DEA BIRKETT ON THE 'SAFETY' PARADOX

I know it sounds absurd but, like cigarettes, health and safety should carry a warning for it too can 'seriously damage your health'.

I have three children - four-year-old twins and a 12-year-old who uses a wheelchair. So my life involves a great deal of lifting.

To help me look after my family in the years ahead, I asked my 12-year-old's community physiotherapist if she could give me some instruction in correct lifting. She replied that, sadly, she couldn't. The only advice she was permitted to give me was, 'do not lift'.

I explained how that simply wasn't an option; lifting is part of my life, all day, every day. My daughter's physiotherapist was obviously quite embarrassed and upset that she was not able to help us. She explained that she was under strict instructions not to give any manual handling advice.

The reason, she explained, was that if I followed her advice, lifted my daughter and hurt myself, I might sue the NHS.

This is obviously a totally ridiculous stance to take. The trust refuses to teach me how to handle my daughter manually , insisting I only use a hoist - which I do not have and they do not provide.

Ironically, the clinic she attends does not have one either. And as the therapists are not allowed to lift her, I have to do so when she attends appointments, hoisting her on and off the examining bed.

Meanwhile, the therapists look on, unable to comment on whether I am lifting correctly. They could even watch while I hurt myself, and, if they were inhumane enough to strictly obey the trust's dictat, not intervene.

How can anyone sanely argue that this is a sensible health and safety policy? But it is not the only absurdity that an over-adherence to health and safety measures throws up. One new hospital - all atriums and original paintings - was designed with balconies so the patients could get some fresh air.

But the hospital invoked health and safety to prevent patients using them - and the balcony doors remain sealed.

Another had a sensory garden with herb beds, windcharms, and a water feature. But the water feature was turned off in case someone climbed in.

And while nurses seem capable of climbing up on chairs and rickety ladders to hang Christmas decorations around a ward, they have to call maintenance if they want to change a light bulb or rehook the curtains hanging by a bed because they might injure themselves.

It is a health and safety situation the Patients Association describes as 'obsessed in one area and ignored in others.' The patient wanting the comfort of a cooling fan, for example, should know exactly what they are letting themselves in for.

The inside of the fans get dirty, but not even the cleaners are allowed to open them up and give them a wipe in case they are somehow harmed.

So the fans stay filthy and the patients are cooler but placed at a greater risk of infection from the dirt and dust.

Nor is it uncommon to find ward windows screwed down, so they cannot be opened even on a boiling hot day, just in case someone tumbles out.

This conflict between the wellbeing of a patient and a trust is totally false, a creation of misguided trusts misinterpreting the law.

The Royal College of Nursing has told nurses not to lift. But contrary to the impression given to patients, there is no national blanket ban, or even guidelines, that prevent them or other clinical staff giving sound lifting advice to a patient - or even doing the lifting themselves.

If trusts imply that there is - to patients or staff - they are simply not telling the truth.

The Chartered Society of Physiotherapy has a much more pragmatic and helpful approach than my local part of the NHS.

The CSP has no objection to therapists teaching proper handling skills, and sees the fear of litigation as unfounded. All you need to do, it says, is to take proper notes of any instruction given. Then, if the carer hurts themselves by cutting corners to make things quicker, it is clear that the therapist has no culpability.

In fact, it says therapists have to teach carers to handle patients in order for them to carry out daily therapy programmes. Nor is the CSP doggedly set against therapists doing the lifting themselves. It says, 'if a physiotherapist never lifted a patient, there would be no rehabilitation, ' and publishes guidance on how to do it correctly.

Trusts up and down the country are eager to be seen to be protecting their staff. But, as my daughter's therapist revealed, it is more about protecting themselves from litigation.

Ironically, they are not doing that either. They are far more likely to be sued for not providing advice, than for offering suggestions that do not work. To both the CSP's and the Disability Rights Commission's best knowledge, no trust has yet been sued by a carer for providing handling instructions that went wrong. However, there have been several cases taken against local authorities whose employees refused to lift patients.

The CSP also argues that the likelihood of a physiotherapist suing their employee for a work-incurred back injury is extremely remote.

Patients' health is being endangered under the spurious excuse of saving therapists from back injuries and trusts from lawyers.

But both are no more than excuses. So let's stop making them, and start having a practical health and safety policy that does just that - keeps us all healthy and safe. .

Dea Birkett is a writer on health and social issues. She can be contacted through www. deabirkett. com . Next week: Simon Stevens, former policy adviser to Tony Blair and Alan Milburn (during his time as health secretary) and now president of UnitedHealth Europe.