Violent patients who attack NHS staff could be refused treatment by health chiefs under new guidelines from the Scottish Executive.

The ultimate sanction of withholding treatment from violent patients will be given to NHS Boards for the first time.

The move is part of a package of wide-ranging health and safety reforms for frontline NHS staff.

Mentally ill people or others judged to be not competent for their behaviour will not be refused treatment.

Malcolm Chisholm: "Right step"

Cases where patients need emergency treatment will also have to be dealt with.

Mr Chisholm announced his intention last year when the proposal was put out to consultation, along with other parts of the reform package.

Now he has formally launched the guidelines, which also cover issues like stress, biological and chemical dangers, lone working, and other matters involving the well-being of frontline NHS staff in Scotland.

"This sanction, backed by staff, is the right step for us to take to deter attacks against health service workers," Mr Chisholm said.

"This new guidance will make staff deal with the small minority of individuals who make such violent attacks and ensure that all NHS staff feel safer and more secure at work."

Violent incidents

He added: "The vast majority of patients have nothing to fear from this new sanction.

"In fact I am quite sure that the public will stand with NHS staff and support them in the valuable job that they do."

The new powers will cover health workers in hospitals, GP surgeries, and dental practices.

A survey in 1998 found there were about 65,000 "violent incidents" a year, or seven each month for every 1,000 NHS staff.

And each year, dozens of patients are removed from GPs' lists for violence. In 2001, the total was 188, compared to 96 the year before.