Diseases spiral in unhygenic hospitals

New research by the Liberal Democrats has revealed serious concerns amongst front-line staff responsible for controlling the spread of infection in NHS hospitals.

With collection of MRSA (the so-called superbug) data now mandatory, figures from Public Health Laboratory Services have exposed widespread under reporting of infection rates.

Paul Burstow MP, Liberal Democrat spokesman for older people said:

"Patients go to hospital to get better, not get even more ill. Dirty hospitals and poor hygiene practices are putting people's lives at risk.

"The Government's response has been shockingly complacent, and they have tried to gloss over the problem rather than deal with the real issues.

"Jill Baker's out of court settlement is a damning indictment of a Government that has failed to take the spread of MRSA seriously. It is a wakeup call to the NHS that lip service can no longer be paid to this, and only with a concerted effort can public confidence be restored.

"We want patients to challenge bad practice when they see it. Doctors and nurses must wash their hands between examining patients so they don't carry infections from one to the other. If patients spot that this is not happening they have every right to complain."

For the first half of 2002, mandatory reporting of MRSA lists 3,515 cases, whereas the voluntarily collected data recorded only 2,563. Despite the wakeup call of a massive increase in deadly MRSA infections, the Government's response to the crisis has been pitifully weak.

Their much trumpeted hospital clean-up drive was little more than a public relations campaign at the expense of the patients' health. Of the 19 measures touted by the Government as a solution to the problem, only one is actually about hygiene.

Paul Burstow's report, Now wash your hands, describes the Government's "Clean Hospitals Programme", (their only answer to the MRSA infections) which graded hospitals on 19 different categories. Unbelievably, only one related to hygiene. The others included such arbitrary issues as C.C.T.V in car parks and adequate signage. A dirty hospital, harbouring MRSA and bad hygiene practices, might be rated as excellent simply because it looks pretty and has a secure car park.

The report also publishes the results of a survey of infection control teams, which found that:

• Almost a third of respondents were either "quite" or "very" unsatisfied that staff were washing their hands as often as was recommended.

• Doctors were worse than nurses about washing their hands

• Over 60% of respondents felt they did not have adequate resources to carry out their jobs properly.

• One infection control team was coping with one manager, three nurses and a secretary trying to cover 1,200 beds.

• 6 out of 10 trusts admitted that their staff wore uniforms to and from work, thus increasing the risk of infection. The reasons cited were a lack of laundry and changing facilities and not enough uniforms.

Mr Burstow said:

"It is appalling that the wool has been pulled over the public's eyes yet again. A big announcement of cash and a picture of Alan Milburn with a mop, and a later statement that there were no remaining "red" hospitals was expected to convince the public not to worry about hospital acquired infection. In reality, most of the money was spent on one-off redecoration and new C.C.T.V. or signs."

"Chronic staff shortages and low morale mean that hard working doctors and nurses are not complying with all the infection control rules. They are not washing their hands enough and many are forced to wear uniforms on the bus, or in the shops on their way home."

"The Government must commit to a sustained effort to tackle these infections, before they continue to spread and new and more resistant strains are uncovered".

-Ends-

Notes to Editors

1. A survey was sent in May 2002 to the Infection Control Teams of 212 NHS Hospital Trusts in England. Responses were received during June and July from 69 Trusts with 56 responding fully, giving a response rate of 26%. As described in the report, while a 1 in 4 response is sufficient to give a significant result, it has been depressed by the deliberate action of the Department of Health to discourage NHS staff responding to the survey. (Number 7 in report)

2. Rates of MRSA in 2001 are therefore nearly 50 times higher than in 1992. Also, the percentage of the bacteria that have become resistant to Methicillin has increased by 2000%. This shows that the rise in this infection has all been down to the resistant strain. According to voluntarily reported statistics available for the first half of 2002, this trend shows no sign of abating with 2563 cases of MRSA. Indeed, if this trend is mimicked in the second half of the year, there will be a total of 5126 cases.

Previously, the Public Health Laboratory Service's statistics on MRSA were collected voluntarily, so the totals were obviously conservative, but in 2001, the reporting of all SA and MRSA infections became mandatory. The new data now shows the full extent of the problem .

Where voluntary recordings for the first half of 2002 show 2563 cases of MRSA, the mandatory figure for the same six month period stands at 3515, and if that trend continues through the whole year, there will be 7030 cases of MRSA in 2002.

In light of these appalling figures, the Government's response to the crisis appears lunatic in its complacency.

3. Key healthcare acquired infection facts and figures

• Patients who get an HAI stay in hospital on average 2.9 times longer than non-HAI patients. This is equivalent to an extra 14 days per HAI patient.

• A patient with HAI costs almost £3,000 more to treat

• Between 6% and 8% of patients acquire an infection during their stay in hospital

• At any one time 9 in every 100 patients is likely to have a hospital acquired infection

• Between 10 and 13% of patients with a HAI died compared with 2% of non-HAI patients during their hospital stay and

• After taking into account factors such as age, diagnosis etc, a HAI patient is 7.1 times more likely to die in hospital than an uninfected patient .

Recommendations

1. Infection control must remain high on the Government's agenda. There must be a sustained effort to maintain cleanliness standards, not just a one-off, gimmicky "clean-up drive".

2. Overworked staff sometimes, of necessity, neglect infection control guidelines. Staff shortages must be tackled as a matter of urgency.

3. Proper changing facilities and enough uniforms should be provided so that staff do not have to wear uniforms out of the hospital.

4. Infection control teams must be given the resources and the authority to undertake their jobs effectively.

5. There should be an independent, scientific inspection of hospital cleanliness and infection control, giving a national picture of performance.

6. Efforts must be made to tackle overuse of antibiotics.

Infection Control Case Study: Mrs Jill Baker

Mrs Jill Baker, a retired lady, contracted MRSA (popularly known as the 'superbug') at an NHS hospital whilst a cancer patient, in July 1999. In January 2001, she opted to have an operation at a BUPA hospital, on grounds that she was not prepared to put her life at risk by exposure to MRSA, and sent the Health Authority the bill. The Health Authority contested the case but has now offered to pay for the private treatment by settling out of court. This is a tacit acceptance by the health authority of the risk of MRSA.

In her own words:

"I am an OAP who is fighting a lone battle against our infected NHS Hospitals. The MRSA killer bacteria cases are rising, frighteningly, each year. Last count in Portsmouth for the year ending March 2002 was 1,200 new cases.

The Health Minister has ordered all hospitals not to answer questions concerning the epidemic.

I caught the dreaded MRSA in hospital where I was a cancer patient. A doctor who has never, to this day, met me put a 'Do Not Resuscitate' on my hospital notes because I was not cost-effective to treat!

I vowed never to enter another NHS hospital for treatment.

Last year, when I found another cancer, I went to a clean private hospital as a day patient, to keep the costs low, and had it removed. I then sent the bill to the Health Authority for reimbursement.

I claimed through the Small Claims Court under the Human Rights Act (article 2 - right to life). I did not ask for compensation, just the cost of the surgery. The Health Authority asked the judge to dismiss my claim. He refused.

The Health authority then asked for the claim to be heard in the Multi-track where the costs would be £12,000 to £20,000. The Judge again refused. The Health Authorities' lawyers then appealed and the appeal judge allowed their request provided they paid their own expenses.

One of the witnesses in my case is their own Microbiologist who berated the Executives, at a Trust Meeting in May, for not acting to prevent the MRSA epidemic when he told them it was happening many months before.

An expert has said that this case could go right up to the House of Lords. The case has the potential to establish an important precedent; it will mean that any patient who fears the NHS hospitals, because of the epidemic of hospital-acquired infections, in particular the MRSA bacterium, will be able to go to a clean one and send the Health Authority the bill.

Mrs Jill Baker is happy to do media interviews, but would need a day's notice to travel to London.

Tel: 02392-261009.