HIV safety review ordered by Bottomley

VIRGINIA BOTTOMLEY, the Secretary of State for Health, has ordered a review of the guidelines designed to protect patients from infection by doctors, dentists and nurses with the Aids virus.

Last night, the Department of Health released correspondence from Mrs Bottomley asking the statutory bodies which regulate the three professions if they are satisfied that safety guidance is being followed.

Her letters follow the announcement at the weekend that a Kent gynaecologist had been diagnosed HIV positive. By yesterday evening more than 10,000 people had phoned two hospitals in Chatham, Kent, for advice. More than 400 have received face-to-face counselling and 374 have been given HIV tests. It is estimated that the surgeon, Terence Shuttleworth, treated 17,000 women, mostly at All Saints hospital, Chatham, and approximately 900 at the private Alexandra hospital, over a 10-year period. He operated on about 6,000 women.

In her letter to Sir Robert Kilpatrick, president of the General Medical Council, Mrs Bottomley says: 'It is clearly essential that doctors scrupulously follow the council's guidelines and seek advice, and have an HIV test when so advised.' She asks whether he considers 'the substance of your guidance is sufficiently widely known', and how best doctors can be reminded of it. She also asks: 'Are you satisfied that the guidance is being fully observed?'

The letter contains a copy of the GMC guidance telling doctors to seek advice and an HIV test if they think they might be at risk. It also tells other doctors who have counselled colleagues with HIV that they have a duty to inform the relevant authority that the HIV doctor's 'fitness to practise may be seriously impaired'.

Similar letters have been sent to the nurses' regulatory body, the United Kingdom Central Council, and the General Dental Council in an attempt to quell public anxiety, which led to calls for doctors to be compulsorily tested for HIV.

After the announcement about Mr Shuttleworth, one of whose patients was Myra Hindley, the Moors murderer, Medway health authority set up 40 telephone helplines, manned by 60 counsellors. But Medway doctors have continued to stress that the risk to patients is 'theoretical', and world-wide there has only been one case of infection involving a Florida dentist, who infected four people, but he is said not to have followed sterile procedures.

The risk to a doctor or other health worker being infected by an HIV patient following an accidental needle puncture is about 1 in 300. For comparison, research on infection following a puncture injury, from hepatitis B, which is many times more infectious than HIV, the risk is 30 per cent; from hepatitis C, 3 per cent and from HIV, 0.3 per cent. About 150 health workers across the world have been infected with HIV by patients.

Calls for compulsory testing of doctors were widely resisted by the profession yesterday, on grounds of impracticality. Michael Adler, professor of genito-urinary medicine at the Middlesex hospital, London, estimated it would cost between pounds 30m and pounds 50m a year to test health workers every three months.

Leading article, Letters, page 20

(Photograph omitted)

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