Thursday, 15 August 2013

NHS lift ban on HIV+ Staff - is this good or not?

Professor-Dame-Sally-Davies-said-many-people-with-HIV-are-now-leading-lives-that-are-normal-in-quality-and-length-
England's chief medical officer, Prof Dame Sally Davies

Today it was announced that In the UK they have just lifted the ban on medical personnel doing certain tasks in the health service. For instance surgeons, doctors dentists, nurses etc living with HIV could not perform certain procedures and operations, nurses also who live with HIV were banned from some tasks and jobs etc.

This has been lifted so they can now do all things within their training.

It has been replaced by regular monitoring to ensure they are taking any medication properly and their HIV is controlled
http://www.express.co.uk/news/uk/422130/NHS-staff-with-HIV-ban-to-be-lifted

http://www.bbc.co.uk/news/health-23698991


On first though it seemed great news. But have some worries too as employers in the UK are very good at getting round anti discrimination ruling. Will this mean that more HIV+ qualified medical people will be employed and stigma lessen for those who are already employed by the NHS, or will it in a convoluted way, increase it if more already employed ‘come-out’ and more apply?

My doubts arise because I know there is underhand and hidden discrimination happening in all areas of the workforce in the UK for those with HIV despite anti – discrimination and Equal opportunity legislation, that has and does stop those with HIV disclosing their status at work.

Therefore I apologise if I offend  but I have a suspicious mind when it comes to how discrimination works in the UK in employment and know to my cost how a lot of anti discrimination and anti stigma is just lip service as ways can always be found around it as the legislation is full of holes and maybe deliberately so?

In theory NHS workers of all categories that live with HIV will now be able to do all tasks they were trained for, including procedures and operations. This will mean they will be ably to openly apply for jobs that involve such tasks without fear of discrimination that has beyond doubt been happening.

For instance even at the level of it made it impossible for people with HIV to do certain jobs within the NHS such as dentistry, surgeon even phlebotomist etc. Many have lost there jobs in the past or not been able to find work if diagnosed. HIV healthcare workers will have to be on ARV medication and have an undetectable viral load. As "With effective treatment, they are not infectious."

This looking at it positively, may be very good news in terms of de-stigmatising those who live with HIV.

However, even before such effective treatment existed with universal precautions that all in the NHS use the chances of getting HIV from a health practitioner was hugely remote and in fact has NEVER happened in the UK!

However it will have to be seen what the effect actually is?


As in fact despite the legislation being as it was, and the NHS thinking they only have fewer than 200 staff that will be affected by this, it is anecdotally the case here that many more workers within the NHS who have direct contact with patients and already do these until now forbidden tasks actually live with HIV then just 110!!. And these are those that know their status. There are of course many more who do not yet know their status but eventually will.

I have met personally, locally and through UK activists groups HIV poz nurses I have been too Nationally. Only one I have met was known to be HIV poz by their employers. Most it was not known because they were diagnosed after they got their job, so there medical records did not say they were HIV+ at interview. As here Anti Discrimination and Equal Opportunity laws also apply to those with HIV. But there has been a certain amount of 'underhand and unseen discrimination going on which worries UK activists more in some ways then when it is out-front.

As for some jobs, medical, social worker and teacher, youth worker which was my profession,  and other jobs, mostly those that work directly with children, young and 'Vulnerable' people, you are asked to give permission for them to see your medical records when you fill in an application form.

You can request they do not see them unless you are offered the job and after interview when your references are being taken out as they are not supposed to discriminate due to any illness or disability. However in practice if you do ask they are only seen if and when you are offered the job, it is assumed you have something that may interfere with you doing your job, so basically it is unlikely you will be hired or even interviewed. So most let them see medical records before interview and if you do have HIV quote the Equal Opportunity act 2010 at them and hope they decide to interview you anyway.

And if you did get the job, in some jobs, special exemptions to what you can do can apply, that overrule on a ‘health and safety’ grounds some of the intended ethos of anti –discrimination for those sick and disabled that is covered mainly by the Equality Act 2010.

Like medical jobs where the Chief Medical Officer can and did make special rules applying to medical staff with HIV, social exemptions on what you can do can apply.  There are others applying to other jobs usually under ‘health and safety’ justifications.

Also there are some inbuilt ‘limitations’ on what a disabled person can do or be allowed to do under the act https://www.gov.uk/definition-of-disability-under-equality-act-2010.

A difficulty as I see it in anti stigma and anti discrimination for those with HIV and other conditions in the UK is that the general public think we are well protected in law in the work place and in our lives, but there are at times ‘built-in’ ways around it or ways around it can be found, such as asking for medical records before you are offered certain jobs at application, but allowing applicants not to let them be viewed unless off offered the job, but then the employer deciding you have something that will impact on your work should you be offered the job, so  and not interviewing if you are not prepared to let them be viewed.

I see this as a very convoluted and built-in ‘Get out Clause’ for employers to get out of the Equal opportunities act!!



However there is also evidence that these rules are also ‘unofficially’ overlooked as well. A nurse I met said she had an incident where she had to disclose and nothing was done, it was not officially registered and she continued her duties the same as before. She said she know several other nurses the same.

That when this announcement was made it was said it only applied to 110 medical personnel within our health service, because that is the number of HIV+ medical staff with direct contact with patients within the NHS that they know about. This is hinted at in the reports today http://www.bbc.co.uk/news/health-23698991

But actually there are far more, that for some reason or other they don't know about. As well as this nurse I had this discussion with I have met personally 2 others and one retired.

So I am now wondering if due to this change of policy if HIV+ medical staff will now disclose to their employers more, and what will happen if they do?

Will more who are qualified apply open about their HIV status for jobs they were restricted form doing in the past and will they be interviewed and employed?

Will this be a positive thing, will it lessen stigma or in a roundabout way increase it?

Sorry to be sceptical, but I think only time will tell.

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