If we knew that one of our service users had a serious illness such as AIDs; HIV, Hepatitis B, we would inform staff (some health & social care companies would, as a matter of policy, not tell staff for fear of discrimination). However, their is no burden of responsibility on the part of the service user to give us this kind of information and, they may not even know themselves. This means that we are simply unaware, on which basis, we insist upon adherence to Standard / Universal Precautions. These include, for example: • Wearing Personal Protective Equipment (PPE), at all times • Regular hand – washing between processes and service users • Mopping up of spillages immediately I further advise all staff to arrange the Hepatitis B inoculation as one of the few barriers available against a blood – borne virus. We see it as part of our duty under the Health & Safety at Work Act 1974 to ensure a safe place of work by advising / encouraging it. It must also be seen as part of the duty of the employee under the same Act to take reasonable care of their own health and safety. Not everybody will do it. Some through apathy and a feeling that “it won’t happen to them”, others because they are “needlephobic”. Like our service users, medication for staff is a matter of their choice and we cannot force anybody to do it, nor can we make it a term and condition of employment, even though we believe it is in people’s best interests. Until February 2010, members of the public were able to go to Occupational Health at the Queen Elizabeth the Queen Mother Hospital in Margate (QEQM), who would provide this free. It was then decided to suspend the facility to members of the public but to continue to provide it, still free, to NHS staff only. Investigation has shown that, in fact, there is only ONE immunology department serving the whole of Kent, in Ashford, at the William Harvey Hospital. Practically, therefore, the only alternative recourse for care staff countywide, is their GPs. Many GP practices will provide this service free to their own patients, as an occupational requirement. I have, however, also been told that some doctors’ surgeries will charge anything up to £150 for this , with what justification it is hard to fathom. There are literally hundreds of care providers in Kent, companies small, medium, large, volunteer, county – administered and private. This means that many thousands of workers in this area should have access to this medication. It doesn’t seem reasonable that they should be effectively forced to pay, seemingly, exhorbitant sums of money simply because they have no alternatives. I would be interested to hear if IOSH have any prior knowledge or views on this serious health & safety issue.

Vaccination is free for people at high risk and is available from sexual health clinics, travel clinics, hospitals or GP surgeries. A GP may ask why you want to be vaccinated, you should have a valid reason (part of work risks) as they may then refer this to a charge however, the health clinics are not allowed to charge for this service.

I am finding it strange that when a work-related risk has been identified and a control specified that an individual employee is then expected to have to fund the cost of the control... or am I misunderstanding the issue? Employees are not expected to pay for their machines to be guarded, nor for the LEV system to protect them from horrible diseases, nor for the electrical systems to be safe; nor would they be expected to pay for appropriate protection measures when working with pathogens in a lab environment. Whether the NHS or private medical services provide the service, I think the cost and charging is a H&S red herring (and no doubt subject to a variety of opinions).