Thanks Linda - a nice summary - I can imagine myself cutting and pasting
your words into forthcoming letters to certain employers!

merry xmas all

--
Dr Mark O'Connor
www.physician.org.uk/

> Mark,
>
> You are correct - under the COSHH regulations and the biological
> agents Approved Code of Practice, the duty lies with the EMPLOYER
> to assess the risks arising from exposure to 'biological agents'
> and then to prevent or control exposure.
>
> Prevention/control and/or health surveillance may well include
> the provision of vaccinations and checks for immune status (e.g.
> Hepatitis B).  So if vaccinations for staff are required because
> of the findings of the COSHH assessment, the employer has a legal
> duty to provide and pay for them.  HSE's current guidance is that
> this should be arranged through a competent medical practitioner
> (normally an occupational physician), and in all cases a
> non-confidential health record should be kept (refer to COSHH
> Appendix) in addition to the confidential medical record.
>
> The physician who carries out the vaccinations should provide
> feedback to the employer on the outcome of any health
> surveillance procedure (e.g. checks on immune status), expressed
> in terms of fitness for work.
>
> A Happy Christmas to all,
>
> Linda Shelmerdine
> ______________________________ Reply Separator
> _________________________________
> Subject: Re: Vaccinations Again
> Author:  MIME:[log in to unmask] at netmail
> Date:    22/12/2000 00:05
>
>
> Hi Jeremy
>
> > Thanks for your comments.  Someone once told me that if
> vaccinations were > necessary for employment purposes then they
> should be given free
> > of charge.
>
>
> Nothing is ever free - so we need to ask, who is paying the fee
> for the medicine/administration/consumables(plasters,sterets
> etc)/heat/light/staff/building etc...?
>
> If something is necessary for employment purposes then in my view
> the employer should pay - by way of a fuller explanation.....
>
> 51 years ago the NHS decided to adopt a model of independent
> contractors status for general practice which for the majority of
> us has not changed IE As a GP I am a self employed businessman
> -GPs do not work for the NHS -
> they have contracts with Health Authorities to provide services
> which may or may not be their only contracts
>
> My main contract is with the health authority to provide "general
> medical services" for which I receive a capitation payment(and
> immunisations is not covered in GMS) - in addition there are
> Items of Service fees for a variety of other activities (lumps
> and bumps removal, contraceptive services,temporary resident
> advice....) which augment my gross income from this contract
>
> In return I run the business ( and therefore have gross expenses)
> , employ 15 people (and thereby have to keep up with all the
> responsibilities of an employer as well as doctoring) and own the
> building in which this "NHS" activity takes place thereby taking
> responsibility literally  for the loo roll to the tiles on the roof
>
> So you will see that with this background it is not surprising
> that many GPs get irritated with "dumping" of work from employers
> or secondary care without a fee attached or promise of a suitable
> contract of terms for the work
>
> > What happens at your practice?
>
> For the odd patient on my NHS list who requests it I do give a
> course (and am happy with the small profit I make on buying bulk
> jabs and the amount the NHS reimburse for dispensing). For
> employees of the small companies I look after (inc a sewer diving
> firm) I charge 35 ukp per jab for Hep B
>
> Any concerted effort by a company/NHS trust to have there
> employees immunised systematically by sending them to me( coz its
> "free" on the NHS") without prior arrangement of terms would meet
> with a simple no accompanied by my terms of business
>
> Sorry to sound so long winded but an awful lot of
> misunderstandings arise because of basic ignorance of  how GPs get paid
>
> If I worked in a different model (IE salaried/40-60 hours per
> week then I would be more than happy to fill those hours with
> immunisations, although I suspect that my new managers would take
> a different view ;-)
>
> cheers
>
> --
> Dr Mark O'Connor
> www.physician.org.uk/
>
>
>
>
> Please note the new email address for the UK Health and Safety
> Executive is @hse.gsi.gov.uk.
> The old address @hse.gov.uk is still valid.
>