Many nursing homes, small clinics and GP surgeries manage their clinical and other wastes in ways that would, should, cross the line toward prosecution. Those wishing to track back through the Clinical Waste Discussion Forum archiveswill find many reports of waste violations in the community, including at least one at the establishment featured below.

Here in Ealing, one such establishment regularly places waste into a drop-front cart that is overloaded and with much side waste. Waste segregation is little more than piling it close to the boundary of the premises with little regard for the change that it may spill into the road. Waste security is non-existant.

This is a long-term problem. The photograph of the left is from August 2010 and that on the right from May 2011. Nothing has changed, though the observation is far from unique.

Nursing homes are subject to periodic inspection, measured against a set of standards that include the safe management of wastes. Many regulators have responsibility, from CQC, to EA, to Local Authority and HSE but none have bothered.

Responsibility lies with the waste producer, and with the disposal contractor who must be aware of continuing breaches of waste segregation and security and must share some responsibility. The regulatory process is overstretched and underfunded – we are constantly reminded of this – but doing nothing has never been an official option. In practice, however, it may in fact be the preferred option.