Health Protection in Scotland

The UNISON Scotland Submission

To the Public Health Division, Scottish Executive Consultation Paper on Health Protection in Scotland.

January 2003

Executive Summary

• UNISON is Scotland's largest trade union representing 150,000 members working in the public sector. UNISON members include workers in both the health service and local authorities who are involved in the provision of health protection services in Scotland.
• UNISON Scotland welcomes the consultation paper as an important step in raising awareness of the problem of health protection in Scotland.
• UNISON Scotland considers it important that all staff are fully informed and consulted over any proposal to merge existing organisations into either a Health Protection Agency and/or a Health Protection Organisation.
• UNISON Scotland believes that any transfer would need to respect employees existing pay and conditions of service.
• There is some concern that hazards at work are not addressed within this document. UNISON believes that all employees should be made aware of any hazards present at their workplace and are provided with effective protection.

Introduction

This consultation paper looks at the issue of health protection in Scotland. It examines the organisations that are currently in place to deal with factors relating to health protection and looks at whether some or all of them should come together to form either a Health Protection Agency and/or a Health Protection Organisation.

The motivation behind reviewing current health protection services included proposals on combating infectious diseases developed by the Chief Medical Officer in England as well as the development of a Health Protection Agency (HPA) for England and Wales. The establishment of this body will result in some services currently accessed in Scotland, such as the National Radiological Protection Board, falling at least partly within the remit of this new HPA in England and Wales.

The consultation paper highlights various threats to health, ranging from communicable diseases to chemical and radiation hazards. It goes on to discuss what are the key functions involved in health protection as well as the main organisations involved. The paper also suggests which agencies should come together to form either a Health Protection Agency and/ or a Health Protection Organisation, looking at what would be the organisational difficulties in combining the various existing organisations. The issue of relationships with other UK and international bodies is also raised.

The main issues raised for consultation include:

• How should we define the scope of health protection?
• What are the major issues involved?
• The organisational and legislative arrangements which might best be made for the delivery of health protection, and,
• Whether, and if so to what extent, would it be beneficial for Scottish arrangements to link into the proposed Health Protection Agency in England and Wales?

How should we define the scope of health protection?

One of the key issues in this consultation is to provide a definition on what is meant by health protection.

Generally speaking health protection would include protecting people from all hazards to health. The consultation paper lists a range of dangers to health ranging from infectious diseases to exposure to chemical, biological and radiation hazards. It is thus difficult to provide a definitive list of all individual dangers.

The paper also comments that it is important to acknowledge that preventing hazards is, where possible, a key element of health protection. In this case it is important that the Scottish Executive and its agencies in health protection as well as employers ensure that all employees are aware of any potential hazards in the workplace. There should also be effective protection for any employee who comes into contact with any hazards during the course of their duties.

This section also details current arrangements and suggests possible improvements. The number of agencies ranging from local authorities, to Scotland - wide and UK level bodies highlights the need for close co-ordination and suggests that a new body (HPA) may provide more effective health protection.

What are the major issues involved?

The consultation paper provides a number of possible issues for health protection including healthcare associated infections and injuries in young children.

However it does not clearly mention the problem of hazards at work, whether through the use of hazardous materials or through the risk of infection within the health service. UNISON believes that all employees should be made aware of any hazards present at their workplace and are provided with effective protection. This would be especially important in the case of any employees who would be involved in the control of any outbreak that provided a hazard to health.

The organisational and legislative arrangements that might best be made for the delivery of health protection.

This next section of the report aimed to identify new procedures for the organisational and legislative arrangements that may be made to allow the delivery of health protection in Scotland.

The main issue involves the establishment of either a Health Protection Agency and/or a Health Protection Organisation. It also raises the question of which current bodies should be merged together to create either or both of these new organisations.

If there is to be any transfer of staff to a new organisation all employees should be fully consulted on this proposal. All staff should also retain their existing pay and conditions of service if any transfer takes place.

Although the paper did imply that a new body would be able to provide a more co-ordinated response to any major incidents and may provide a clearer overview of health protection, it provided little proof of this. There is some concern over the range of options offered in the proposal to develop a Health Protection Agency or even the option of forming a Health Protection Organisation. The paper only introduces the option of a Health Protection Organisation in the last few pages but does not clearly identify what would differentiate this from the proposed Health Protection Agency.

There is also a concern that in establishing a new body that it may become overly bureaucratic and unwieldy, leading to less accountability. There is concern over the level of integration that would be achieved, as highlighted in the response of the National Radiological Protection Board (NRPD) to the proposal for a Health Protection Agency for England. In their submission the Board of the NRPB strongly recommended that it should remain as a discrete entity within any new agency. This could lead to funding disputes between the constituent bodies of the new agency.

There may be a case that closer co-ordination and communication between the various agencies charged with health protection could provide a better service than the establishment of a new body. The strengthened powers for local authorities with regard to community planning via the Local Government Bill may also be one aspect of providing better co-ordination.

Whether, and if so to what extent, would it be beneficial for Scottish arrangements to link into the proposed Health Protection Agency in England and Wales?

It is important to recognise that health hazards, such as infections, do not respect boundaries, and that there will need to be close communication with our neighbours not only at a UK level but also possibly in a wider European and global level.

Not all health protection services will be available within Scotland. Currently some cover for the Scottish National Reference Laboratories is arranged via the Public Health Laboratory Service in England. This situation is likely to continue, as there will still need to be services that could only be carried out at UK or European level in order to maintain specialist skills.

Therefore if any new body does become established it is important to retain and develop good communication links with agencies outside of Scotland.

For Further Information Please Contact:

Matt Smith, Scottish Secretary
UNISONScotland
UNISON House
14, West Campbell Street,
Glasgow G2 6RX

Tel 0141-332 0006 Fax 0141 342 2835

e-mail matt.smith@unison.co.uk

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