NHS Hospitals: Security Arrangements (Hansard, 11 December 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the Government are gravely concerned about recent attacks on patients and staff in hospitals and we must be prepared to draw lessons from such incidents. Local management is and must be responsible for security arrangements at health service premises. This Government first asked local health authorities to develop a security strategy in 1982. Guidance in the form of the NHS Security Manual first issued in 1984 is currently being updated with government funding.

§ Lord Auckland
My Lords, I thank my noble friend for that Answer which is only partially satisfactory. I declare my interest as the president of the friends of my local district hospital. Will central funding be made available for that very real problem which is of nationwide significance? Consequent upon that, is sufficient vigilance given regarding security people employed at local hospitals? Is the noble Baroness aware that at one hospital not far from where I live a 19 year-old was allegedly in charge of security? Will she ask her right honourable friend to look into those very real problems, while realising that hospitals with large grounds have problems? Will the Minister look seriously into those problems?

§ Baroness Hooper
My Lords, I am grateful to my noble friend for raising this topic. We are very seriously looking into the whole issue because there are particular problems. By their very nature hospitals should be accessible and policy has been directed at, for example, liberalising hospital visiting arrangements, particularly with regard to children.
Clearly, we cannot turn hospitals into fortresses; but there is no doubt that local managements are now fully aware of the need to provide the highest possible level of security commensurate with that freedom which is expected by staff and patients. In the light of recent tragic events, managers are reviewing procedures. It must be a matter for local managements, which are in the best position to decide what are local needs, to be responsible for that very important matter.

§ Lord Molloy
My Lords, is the noble Baroness aware that many of the health service associations agree that the Government are concerned about this matter? However, they feel that it is now necessary for 380 the Government to implement their recommendations, which have been accepted, and that more funds are needed so that security officers are properly trained and know exactly with whom they should liaise in the hospital for which they are responsible.

§ Baroness Hooper
My Lords, I assume that the noble Lord is referring to the report on violence to staff which was chaired in turn by my noble friends Lady Trumpington and Lord Skelmersdale, the recommendations of which were accepted by the Government particularly in relation to staff training. We are fully aware of what is needed in that respect and we are certainly looking at the situation to ensure that procedures are being carried forward. The use of professionals in this sphere is becoming more and more important.

§ Baroness Robson of Kiddington
My Lords, does the Minister agree that we are right to be deeply anxious when patients and young children are attacked in hospital wards? While we are all in favour of greater security, can the Minister assure us that those attacks did not take place because of staff shortages and no supervision in the wards?

§ Baroness Hooper
My Lords, I am grateful to the noble Baroness for raising that point because in none of the incidents reported has it been suggested that staff levels were in any way to blame. For example, when the St. Helier hospital incident affecting a young child took place on 14th October, the normal level of staffing was present on the children's ward for a Saturday evening; namely, two nurses for five patients. Normally the doors and windows of the children's ward are kept locked during the night, but at that moment the doors had been opened for a few moments to admit an emergency. That is when the lapse occurred.

§ Lord Mason of Barnsley
My Lords, can the Minister say to what extent security was a factor in the recent killing of the two surgeons at Pinderfields Hospital?

§ Baroness Hooper
My Lords, the murder of the two consultant plastic surgeons was a most appalling incident. My honourable friend the Secretary of State called for a full report, and we shall need to examine that. A summary report was prepared immediately, the following day. However, the police in question said that nothing physically could have been done to improve the security in that situation.

§ Lord Taylor of Blackburn
My Lords, the question that the Minister has not answered relates to central funding which is vital to the whole matter. Each authority is anxious to obtain as much security as possible. Are the Government prepared to make extra moneys available for that purpose?

§ Baroness Hooper
My Lords, we all know the arguments regarding central funding and the desire of noble Lords opposite to obtain earmarking on all possible occasions. This is the kind of situation for which local management is responsible. As a result of the last public expenditure round more funds will be 381 available for devolution to local level. It is important that local management uses those funds in the best possible way to meet local needs.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that in St. James's Hospital, Leeds, last week a woman was raped in the night? Many hospitals are very big. Would it not be a good idea to install panic buttons connected to a central point so that offenders could be caught?

§ Baroness Hooper
My Lords, as I said, the position is being reviewed. I am aware of the incident at St. James's Hospital. Again, it is another deplorable incident. I am also aware that in many hospitals panic buttons are already installed partly as a result of the publication of the National Health Service security manual, which is under revision. A special conference on security is also due to take place. It was called by the National Association of Health Authorities and Trusts to review the position. Local managers are reviewing the situation, and I feel sure that panic buttons will be discussed. Referring to the specific incident, there is no doubt that the alarm call was given almost immediately by the nurse involved.

§ Baroness Faithfull
My Lords, can my noble friend say how many hospitals employ outside contractors as security officers, and how many security officers are permanent members of staff? Would the Minister agree that staff have a greater sense of responsibility and loyalty to a hospital when they are permanent employees?

§ Baroness Hooper
My Lords, as I said earlier, it is obvious that the business of security is becoming increasingly professional. I am afraid that the cosy days of caretakers keeping an eye on things are long past. The department encourages health authorities to consider competitive tendering for a wide range of non-clinical support services, including security. In that regard we believe that outside contractors can be as efficient as if not more efficient than in-house security arrangements.

§ Lord John-Mackie
My Lords, has any survey been made by any party to ascertain whether there is any pattern to these extraordinary assaults in hospitals? It is the most strange place one can think of for assaults to take place. If there is a pattern it could perhaps give guidance as to the kind of security required.

§ Baroness Hooper
My Lords, it is difficult. It appears to be a self-generating matter. The more incidents there are, the more publicity is given to them and unfortunately the more people are attracted to commit these crimes. As yet no final analysis has been made.

§ Lord Ennals
My Lords, I am sure the Minister accepts that there is a great deal of concern in the country regarding so many different kinds of violence leading to death caused either by self or by murder. I believe I heard the Minister's honourable friend Mr. Dorrell say this morning that the department was setting up an inquiry in this regard to make recommendations. I thought that I would recommend that. Is it not something that the department should 382 urgently do? Finally, would the Minister accept that the idea that security could best be carried out by outside contractors is one that many people on both sides of the House gravely doubt?

§ Baroness Hooper
My Lords, whatever means are used to implement a security strategy, the important point is that responsibility lies with the local health authority, which is in the best possible position to know and cope with local needs. There is a variety of responses at both central and local level to the recent spate of incidents. There is no doubt that the whole situation will be thoroughly examined.

§ Lord Ennals
My Lords, is there to be an inquiry set up, as I believe Mr. Dorrell suggested this morning?

§ Baroness Hooper
My Lords, the programme to which the noble Lord, Lord Ennals, refers, which he no doubt heard on the radio this morning, was in regard to mentally ill people. The inquiry to which my honourable friend referred related, I believe, to former psychiatric patients.

§ The Countess of Mar
My Lords,—

The Minister of State, Home Office (Earl Ferrers)
My Lords, perhaps I may interrupt for a moment. We have already spent 11 minutes on the first Question. I think that prudence suggests we move on even though, as the noble Lord, Lord Ennals, said, it is an important Question. The normal arrangement is that we allow 20 minutes for four Questions. Ten minutes for one Question is perhaps sufficient. Perhaps the noble Countess would like to ask her question and we can then move on.

§ The Countess of Mar
My Lords, what advice would the noble Baroness give to area and district health authorities which are shutting beds because they cannot meet budgets for this year, and at the same time are being asked to increase their security arrangements? Where will the funds come from? Perhaps more bed closures?

§ Baroness Hooper
My Lords, the noble Countess emphasises the point I made previously, that it is extremely important that local health authorities should decide on their own priorities.