The Southern Health Board was convicted last Thursday of breaches of sections of the Safety, Health and Welfare at Work Act, 1989, following two serious incidents involving violence to staff at Cork University Hospital during 1998.
Mr Michael Henry, chief inspector with the Health and Safety Authority (HSA), told The Irish Times: "The implications of the case are that all employers are expected to provide a safe place of work." This must deal with risk of injury, from whatever source it comes, including violence to staff.
Speaking of the case, Mr Mark Rowlands, a HSA inspector, says that the two incidents involving the Southern Health Board "illustrated in different ways - in our opinion - the inadequacies of the security arrangements" at the hospital.
"I think an important point to make is that this is the first case of this type taken either here or in the UK. It is the first use of health and safety legislation to deal with violence in the workplace - well, certainly in a hospital context," he says.
In one incident, a 19-year-old housekeeping assistant was put to "specialing" a patient - that is, allocated to maintain a watch over a particular patient - without adequate training, he says.
"This patient was in her own room off the main ward. She was in a burns unit. The room contained a small bathroom and toilet and the patient asked the attendant if she'd go into the bathroom to look for a ring which she'd allegedly lost there. And while she was doing this, the patient, who was a fairly strong woman, came up behind the girl and coiled the alarm chord - which wasn't working - coiled this chord around her neck and nearly choked her with it. The girl found herself being choked and unable to summon help. Luckily for her, a colleague happened to be calling at the time and was able to summon help."
The girl had no means of raising the alarm herself and was inadequately trained to "special" such a patient, he says.
The second case occurred in the accident and emergency ward where a strong young woman became violent several times during one night. Two security officers were on duty and one of those had to leave to relieve the switchboard operator, he says. The patient sprayed a security officer with a mace pepper spray and held a nurse by the throat against a wall. Later, she became violent again and held another nurse by the throat, he says. "Now, this incident illustrates the inability of the system to contain a known problem. There should have been some means of isolating that patient, of taking her away from the ward where she was a danger not only to staff but to other patients. There should surely have been some means of containing her and isolating her. "At the time the security arrangements were, in our opinion, poor. They only had two, sometimes three people on at night."
Mr Rowlands says that while the Southern Health Board pleaded guilty, "they have put in significant improvements, the main one being they have provided certain staff members with a personal alarm attack system". According to Mr Rowlands, the judge deferred penalty to give the health board a chance to improve further and the judge asked him to revisit the hospital and to satisfy himself that the conditions there were adequate. "They have until the 25th of May next year," he says.
In a statement issued to The Irish Times, the Southern Health Board said it had "pleaded guilty to the court". It continued: "The Southern Health Board confirmed to the court that it takes extremely seriously issues regarding health and safety matters, and in particular issues pertaining to staff safety.
"The board's health and safety officer, Mr Richard McCann, further outlined to the court the various improvements the board is taking at Cork University Hospital, these include: C.C.T.V.; extra security personnel; control and restraint training for staff; expansion of hospital watch programme; personal alarm system installed.
"The court noted with approval the measures which have been and are being taken by Cork University Hospital, and accordingly adjourned the case for six months."
jmarms@irish-times.ie
