Hospital infections need a sensible, approach without gimmicks

Written by Jenny Randerson and published in Western Mail on Tue 10th Jun 2008

Last week, the BBC's Week in Week Out Programme uncovered a shocking state of cleanliness in the Royal Gwent hospital. In particular, the ability of the undercover reporter to gain a job without references and the poor attention to detail of some cleaning staff were terrifying. Most worrying of all, there is little reason to believe that the RGH is greatly different from any other trust in Wales. All face the same pressure to spend more on patients and less on essential background services like cleaning.

The anecdotal evidence I hear as an AM is equally appalling. Too many people are being exposed to great danger, at a time when they are already sick and want to get well.

Hospital infections are a terrifying and dangerous phenomenon. Up to now we have not even known the real extent of the problem because in Wales, the recorded statistics for many of these infections only cover instances among those who are over 65 whereas in England this is not the case. I welcome the Minister's decision to switch to the English system whereby all cases affecting those over two years old are reported. Much of the comment on the rise of super-bugs like C-Difficile and MRSA has focused on the contracting out of hospital cleaning services within hospitals. It is a red herring. The Royal Gwent however has an in-house cleaning team.

I believe that controlling infection is not about who the cleaners are, but who has control of them. The Royal College of Nursing have strongly suggested putting a ward sister in charge of a team of ward cleaners, who are available on demand, and not just at the end of the day. The Health Minister seems to be responding to their demands and we await a report later this month.

But it isn't just hospital staff and patients who have to raise their game. All of us, who visit our friends and families in hospital have to do the same. How many of us have gone to visit without washing and disinfecting hands, thinking it won't matter just for a few minutes. The reality is that each of us has to sign up to make a difference.

There are many strands to the problem of infections and cleaning. These include hand washing and disinfection, the issue of staff being allowed to wear uniforms off sight, how long drips and catheters are left in and lack of time for deep cleaning. There is no silver bullet, just continued vigilance.

What most of these strands come back to however is the issue of bed occupancy. All of these things become easier to deal with when bed occupancy is lower. When beds are cleaned properly between patients, the instances of infections are greatly reduced.

It is no surprise that when services are so greatly overstretched, proper cleaning of beds becomes less of a priority. Only last week, there was more bad news when Singleton Hospital in Swansea had to close it's A+E department to patients because of a shortage of doctors. When hospitals are this overstretched, things go wrong, including, in my view, the increases in super-bugs and infections.

It all comes back to using resources more carefully. The tighter financial conditions that the NHS is now facing after years of plenty mean that frontline services have to be prioritised. I have often been attacked by Labour and Plaid Cymru for not supporting their policies of free paracetomol for millionaires and free parking for commuters in spaces meant for patients, but all of the NHS' problems, from infections to ambulances queuing at A+E come back to their misjudgements over priorities. More cash for frontline services will begin to tackle these problems. We cannot afford to spend precious resources on gimmicks.