Health and Safety at Work

My Lords, this topic is of huge importance and I am enormously grateful to the noble Lord, Lord Harrison, for initiating this debate. I am also enormously grateful to the Minister for speaking on this matter on a variety of occasions and I propose to quote him a couple of times. Health and safety at work is a very serious issue. I got involved with it through chairing a National Health Service trust and later being chief executive of the King’s Fund. As the noble Lord, Lord Harrison, said, there are other areas where health and safety is hugely important—for example, agriculture, business and heavy industry—but I shall restrict my comments to the area of health and social care. Like the Minister, that is where my experience lies. The Minister has frequently spoken about the risk to nurses and their problems with their backs, but they are also at risk from needlestick injuries that occur when people stab themselves with a needle that they were supposed to be sticking into a patient. That can cause considerable damage and at the height of nervousness about the transmission of variant CJD and AIDS, it became a huge issue. There is also the issue of violence against members of staff, which the noble Lord, Lord Harrison, raised. That is a huge risk, particularly for people working in the health side of health and social care. The question of backs is a hugely vexed issue. Nurses have, rightly, strict instructions not to lift older people who have fallen unless a suitable hoist can be found. That, as the noble Lord, Lord Hunt, said in a speech on 13 July 2005, is,"““a particularly thorny issue. The major cause of work-related ill health for nurses is musculoskeletal disorder, particularly back pain. 5.8 per cent of nurses reported musculoskeletal disorders caused by, or made worse by, work””," That, as the noble Lord said, is more than twice the national average. He continued, saying that it was:"““Hardly a surprising statistic given the kind of lifting the job can entail, but it causes great pain and costs our health services dearly””." Clearly, as the noble Lord also said,"““nurses are owed protection from back injury””," but,"““at the same time patients are owed the right to be treated promptly and with dignity””." All the evidence shows that routine use of lifting aids reduces back injury and greatly increases attendance at work. Yet, as the noble Lord, Lord Hunt, also said,"““it is worrying if nurses feel that even in an emergency they must never resort to manual handling. The Health and Safety Executive recognises that there are exceptional times when manual handling will be necessary, but that message is clearly not getting through””." The Minister continued by quoting the Disability Rights Commission, which has said that,"““fear of litigation leads to a completely illogical conclusion which denies disabled people independence””." The commission also said:"““Legislation effectively shifts the burden of managing risk onto public authorities, who, rather than supporting people to manage risk, instead feel compelled to attempt to eliminate all potential risks. In doing so they deny disabled people the chance to lead an independent life—in which a reasonable level of risk is a normal part””." That is the problem; we keep setting one benefit against another risk. Let me also quote a headline from the Guardian of two years ago. Your Lordships can see from its yellowing state that it is my favourite newspaper quotation of all time."““Q. How many care workers does it take to change a light bulb? A. Ask a risk assessor””." This was the true story of a Department of Health advertisement, trying to encourage people to join care services, which showed one care worker holding up an arm to change a light bulb in an older person’s ceiling. It was successful, and said that if you felt you could do the small things that make a big difference, you too could earn a living in social care—except that every local authority in the country wrote in to say that no one was allowed to change a light bulb alone. You need one person to change the bulb; secondly, and rightly, another person to hold the ladder. A third person is needed due to electricity regulations to turn off electricity at the mains—since most older people, and many younger people, fail to check their wiring or have it renewed sufficiently often. Some local authorities also wrote to say that a fourth person is often needed to comfort the older person who, by then, has Piccadilly Circus happening in their flat.