Abstract
This article considers the challenges for hospitals in the United Kingdom that arise from the threats of mass-casualty terrorism. Whilst much has been written about the role of health care as a rescuer in terrorist attacks and other mass-casualty crises, little has been written about health care as a victim within a mass-emergency setting. Yet, health care is a key component of any nation's contingency planning and an erosion of its capabilities would have a significant impact on the generation of a wider crisis following a mass-casualty event. This article seeks to highlight the nature of the challenges facing elements of UK health care, with a focus on hospitals both as essential contingency responders under the United Kingdom's civil contingencies legislation and as potential victims of terrorism. It seeks to explore the potential gaps that exist between the task demands facing hospitals and the vulnerabilities that exist within them.
Highlights
A patient walks into a hospital dragging a wheeled suitcase
To illustrate the ongoing presence of such vulnerabilities, we offer two short vignettes based on our own observations in city-centre hospitals: 1. Several patients with small, wheeled bags were observed walking through the foyer of the hospital
The threat from insiders can be expressed as follows: service organizations are more vulnerable to the threats from insiders due to their greater reliance on human capital and the need to source the workforce from across society and internationally. It is this proposition that informs the remainder of this article as a means of highlighting the core vulnerability that exists across health care, namely those who work within it and their potential to cause harm
Summary
A patient walks into a hospital dragging a wheeled suitcase. To all intents and purposes, the individual is coming into the hospital for a procedure and seems to be expecting an overnight stay at the very least. A conceptual framework is developed that considers how public organizations, and hospitals in particular, can be vulnerable to attack at multiple levels.
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