Health and Safety Executive (HSE) Correspondence

On the afternoon of Friday 24 July 2009, I attended a medical appointment at the Atos Origin, Highgate Medical Examination Centre, 1st Floor, 1 Elhorne Road, Upper Holloway, London N19 4AL. This medical facility is run by Atos Origin as part of a multi-year, multi-million medical contract they have been awarded by the Department of Work and Pension. I feel the health and safety environment did not meet the highest standards I expect for doctor's surgeries and clinics which deal with patients.

I did not see a health and safety notice saying when the premises were last inspected. There was a complete absence of cleansing gels and wipes. In the office used by the doctor, I did not see separate waste facilities for medical waste. I spent some hours there and noticed sick and coughing patients. I did not see any evidence of a regular cleaning routine every few hours which I expect to see in such places. I mentioned my concerns to the Doctor I saw. I formally wrote a letter of complaint on the 29 July. I have had no response on the matter from Atos Origin.

It may be my experience is atypical. I would interested to know when you last conducted an audit of the Highgate Centre and the other medical facilities set up by Atos Origin as medical examination centres around the country. The DWP publish statistics that in February 2009, Atos Origin handled 176,000 ESA cases and they handle other non ESA related medical cases. I would be interested in the results of the audit. I am not sure if you are allowed to put the details of this information into the public domain but I am sure the Secretary of State for Works and Pensions should be made aware. I would be happy to receive an assurance from you that audits show there are no problems or that you have found improvements are needed and you have served the appropriate notices.

On a personal note, I worked for twenty years as a senior manager for L.... I am very familiar with how important HSE issues were regarded and rightly so. Any incident was reported at Board level. Everyone was given annual HSE improvement targets. Between 1982 and 2002 when I left the company the HSE culture of the company changed for the better. We became health and safety aware. I may be wrong but I did not get the impression at Atos Origin that HSE issues were high on their priorities. I look to you for reassurance.

I refer to the complaint you made about the Atos Origin offices at the Highgate Medical Examination Centre, 1st Floor, Elthrone Road, Upper Holloway, London N19 4AL through the Health and Safety Executive's Infoline Service and received by this office on the 18 August 2009.

This letter is to advise that your complaint has been taken forward and someone will contact you in due course. We have written to Atos Origin in connection with your concerns about the standards of cleanliness and the disposal of clinical waste as that falls under the remit of the HSE.

If you have concerns regarding patient welfare, you should direct them to the Care Quality Commission (CQC). I have included contact detaiIs for the CQC at the end of this letter.

In response to your question, the HSE have no record of any audit having been carried out at the company concerned at this time.

Thank you for bringing these matters to our attention. Please quote Case No 4177247 in any correspondence with or any phone call to the Health and Safety Executive.

Regarding your letter dated 4 September 2009. I received a letter from Ms B..., Customer Relations Manager, Atos Healthcare dated 22 September 2009 which followed a letter from her dated 10 August which followed my original complaint in a letter dated 29 July 2009 which raised my concerns regarding Health and Safety issues at the Highgate Medical Examination Centre (MEC).

Ms B... writes in her letter paragraph 10 "...the Site Manager has advised that as the MEC is not a GP surgery or hospital, it does not have alcohol rubs for people to use in the waiting room, but soap and washing facilities are available in the toilets...". No mention, in her letter, was made of cleaning regimes or the disposal of clinical waste.

My understanding is that the Medical Examination must conform to the Welfare Reform Act 2007, relevant Acts and relevant Case Law. It is seems reasonable to assume that the intention of Parliament was that the Medical Examinations covered by this Statute should be consistent with existing (NHS) Medical Examinations and in quality to be as good as or better than existing.

NHS Medical examinations are carried out at the local GP surgery or hospital, by qualified medical practitioners with access to the patient's history, in locations that meet Health and Safety Rules for such places and take into account difficulties in travel and accessibility. Parliament has not clearly expressed, in the above Statutes, a wish that lesser standards should apply generally or in particular in Health and Safety issues.

Please can you consider whether you agree with this interpretation of above Statutes and if so instruct Atos Healthcare to comply with the legislation. Hopefully Atos Healthcare will comply and it will not be necessary to petition the High Court to rule on whether, under Administrative Law, an abuse of process has taken place and to seek an order of mandamus to compel Atos Healthcare to comply with the legislation.

I can provide full copies of correspondence if necessary. I would be willing to give evidence in court if required and if I am able. The latter is dependent on the progress of my brain tumour. I look forward to hearing from you.

HEALTH AND SAFETY AT WORK ETC. ACT 1974

I refer to the complaint you made and received by this oMce on the 18th August 2009 about the Atos Health Care offices located at the Highgate Medical Examination Centre, 1st Floor, 1 Elthorne Road Upper Holloway, London N19 4AL and your latest correspondence dated 24th September 2009.

Following our enquiries about your concerns, we have received a response from the company's Regional Manager. With regards the disposal of clinical waste; we were advised that the Centre does not carry out any "invasive" surgical or medical techniques such as blood tests etc requiring medical waste facilities. The Centre assesses people's functional ability through consultation, discussion and simple physical tests (e.g. reflex) and only generates standard office rubbish so does not require a dedicated clinical waste facility.

The issue regarding cleanliness; the cleaning regime at the Centre takes place once a day; in the Highgate Centre, this begins at approximately 17:30, at the end of the working day. Additional cleaning periods are not considered necessary but procedures are in place should further cleaning be required.

Hand gels, tissues and cleansing wipes are supposed to be available to all staff at the Centre, together with soap and water for use by visitors in the public toilets. The cleaning contractors check the toilets throughout the day and a card, which is displayed in the toilets, signed after each inspection.

Your letter of 24th September cites various legislation relating to the running and organisation of medical centres and attendant practitioners. The Health and Safety Executive are not in a position to comment on this legislation, as we are not the enforcing authority in these matters. We advise that you speak to Care Quality Commission (CQC) or the General Medical Council (GMC), who are qualified to discuss these concerns. I have included contact details for both these organisations at the end of this letter.

The HSE are satisfied with the response by the company in matters relating to health, safety and weIfare in the Centre and do not propose to take any further action. However, the company have been advised that we may consider reviewing this decision should further evidence be presented on this matter.

Thank you for bringing these matters to our attention. Please quote Case No 4177247 in any correspondence with or telephone call to the Health & Safety Executive.