Select Committee on Science and Technology Written Evidence

Memorandum by Dr Stephen Radwanski, Public Health Laboratory Service, South-West Group

  I am writing on behalf of myself, a Bio-Medical Scientist (Microbiology and Virology), and as the PHLS (South West Group) Staff-Side Representative of the National Joint Staff Consultative Committee (NJSCC).

  As you are aware, in January the Chief Medical Officer published his strategy, proposing the formation of the Health Protection Agency (HPA), combining the Public Health Laboratory Service, the Centre for Applied Microbiology and Research, the National Radiological Protection Board and the National Focus for Chemical incidents, to take effect from 1 April 2003.

  This strategy has been widely supported, and when announced produced excitement throughout the ranks as a means of radically rethinking and restructuring the above services, with all departments working "shoulder to shoulder" under the same banner. However, the proposal that the majority of the Public Health Laboratory Service (PHLS) laboratories in England should be transferred to NHS management by 1 April 2003 has been met with opposition, both in principle and particularly in terms of the unrealistic timeframe, by a majority of staff in the PHLS. This includes the PHLS Board, who have expressed serious reservations about the public health implications of the proposals, and in particular the speed at which the process has been conducted.

  Furthermore, while full consultation on the creation of the HPA has been carried out under a Regulatory Reform Order, the transfer of the PHLS laboratories has been deliberately excluded from that consultation process because it does not require the use of such an Order. Instead, a separate restricted consultation (Trade Union and Staff-Side Groups were not consulted with at any time) was conducted by the Department of Health regarding the transfer of laboratories.

  As you know, the PHLS was originally established as an emergency PHLS, at the beginning of WWII, to protect the UK against the potential infectious hazards of warfare, including the use of biological weapons. The PHLS has been reviewed on numerous occasions, and on each occasion the management of a network of diagnostic laboratories has been considered a strength of the service, and has been recommended to continue. For example, the Strategic Review of the PHLS in 1994 concluded that: ". . . the management of a network of laboratories carrying out clinical and public health microbiology, and providing microbiological and epidemiological support and advice to all appropriate agencies in their locality, should remain a core responsibility (of the PHLS Board)".

  The report went on to say that, "if many PHLS withdrawals from laboratories were necessary by financial pressures, it would happen . . . without the same degree of confidence that the public health function could be safeguarded".

  There are also many experts outside England and Wales who have long regarded the network of PHLS laboratories as an extremely effective system. In a letter to Lord Turnberg sent on 29 January 2002 after "Getting Ahead of the Curve" was published, Dr James Hughes, Director of the National Centre for Infectious Diseases, CDC, Atlanta, USA said: "In summary, reducing the number and capacity of existing public health laboratories under the proposed reorganisation may be counterproductive. The flow of information between the public health and clinical sectors will likely be reduced, as will the ability of public health agencies to leverage new information into changes in laboratory practice and policy on a broad scale . . . I suggest that you carefully assess the potential ramifications of the changes in laboratory services recommended by this excellent report."

  Following the 1994 Strategic Review, the PHLS was organised into a number of regional groups of laboratories. Originally the South West group comprised of the laboratories in Truro, Plymouth, Exeter, Taunton, Bristol/Bath, Gloucester and Hereford. The group now also includes Dorchester, Poole/Bournemouth and Salisbury. PHLS South West has been an extremely effective group of laboratories, with both senior and more junior members of staff wishing to see the benefits that have been achieved from this regionally managed network being extended and implemented by NHS laboratories. However, the decision by the Permanent Secretary and the Chief Medical Officer has snuffed out and possibility of this ever happening, with the recommendation that there is to be only a single HPA laboratory in Bristol, initially only for one year, with all other laboratories in the South West Group returning to NHS management by 31 March 2003.

  On a personal note, I have been employed as a Bio-Medical Scientist at Poole PHL for some 12 years now. I sought out employment within the PHLS network because of my determination to work for the benefit of public health with my efforts ultimately extending to the rest of the UK. The work I undertake on a daily basis is rewarding, but ultimately I put myself at risk. Although utmost care is taken regarding the techniques used to examine microbiological and serological specimens there is always the possibility of becoming contaminated with pathogenic organisms, some of which are life-threatening. In addition to this, low pay, a mixture of unsociable hours, and the continual pressure to be 100 per cent accurate in my work, is sobering and negates some of the rewards of the profession. Staff morale has steadily declined over the last decade, and the proposed destruction of the PHLS network has taken morale into an even steeper decline, despite the assurances from the CMO that swift action would stave off a worried work force. Many staff have telephoned me over the last few months asking for clarification as to why they are to be abandoned to NHS management. Great fear and anguish has been expressed, especially as there is the perception that NHS Trusts already over budget will have a major effect upon the Microbiology and Virology service funding. Whilst assurances have been given by the CMO for the first year post-transfer, there is a "fog" still obscuring our futures. The formation of the HPA is a wonderful concept. But the timescale proposed is unrealistic to ensure continuity of service on a national scale, especially in light of the spectre of war in the Middle-East, and therefore likely repercussions here within England from the risk of bio-terrorism. Myself, and my colleagues are here to passionately continue serving our communities and by doing so, ultimately this great country of ours, through our work as Microbiologists and Virologists. But we ask for a realistic timescale to implement such a valuable asset to this country, the formation of the HPA.

  I sincerely hope that caution will be heeded. The PHLS is vital to the surveillance of public health, and it would be tragic if lives were lost due to unnecessary haste in dissecting it. Perhaps a stronger outcome would be achieved if all NHS laboratories became PHLS laboratories, and their standards raised to those currently being employed by the PHLS.

October 2002

previous page contents next page

House of Lords home page Parliament home page House of Commons home page search page enquiries index

© Parliamentary copyright 2003