A ZERO tolerance approach to tackling violence against NHS staff is being recommended in a draft National Assembly for Wales report sent to all trusts and health authorities.

The approach, exclusively revealed in the Argus earlier this month, falls short of the hardline red and yellow card measures this newspaper has campaigned for since the summer.

Despite a national newspaper report that the card system - which would enable hospitals to ban persistently violent and abusive patients - will be confirmed in the New Year, it is understood that the draft Assembly report does not support the measure.

Trusts and health authorities across Wales are being consulted on the zero tolerance recommendations and a final report, taking account of their comments, will be available early in 2002.

"The Assembly recommends that trusts and health authorities adopt a programme of continuous improvements and follow the zero tolerance approach," said health minister Jane Hutt.

"They must ensure they have in place policies on violence and aggression which have been discussed with staff and take their views into account.

"This can only be tackled in partnership with the service and those who work on the frontline of healthcare."

The British Medical Association in Wales supported firm action against violent patients and their relatives.

Dr Bob Broughton, Welsh secretary of the BMA, said: "NHS staff deserve to work in a safe environment where violence and abusive language is not tolerated.

"We support the health minister's stance on zero tolerance. However, zero tolerance can only work if it is backed by the resources and manpower to give staff the support they need.

"Drunken, loutish behaviour is one of the most common problems facing A and E departments. We must have enough staff, including security staff, to keep the problems under control and keep the waiting rooms and treatment areas safe for both patients and staff.

"There can, however, be genuine medical reasons why a patient behaves violently or abusively.

"Confusion as a result of a major infection, severe pain or following a stroke, and of course mental illness, can all lead to a patient behaving in a threatening way. "In circumstances like these, doctors and nursing staff want to get to the root of the problem and treat the patient."

The red card scheme would involve a formal written warning or yellow card for abusive adult patients, followed by exclusion from trust hospitals or a red card if their behaviour continues.

*PICTURED: A zero tolerance approach is being recommended to health trusts by Assembly health minister Jane Hutt. (Photograph posed by models)