NHS staff to be tested for hepatitis B: Doctors' concern over compulsory testing for HIV. Judy Jones reports

HOSPITALS and health authorities are to be instructed to screen nearly 100,000 staff for hepatitis B, the potentially lethal viral infection.

The Department of Health confirmed last night that NHS employers would be expected to act on guidelines, due later this year, to bring in testing and immunisation for staff involved in surgery and other invasive procedures. That would mean the introduction of compulsory testing of NHS staff. Doctors argued last night that it might be a first step to compulsory testing for HIV, the Aids virus.

Hepatitis B is a viral infection transmitted through the mixing of blood, saliva or other body fluids. It is often spread by sexual intercourse or drug users sharing needles.

According to the most recent figures from the Public Health Service Laboratory, hepatitis B affects 50,000 people a year, but only one in 10 of those becomes highly infectious. In 1991, 500 people were admitted to hospital with the disease. Some specialists in genito-urinary medicine have reported a significant rise in cases recently, particularly among holidaymakers returning from southern Europe.

Cases of hospital doctors carrying the virus have caused several hospital alerts this year: at Kilmarnock and Irvine in Scotland; at Stafford; at Wrexham, North Wales; and in north Middlesex. Hospital helplines have received thousands of calls. Several hundred patients treated by the doctors have been screened.

The Department of Health last year mooted in a consultation paper the idea of immunisation and testing for hepatitis B for staff in high-risk categories.

A departmental spokesman confirmed last night that current guidance was being tightened up, and did not deny claims made earlier in the day by a senior British Medical Association official that the forthcoming guidance would pave the way to compulsory testing and immunisation for this category of worker. Money for the screening and vaccination programme will come out of existing budgets.

The move towards testing for hepatitis B was disclosed at a British Medical Association consultants' committee meeting in London yesterday. Jim Johnson, its deputy chairman, said during a debate on the spread of Aids: 'Establishing the principle of compulsory testing for health care workers worries me greatly. It means that you are no longer arguing about whether you test, but what diseases you test for.'