I will not delay the House long on these amendments, but I should explain why I tabled them. They would take three clauses out of the Bill, which I am fairly confident will have the support of the whole House.
Although these clauses are about the taking of samples, in particular when an emergency worker is in danger of contracting an infectious disease by virtue of being spat at or through some other means, the aim of the Bill was never to take samples. The aim of the Bill was always to stop spitting. Thanks to the Minister’s earlier interventions, and to today’s debate more generally, I think we have had a clear statement from Parliament that spitting is included as part of common assault or battery.
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Consequently, there is a bigger question about whether clauses 4, 5 and 6 are necessary and proportionate and whether they would work. The honest truth is that some significant concerns have been raised. Those directly involved in working with HIV, AIDS, hepatitis and other infectious diseases are worried that, for two possible reasons, the clauses would not do what it was hoped that they might. First, if there is a real risk by virtue of what has happened to the emergency worker, either forced testing or testing after consent would make no difference whatsoever to the medical advice that would then be given to the emergency worker because, if the risk of infection was real, the prophylactic would be provided. That is a medical decision, and it should not be for a police officer, however senior, to decide whether to take a sample, whether intimate or not. Secondly, if there is no real risk, the test itself would merely tie up police time, create additional anxiety for the emergency worker and waste resources.
There has been some degree of misinformation at the heart of the debate about all of this. Some people seem to have the impression that HIV can be contracted from being spat at, but there is no evidence of that whatsoever. Indeed, the risk of HIV transmission through biting is estimated, in well-attested and peer-reviewed results from around the world, to be one in 17.5 million, and there have been only four cases in the whole history of the HIV epidemic. There has been not a single recorded case of HIV transmission through spitting. In other words, if there is no risk of infection, it would be wholly
inappropriate to cause some degree of anxiety to the emergency worker by suggesting that they might somehow, miraculously, be going to contract HIV and that tests therefore need to be taken from the other person. In addition, the advice on prophylactics would remain unchanged.
Some have suggested that samples might be useful in relation to hepatitis B. However, the risk of hepatitis B infection through spitting is one in 257 million, and we are aware of only one possible case. The risk of contracting it through biting is one in 43 million. In other words, the risk of transmission is very low. Anyhow, emergency workers should be provided with hepatitis B vaccinations so that they will not be affected. There is a worry among such workers about a shortage of the vaccination, and some are not receiving it when they should be, but that is not a matter for legislation; it is for NHS England and the relevant authorities in Wales. We need to do far better on ensuring that that protection is in place, but clauses 4, 5 and 6 would not in themselves provide it. There have also been no recorded cases of hepatitis C infection through spitting.
Various charities have written to me to say:
“New analysis of worldwide evidence published in April 2018 by the British HIV Association and the British Association of Sexual Health and HIV shows that there is no risk of transmission of HIV or Hepatitis C from spitting and negligible risk from biting in extremely rare circumstances. For Hepatitis B, risk from spitting or biting is also negligible to the point of being unquantifiable.”
Taking samples without consent is an invasion of the body of another person, which means we are in the territory of introducing legislation that would be neither effective nor proportionate, nor would it lead to better healthcare for emergency workers. Clauses 4 to 6 are therefore inappropriate and, on that basis, I have tabled these amendments to remove them from the Bill, not because I have any hesitation in declaring that spitting at an emergency worker is wrong and despicable, as we have heard many times today, but simply because the clauses would not be efficacious.
Clauses 4 to 6 therefore should not remain in the Bill.