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UK: Doctors and nurses to face random drug tests
Sue Leonard The Times
Sunday 23 Feb 2003 DOCTORS and nurses could be randomly tested for drugs or alcohol under new guidelines to be issued by the National Health Service in Scotland. The guidelines have been drawn up among growing concern at high levels of drug-taking and drinking among GPs and consultants. A study published last year claimed that more than half of Britain's doctors and dentists have used illegal drugs and regularly drink over the limit. The guidelines, to be published next week, are part of a wider initiative aimed at improving the health of staff at work in the NHS and to protect patients. Any testing would have to be done with the consent of staff. NHS authorities in Scotland will be advised to promote substance misuse policies to ensure that staff are not under the influence of alcohol or drugs while at work. It says government statistics show that drinking alcohol and taking drugs are on the increase. "NHS Scotland organisations have a duty of care to patients and visitors to make sure that they are not at risk," it says. "If the performance of a staff member is impaired by the use of drugs or alcohol, the duty of care to patients and visitors may be breached." Employers have no right to conduct tests without the consent of the individual concerned. The guideline points out that "it would be unwise to introduce alcohol and drug testing where there is no existing provision in the contract of employment, so proposed changes must be negotiated with staff representatives or individual staff". It adds: "Securing the agreement of the workforce to testing is essential except in the cases of pre-employment screening." Testing may be carried out with prior consent when staff are being promoted or transferred, before they start work or on a random or unannounced basis or following an incident or accident. Research into substance misuse by medical and dentistry students at Newcastle University found that more than half continued to experiment with drugs even after they had qualified and become practising doctors and dentists. Ecstasy, cocaine, cannabis and heroin were among the drugs that students and practising health professionals admitted using. Studies by the Institute of Alcohol estimate that one in 12 doctors in Scotland has a drink problem. Addiction experts warned last year that increasing numbers of doctors, dentists and other healthcare workers were drinking heavily because of overwork and spiralling stress levels. The health department recommends a weekly limit of 21 units for men and 14 for women. The problem of alcoholic doctors hit the headlines in 1997 when Gerald Davies, a surgeon at St John's hospital in Livingston, admitted to a fatal accident inquiry that he drank half a bottle of whisky a night. His drinking only came to light after operations on two people who subsequently died. However, the inquiry concluded that there was no proof that his drink problem had contributed to the deaths. Health unions and doctors' organisations insist that there is no evidence that drug and alcohol abuse is a particular problem among NHS workers in Scotland. Dr Ewan Macdonald, an occupational health specialist, said: "The scope to be abusing substances or alcohol and be able to work and remain at work is very much less than it was historically." He said this was because people worked in teams and that nursing and medical staff now had a duty to report people if they suspected that a colleague had problems. The British Medical Association said the organisation's confidential counselling service logged just one call relating to substance misuse last month out of about 160 inquiries. David Watson, Scottish organiser of the health workers' union Unison, said drug testing could be undertaken only if it was recognised as a health and safety risk. "They would have to identify that there was an issue and it would have to be proportionate to any health and safety risk," he said. "It is not about moral judgments." The guidelines, which also include advice on encouraging staff to walk to work and eat more healthily, were drawn up in collaboration with unions. An executive spokesman said he was not aware of any health board or trust having a specific drug-testing programme in place. "If there is prior consent from the employee or employee group then such tests could be carried out, but it all boils down to having consent," he said. "Failure to comply with health and safety legislation is a criminal offence and that includes staff being under the influence of drugs and alcohol at work. "We are not saying organisations must have a drugs-testing system, rather that organisations would be advised to consult staff to introduce a 'drugs issues' policy that would mirror the 'alcohol issues' policy - this would ensure organisations meet their legal responsibilities and duty of care to patients. "We would like to think that most trusts would observe this particular guideline and follow it as best they possibly could."
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