Memorandum from NHS London
The draft Civil Contingencies Bill was released
for public consultation on 19 June 2003. The document was circulated
widely to NHS organisations throughout London. Comments were sent
to the Director of Emergency Planning, SW London Strategic Health
Authority. This report represents a compilation of the responses.
The response is supplied under three headings
that correspond to the Parts and Schedules listed in the draft
The NHS (apart from ambulance Trusts) is currently
excluded from either of the two categories in the draft. A case
could be made for the inclusion of acute Trusts, Primary Care
Trusts (PCTs), Strategic Health Authorities (SHAs) and Regional
Public Health Groups in Category 1.
The organisations currently listed in Category
1 all have a function in the aftermath of an incident that results
in the immediate protection of life. Acute Trusts, PCTs, SHAs
and Regional Public Health Groups share this duty; indeed these
organisations have their emergency role well documented. These
NHS organisations are currently required to plan for and react
to an "emergency".
There may be a special requirement to consider
the development of Foundation Trusts, whose status inside or outside
the NHS is not yet clear due to the current progress of the legislation.
The Bill could make provision for acute facilities that sit outside
of the NHS.
There is also no mention of Special Health Trusts
or non acute Trusts. It may be expedient to mention formally these
structures in Category 2, as they will have a key support role
in an "emergency".
These powers are unprecedented and far-reaching.
They may, for the first time, provide a legal mechanism to enforce
necessary public health precautions, such as quarantine or detain
It is not clear whether indemnity for organisations
acting under the direction of a regulation is properly addressed.
Clarification is required as to whether the NHS could be held
legally and financially accountable for actions undertaken under
the terms of the draft Bill.
A power to give directions or orders can be
given to a "specified individual". This may need some
clarification: will this individual be an elected official, a
member of a Category 1 or 2 organisation or some other person?
Clarification needs to be sought on how the
Category 1 organisations can seek to benefit from emergency powers.
How, for example, would the NHS seek to enforce an area of quarantine
or the commandeering of private sector facilities?
Clarification is also required on the appointment
of Regional and Emergency Co-ordinators. Will these individuals
be pre-selected or will it vary depending on the type of incident?
Acute Trusts, PCTs, SHAs, Regional Public Health
Groups and future acute organisations outside of the NHS could
be listed in Schedule 1, Category 1 under the existing "Miscellaneous"
or a new heading, "Health".
Special Health Trusts and other non-acute Trusts
could be considered for Schedule 1, Category 2. The Health Protection
Agency could also be listed under Schedule 1, Category 1 under
"Miscellaneous" or a new heading, "Health".
The wider NHS and the Health Protection Agency
(including the Health Emergency Planning Advisers) could be considered
for inclusion in the main body of the final Bill. The Bill could
confer some real advantages to NHS operational effectiveness.
The Bill also throws up a wide range of issues that need careful
consideration. For example, it may be necessary to plan pre-defined
responses to regulations or orders proposed in the "heat
of the moment".