Row over photos of bins labelled anatomical waste outside Edinburgh's Western General

The row centres on a series of pictures, passed to The Herald on Sunday, which were taken at the Western General hospital in Edinburgh. The pictures show bins labelled “anatomical waste” – defined as body parts – piled up outside the hospital. Multiple bins were pictured with biohazard labels and marked “anatomical waste”, “main theatre” and “anatomical WGH”.

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The Scottish NHS has been struggling to cope with the disposal of vast amounts of dangerous waste since the collapse of the waste management company Healthcare Environmental Services at the end of 2018. HES dealt with waste from the Scottish NHS. The collapse centred on the lack of capacity at incinerators across the UK to deal with the amount of hospital waste needing burned.

Last month, The Herald on Sunday revealed public health concerns over the way hazardous waste is now being handled and disposed of across the Scottish NHS. Both Pennington and Neil called for an inquiry into these concerns also.

Concerns over the procedures on the handling of body parts deepened when the Scottish Government and NHS Lothian, which runs the Western General, were asked to explain why bins marked for body parts were piled up outside a hospital.

The director of facilities at NHS Lothian, George Curley said that bins were incorrectly labelled.

Professor Hugh Pennington, the renowned scientist who chaired the inquiry into the E coli outbreak in Wishaw which saw 21 people die in 1996, said that if body parts had been placed in bins outside hospitals then there were “moral and ethical concerns”.

“You wouldn’t expect bits of your body to be thrown in a rubbish bin and left lying around,” he said, adding that body parts should be treated in a “respectful and dignified way” and disposed of speedily through incineration. Pennington said of the NHS waste management system: “It isn’t a system, is it?”. He added that there was “obviously a bottleneck in incineration”.

“We need an inquiry to find out how we stop this sort of thing happening again.”

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Any inquiry should have an independent chair to ensure public confidence that it would not be “some government stitch-up”.

Pennington said the claim that bins were wrongly labelled anatomical waste “really disturbs me”, adding: “It’s absolutely essential that everything is labelled properly.

“If you get mislabelling then you don’t know what the bloody hell is going on and that’s quite a deficiency in the system.”

The concern is that if bins are being labelled wrongly for body parts, then other forms of waste may also be wrongly labelled, and body parts may be stored and handled incorrectly.

“If they’re not labelling things properly, and putting labels on that shouldn’t be there, then are they not putting labels on things that they should be?” Pennington asked.

“Incorrect labelling is a no-no. You have to have stuff labelled properly, particularly things like anatomical waste – there might be bugs in there that would harm people who are handling it … If they are doing incorrect labelling then something is badly wrong somewhere.”

Pennington went on: “It’s like putting the wrong label on a bottle of medicine … You should be putting the right label on the right container and that’s the end of it, as you’re putting people at unnecessary risk if you aren’t.” He added: “What else have they incorrectly labelled? … Dangerous stuff might not be being correctly labelled.” Pennington said that the contingency plan put in place to deal with waste when HES collapsed “is not fit for purpose”.

Referring to claims of bins for anatomical waste being mislabelled, Alex Neil said: “The amateurism being displayed by NHS Lothian is very concerning indeed. They really have to, at the most senior level, get an urgent grip on this situation.

“If there’s that amount of mislabelling going on it leaves people without any trust in NHS Lothian’s handling of medical waste whatsoever. The board and the chief executive have to get a grip on this as a matter of urgency. We cannot play about with medical waste.”

NHS Lothian “has failed badly”, Neil said. “If they don’t get their act together then they could end up in very serious trouble, and more importantly we could end up with something happening that the procedures are designed to prevent happening.”

His concern is that anatomical waste could “end up in the wrong place”. He added: “If they got the labelling wrong what is to say that the procedures on anatomical waste are properly being followed … we don’t know. This level of incompetence leaves people bewildered and worried about what the hell is going on. There should be a proper review of what is happening across the country.”

CRISIS TO CONTINUE FOR MONTHS

AFTER COMPANY COLLAPSE

CHAOS over the disposal of waste in the Scottish NHS looks set to continue until at least August. After the collapse of HES in December last year, the firm Tradebe was granted a £10m contract to deal with Scotland’s medical waste in February. However, the contract will not commence until August 2 as Tradebe needs to get all necessary permits before it can begin work.

Since the collapse of HES the cost of collecting hospital waste has more than doubled. Contingency measures were put in place and contractors are now getting £460,000 a week. The former head of HES, Garry Pettigrew, says his firm charged around £211,500 a week.

Last month, a Herald on Sunday investigation revealed public health fears over the way hazardous hospital waste - such as needles, body fluids and soiled or infected bandages - was being handled after the collapse of HES.

Until recently, hazardous waste was secured in leak-proof large plastic bins when moved through hospitals. However, evidence emerged that waste was being transported in open-sided ‘roll cages’ which could leak.

Previously, staff didn’t have to touch waste - however, it is claimed porters had to pick up waste from roll cages to put into skips. Needle stick injuries appear to have risen.

There were further concerns that roll cages were transporting food and linen around hospitals without being cleaned after moving waste. There were additional fears that food and linen companies, which deliver to hospitals, were unwittingly collecting roll cages and using them to deliver to schools, care homes and hotels without being sterilised.

Former health secretary, Alex Neil MSP, and Professor Hugh Pennington both called for an inquiry back in April.

HES recently went into liquidation, after it ceased trading in December with the loss of 150 Scottish jobs, following claims that it was stockpiling waste.

Pettigrew blames the collapse of the company on the UK government. He says he warned the UK government months previously that he was having to store waste due to capacity problems at incinerators - but no assistance was given.

National Services Scotland, which provides services to the NHS, said: "As part of the contingency plans, we provided clear instructions to health boards that cages are not the preferred method of transport for clinical waste on their sites. In the event that cages cannot be avoided, their use should be dedicated to this activity only and thoroughly disinfected after use."

BODY PARTS ROW: WHAT THE AUTHORITIES SAY

George Curley, Director of Facilities, NHS Lothian, said: "All our clinical waste is stored according to National Guidelines and our clinical waste storage has been inspected by SEPA and meets local infection control guidelines. The yellow bins at the Western General Hospital have been incorrectly labelled ‘anatomical waste' and this is now being rectified. Anatomical waste across NHS Lothian is refrigerated in secure conditions."

A Scottish government spokesperson said: "We are clear that boards must store and dispose of all categories of waste in a safe and appropriate fashion.

"NHS National Services Scotland were made aware that waste had been incorrectly labelled at a NHS Lothian site during April. Whilst there was no evidence of incorrect treatment of waste or risk to staff, patients or the public, this was clearly unacceptable. NSS responded promptly by visiting the site and provided further training to ensure correct procedures are maintained in the future. Contingency arrangements ensure clinical waste is appropriately stored, collected and disposed of in line with industry regulations and are subject to robust regulatory checks by SEPA and the Department for Transport."

A SEPA spokesperson said: "SEPA continues to support the Scottish Government, NHS Scotland and health boards as part of the ongoing contingency arrangements, to ensure that clinical waste across all NHS boards in Scotland continues to be stored, collected and disposed of appropriately.

"Recent inspections of 11 hospital sites across the Edinburgh and Lothians found that clinical waste is being stored securely and in line with environmental requirements at each facility. Where present, SEPA officers were satisfied that anatomical waste was contained within sealed and colour coded bins and appropriately stored in secure areas.

"All contingency measures will ensure that environmental and human health are appropriately protected and, to date, our inspections have not identified any current risk of pollution from the waste stored on these sites."