Health Protection in Scotland
The UNISON Scotland Submission
To the Public Health Division, Scottish Executive
Consultation Paper on Health Protection in Scotland.
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
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.
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
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,
- 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
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
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
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
14, West Campbell Street,
Glasgow G2 6RX
Tel 0141-332 0006 Fax 0141 342 2835
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