duty of care to an employee who has been afflicted in this way with the cost of being taken to an employment tribunal and all the legal costs, and I think this is a sort of rule of thumb figure which sorts that out.

  Q206  Mr Steinberg: If you can get £2,000 for being stuck by a needle, why are 23% not reported? The first thing I would do if I was stuck by a needle would be to report it and go and get my £2,000.

  Sir Nigel Crisp: We do not have the details here but it does say very clearly that this is for certain needlestick injuries, and presumably it is ones where the employer is going to be found at fault, which would not be every case.

  Q207  Mr Steinberg: You do not mean the employer—yes, sorry, you mean the person who has stuck themselves and missed.

  Sir Nigel Crisp: There are 250 million a year so 23,000 is serious but not very big.

  Q208  Chairman: This memorandum we received from the Safer Needles Network[8] says that five health care workers asserted they acquired HIV occupationally, four of whom are deceased, a further 12 health care workers have probably acquired HIV occupationally. So it can be very serious but equally if the needle has not yet found its way into the patient, it is not very serious at all, I would think. So we need further reassurance from you that this is being dealt with properly.

  Mr Foster: May I make one point? As I understand it, none of those cases were in the UK, those are not NHS cases, those are worldwide. So presumably the figure of 250 billion can be multiplied by a lot. We do not have a record, as I understand it, of anybody acquiring HIV.

  Q209  Chairman: Thank you for making that clear. That is important. Thank you very much for appearing in front of us today, it was an interesting hearing. There is clearly a cost of something like £170 million. After our last hearing various assurances were given, a target was made but this target has not been met. It may indeed be true that the target has not been met because people are encouraged to report more but that does beg the question whether the target was thought through satisfactorily in the first place. We also still have this point which was particularly dealt with by my colleague, Mr Williams, in paragraph 17, that there was little information in 1996 on the cost of accidents. "Despite Departmental initiatives to encourage NHS trusts to introduce procedures for assessing the costs of accidents, little progress has been made." So presumably my colleagues will wish to return to this in our report which will be published shortly. Thank you very much.

  Sir Nigel Crisp: Thank you.





8   Ev 23-25 Back


 
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