 |
 |
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. >