Five assaults a day on health workers across Lothians

Already in the four months since April more patient attacks on NHS Lothian staff have been reported than in the whole of 2009-10, leading to claims that doctors and nurses are increasingly being used as “punchbags” by some members of the public.

In recent years, the number of physical assaults on NHS Lothian staff has continued to rise and if the trend over the first third of this financial year continues, health board employees will have come under attack nearly 2000 times in 12 months.

Tom Waterson, Lothian branch chairman for Unison, branded the figures “extremely concerning” and said he believed a number of factors, including a breakdown in social responsibility, reduced staffing levels, diminishing respect for health professionals and an upsurge in alcohol-related hospital admissions, lay behind the rise.

“Some people see those attempting to help them as an easy target for assault,” he said. “I remember going to hospital as a child and they were treated almost like chapels. But I have seen a change in people’s attitudes to health service staff over the last 20 years. It’s a social problem.

“I don’t think the courts have been hard enough. Too many times we are seeing people being removed from accident and emergency departments by the police but they are not dealt with properly.”

Mr Waterson also raised concerns that reducing staff levels could lead to workers being put in one-to-one situations with potentially dangerous patients.

The data, obtained by the Evening News under freedom of information legislation, shows that between April and the end of July, 645 NHS Lothian workers were attacked by patients – an average of more than five per day.

In all of 2011-12, 1075 assaults, or nearly three per day, were recorded. That figure rose from the previous year, when 939 assaults were reported, following 2009-10, when 492 attacks were officially noted.

It is believed that most assaults on staff occur at the Royal Edinburgh Hospital, which treats patients with mental health issues.

A significant number of attacks were also reported at the Edinburgh Royal Infirmary, the Western General Hospital and St John’s Hospital in  Livingston.

Assaults on paramedics and staff working at GP surgeries in the Lothians were not included in the figures.

Alan Boyter, NHS Lothian’s director of human resources and organisational development, said the health board would not tolerate any form of violence towards its staff.

Workers are given training in how to de-escalate threatening situations and have been encouraged to report even minor altercations, he said.

Accident and emergency staff are issued with personal alarms, while panic buttons have been installed at strategic points at hospitals in the Lothians so staff can call for help.

Mr Boyter added: “Our workforce rightly expect to be able to deliver healthcare in an environment free from the fear of violence and intimidation and we will do all that we can to protect them. We will seek prosecution of anyone who is violent or abusive to staff.”

The Emergency Workers (Scotland) Act, introduced in 2005 and extended in 2008, was intended to act as a deterrent against assaults on public sector staff, making it a specific offence to assault, obstruct or hinder someone providing an emergency service. But with the number of assaults on health staff in the Lothians rising, politicians said more had to be done to protect NHS employees.

Scottish Conservative health spokesman Jackson Carlaw said that he believed consideration should be given to denying treatment to patients who are known to regularly attack health service staff.

He added: “NHS workers have to endure many challenges in their line of work, but violence from patients should not be one of them.

“This worsening problem cannot be allowed to continue to increase, and such statistics really highlight the danger our medical workers place themselves in on a daily basis.

“There are cases when incidents can be attributed to mental ill health, but when this is not a factor we should come down on these criminals severely.

“We should consider denying, where possible, these violent individuals treatment, and a list should be created so we know who regular offenders are.”

Labour Lothians MSP Sarah Boyack said the statistics obtained by the News were “deeply disturbing”. She added: “It’s not a one-off trend either and looks like it’s going to be an even higher number this year. I’ll be writing to NHS Lothian to ask for more information about what the circumstances are behind these attacks.

“Front-line NHS staff work incredibly hard and they shouldn’t be put at risk while caring for patients.”

Those in the health service who have the most direct contact with patients, particularly nurses, are seen as being in most danger of being attacked.

In 2009, it was revealed that one nurse in the Lothians was being assaulted every day, prompting calls for a zero- tolerance approach to aggressive patients.

Three years on, the Royal College of Nursing (RCN) Scotland is continuing to lead calls for better integration of authorities to ensure a safe working environment for its members.

The body’s associate director, Norman Provan, said: “RCN Scotland has campaigned vigorously to raise the issue of violence and aggression against nurses and other staff. Violence and abuse of any kind should not be tolerated in any circumstances.

“It’s not just about dealing with the problem after it’s happened – employers, the police and the justice system must work together to ensure that staff have a safe working environment at all times and that violence against healthcare staff is seen as completely unacceptable behaviour.

“We would encourage all health care staff to report such incidents in order that the perpetrators are prosecuted  wherever possible.”

Facing an ever-present threat of violence

One of the most high-profile cases of assault on medical staff by a patient was the case of Donald Gibson, dubbed Hannibal by staff because of his aggressive behaviour.

The violent rapist requires regular life-saving dialysis treatment for kidney failure, but has persistently been abusive and violent towards those providing the care.

NHS Lothian successfully gained a court order banning him from physically or verbally abusing staff in 2006, but he continued to offend and was jailed for nine months for assaulting nurse David Walker at the Edinburgh Royal Infirmary in 2006, leading to calls that he be refused treatment.

Edinburgh nurse Steve Holder is one of the few who have spoken out in the past about the issue of violent patients.

He said he had experienced violent attacks during his long career, and called for nurses to be given more protection.

Elizabeth Coe, 37, was attacked during an incident in a dining room at the Royal Edinburgh Hospital in May 1999.

She suffered scalds to the chest and abdomen after a mug of boiling water was thrown over her, and was left with permanent scarring.

The psychiatric nurse later left the profession as a result of the attack.