Summary: Mr X complained about the Council’s healthcare waste collection service. We have not found fault with how the Council has chosen to operate the service.

The complaint

1. Mr X complains about the Council’s healthcare waste collection service and that it expects him to leave medical waste awaiting collection where it can easily be seen and accessed by passers-by. He also complains the Council has failed to address his concerns regarding medical confidentiality.
2. Mr X says this has caused him worry regarding his medical confidentiality and the safety of others.

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The Ombudsman’s role and powers

3. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
4. We cannot question whether an organisation’s decision is right or wrong simply because the complainant disagrees with it. We must consider whether there was fault in the way the decision was reached. (Local Government Act 1974, section 34(3), as amended)
5. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

6. I have considered all the information Mr X provided and discussed this complaint with him. I have also asked the Council questions and requested information, and in turn have considered the Council’s response.
7. Mr X and the Council had the opportunity to comment on my draft decision before I reached my final decision.

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What I found

Relevant law, policy and guidance

8. The Environmental Protection Act 1990 sets out a council’s responsibilities for disposing of household waste. There is no requirement for councils to provide a clinical waste collection service from domestic properties. It is therefore for the Council to decide what arrangements it offers.
9. The Department of Health, Environmental and Sustainability, Health Technical Memorandum 07-01: Safe management of healthcare waste guidance document sets out guidelines for disposal of sharps (needles or syringes). Where the householder self-medicates, it says:
• the sharps receptacle (sharps bin) should be filled to the ‘fill line’ and sealed;
• the householder should take this to their GP surgery or local pharmacy for disposal; or
• arrangements should be made with the local health authority (ICB) or local authority (in this case the Council).
10. Article 8 of the Human Rights Act 1988 states that everyone has the right to respect for their private and family life, home and correspondence.
11. The NHS website advises that arrangements for disposing of full sharps bins vary depending on your location and to contact your local council to find out more.

The Council’s collection service

12. The Council’s website provides details of its free service to collect clinical waste and sharp instruments from people’s homes. The service can provide weekly or ad-hoc collections depending on the need presented.
13. The Council asks householders to leave the container outside their homes so that it can be collected at some point during the pre-arranged date for collection.

What happened

14. Mr X uses a sharps bin. In mid-August 2022, he made a complaint to the Council about its healthcare waste collection service after he had contacted it to make a collection from him. Mr X was unhappy the Council expected the sharps bin to be left fully visible, between his front door and the pavement a short distance away, on the day it was due to be collected. Mr X wanted the collection service to knock on his door so that it would protect his medical confidentiality and the box would pose no risk to passers-by.
15. At the beginning of September 2022, the Council wrote a stage one complaint response to Mr X. In this letter, it said:
• it had historically offered a collection service where staff knocked on doors but was currently unable to offer this to ensure an efficient service;
• that sharps containers were designed to be difficult to open once closed and it had no reason to believe there was a risk of anyone wishing to take the container to try and access the contents;
• its assessment of the service was that there was no inherent risk to the public; and
• the collection team would be able to take the container from a ‘hidden’ location such as an upturned flowerpot or an upside-down glass recycling box. The Council offered to provide to Mr X the glass recycling box free of charge.
16. Mr X escalated his complaint to stage two of the Council’s process a few days later. He remained unhappy that he was expected to leave the container outside.
17. Later in September 2022, the Council sent Mr X a stage two complaint response. In this letter, it said:
• its waste protocol had been developed in accordance with the local healthcare trust;
• its protocol was also shaped by various healthcare and waste management policies;
• that it was not aware of any legislative or best practice guidance which dictated where sealed containers should be left; and
• it recognised its shared protocol did not specify where containers should be left, but that this would be given further consideration by working groups and partner organisations.
18. At the end of the response, the Council directed Mr X to us if he remained unhappy.
19. Mr X complains that he contacted the Council several times via telephone to ask why it had not addressed his concerns about medical confidentiality but that he was eventually advised it had no more to say on the matter and referred him to its stage two complaint response.

Analysis

The role of the Council

20. The Council does not have a duty to collect hazardous waste, such as a sharps disposal bin, from residential properties. Nonetheless, it does offer such a service free of charge.
21. In response to my enquiries, the Council advised Mr X is an ad-hoc service user and that it had been more than two years since he had last used the collection service.
22. The Council has a collection process in place and has chosen that at this time, its operatives will not knock on doors for efficiency purposes. Whilst Mr X may disagree with this and not view it as suitable for his particular circumstances, the Council has a right to adopt this stance. I am satisfied the Council has not acted with fault in this regard.
23. The Council said that by knocking on the door of Mr X’s property and waiting for him to respond, it would potentially increase the amount of time the operative was outside his house and thereby draw unnecessary attention from passers-by or neighbours.
24. The Council also said that rules around the collection of sharps meant that vehicles performing collections must be appropriately marked and that operatives working on the highway are required to wear high-visibility clothing. It made the point that a certain level of attention being drawn to the property would be unavoidable in any case.
25. When Mr X said he was unhappy leaving the sharps bin visible outside his property, the Council suggested the alternative of the glass recycling collection box which I view as a reasonable suggestion.
26. It also said that as glass recycling collection boxes are widely used and a common appearance throughout the borough, using one would not draw any undue attention to his property. If Mr X chooses not to take up this option, it remains open to him to dispose of the sharps bin by other methods available in the local area, as outlined above. The Council said that the healthcare provider should have advised Mr X about the alternative options.
27. Whilst Mr X is unhappy with the Council’s position on the collection process, it has a right to make this decision, has suggested a reasonable alternative and I therefore find no fault in its actions here.
28. As part of my enquiries, I asked the Council how it had shown regard for Mr X’s rights under Article 8 of the Human Rights Act 1988. The Council responded to say that by offering to provide a commonly used container to hide the sharps bin, a discreet collection could take place and protect Mr X’s right to privacy. The Council also said that using one of the other available options for disposal would also protect Mr X’s privacy.
29. I am satisfied that in the circumstances of this complaint the Council has demonstrated it has shown regard for Mr X’s human rights.

Medical confidentiality

30. Mr X also complained the Council failed to respond to his concerns about medical confidentiality when he called to chase a response, despite promises to the contrary.
31. The Council has not provided any evidence of these calls in its chronology or response to me. As there is no evidence of the Council’s handling of these calls, I cannot draw a conclusion on potential fault. However, the Council’s comments about privacy (as above) adequately address Mr X’s confidentiality concerns. With this in mind, I am satisfied it is not proportionate for us to pursue this particular issue further.

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Final decision

32. I have now completed my investigation and do not uphold this complaint. There is no fault on the part of the Council.

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Investigator's decision on behalf of the Ombudsman