Regulation of Operating Department Practitioners (Hansard, 29 June 1999)

§ Helen Jones (Warrington, North)

I beg to move, That leave be given to bring in a Bill to make provision for a registration scheme for operating department practitioners and for the regulation of their professional conduct; and for related purposes. I am conscious, from conversations with colleagues, that some hon. Members are not wholly aware of what operating department practitioners are or what they do. They are a key group of health care workers who were first formally identified in the Lewin report in 1970, but who have existed under different names for a good many years. They were known first as theatre technicians, and then as operating department assistants. In the 1990s, as their qualifications changed from those awarded under the city and guilds course to the national vocational qualification level 3 in operating department practice, they adopted a different title to reflect the increased level of skills involved.

Originally, ODPs dealt with anaesthetics and the care of anaesthetised patients, but they are now involved in all work of the operating department, including not only anaesthetics, but the surgical process and the monitoring and care of patients in the recovery room. In addition, because of the technical skills that they acquire for work in the operating department, they now work in other areas of the hospital where a knowledge of technology is required. It is common to find ODPs working as part of cardio-pulmonary resuscitation teams, or in accident and emergency departments and intensive care units, as well as in other areas such as radiology departments. They are also involved in the transfer of critically ill patients.

Operating department practitioners have responsibility for checking, calibrating and monitoring much of the electromechanical equipment that is used in hospitals, including lung ventilators, automatic infusion devices and other patient monitoring equipment. They are skilled personnel, and the number of skills required of them has increased as technology has expanded. Many of them go on to take additional qualifications to allow them to work in specialised areas, such as ophthalmic, vascular or plastic surgery. Others move on to manage operating departments and into associated services. The theatre manager in my local hospital is an ODP, not a nurse.

I hope that what I have said is enough to convince the House that ODPs not only carry out a vital role, but care for incredibly vulnerable patients. Most members of the public would be surprised to learn that when they go into hospital for an operation it is a matter of chance whether they are cared for and supported in theatre by a nurse or by an ODP.

Since the Bevan report in 1989, it has been common for ODPs to be considered alongside their nursing colleagues for all roles in the operating theatre. In many trusts, they are on the same pay spines and the same rotas. People would be astonished to discover, however, that nurses working in theatres are subject to a registration scheme, whereas the ODPs working alongside them are not. It is nonsense that ODPs are subject only to a voluntary registration scheme, given that they care for the same vulnerable patients as nurses and both have access to controlled drugs and sensitive equipment. That situation has been allowed to persist, despite the fact 138 that the Bevan report recommended a compulsory registration scheme, as did the Audit Commission in 1997.

That difference flies in the face of all professional opinion, since ODP registration is not only supported by the Association of Operating Department Practitioners, but the Royal College of Surgeons of England, the Royal College of Anaesthetists and the Association of Theatre Nurses—in other words, the very people who work in operating theatres day by day and know what happens—want registration. The safety of the public demands it.

My Bill is necessary to put an end to the chaos, because the current voluntary system has failed. The Association of Operating Department Practitioners has only about 1,500 registered members, but the estimates of the numbers of ODPs practising in the United Kingdom vary between 5,000 and 8,000. The fact that we do not know the numbers shows the chaos that has been created. It also means that only between one quarter and one fifth of practitioners are registered.

My Bill would put an end to that confusion, and would protect the public by setting up a board under the Council for Professions Supplementary to Medicines to oversee the education and training of ODPs, and it would ensure that only state-registered ODPs were allowed to practise. It would provide for a similar system to continue when the Health Bill comes into force and a council for health service professions is set up. The Bill would ensure that the board had the power to investigate evidence of poor practice or of malpractice, and to suspend or remove a person's registration if the evidence warranted it.

Malpractice is, of course, rare but when it does occur in such work, it is serious. Well-documented cases include that of Anthony Kelly, who was found practising as an ODP on a forged certificate, or Justin Lee Alliston, who was arrested after abusing controlled drugs at the hospital where he worked. There have been other cases of people abusing or selling drugs, of tampering with sensitive equipment and even one case of a serious sexual assault on a female patient in the anaesthetic room.

The real scandal about those cases is that the people who commit those offences are perfectly free to continue practising in the NHS afterwards. Indeed, there are well-documented cases of people being dismissed from one hospital for poor professional practice or for malpractice and then getting a job in another hospital because their history has not been checked. That is not safe for patients, and it is an insult to the many good and conscientious ODPs.

Trusts are poor at checking registration and the problems in the system are exacerbated by the fact that many people find work in theatres through agencies. My Bill, therefore, would also regulate agencies providing work for ODPs. It would make them responsible for checking the registration of anyone on their books, and it would impose a compulsory code of practice, requiring agencies to report any evidence of failures to reach the highest standards of professional conduct. Importantly, agencies also would have to check that the requisite occupational health screening had been carried out.

The Bill is about the safety of the public. People have a right when they go into hospital for an operation to be sure that they will be treated by adequately qualified and trained staff who subscribe to a proper code of professional ethics. That is not the case at the moment. 139 I believe that the safety of the public must come first. I hope, therefore, that the case for registration is seen to be unanswerable, and that the Bill will have the support of hon. Members on both sides of the House.