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Last Updated: Thursday, 11 January 2007, 18:57 GMT
MRSA target 'likely to be missed'
Image of hospital cleaning
The MRSA target should have been met next year
The NHS is not on track to meet its MRSA target and perhaps never will, a leaked government memo says.

In November 2004, then health secretary John Reid pledged MRSA rates would be halved by April 2008.

But the memo, sent to ministers by a Department of Health official, said it would only be cut by a third by then.

And it warned another bug, Clostridium difficile, is endemic in hospitals and has overtaken MRSA. The government pledged to get on top of the problem.

Health Minister Andy Burnham said: "The decision that we took after the memo that was prepared for us was that we will stay the course, that we will hold for the target, that there's no complacency."

The Health Service Journal reported the document recommended delaying or dropping the target, as a way of dealing with media interest.

The memo, written by the Department of Health's director of health protection Liz Woodeson and circulated in October, said: "We have a three-year target to halve the number of MRSA bloodstream infection by April 2008.


"Although the numbers are coming down, we are not on course to hit that target and there is some doubt about whether it is in fact achievable.

"The opinion of DH infection experts is that we will succeed in reducing MRSA bloodstream infections by a third, rather than a half - and even if we had a longer period of time, it may not be possible to get down to a half."

But it said the NHS was now "light years ahead" of where it had been a few years ago.

Dr Mark Enright, an infections expert at Imperial College, said the target was "unrealistic".

He said: "I think the target was set really out of a lack of any knowledge of how difficult these things were going to be to put right."


Much of the document focuses on the "handling" of the target.

The memo said: "Although the MRSA target is regarded as one of our highest priorities by the Prime Minister's Delivery Unit, it is not a Public Service Agreement target so there is theoretically scope to change it.

"But it has been publicly announced by ministers, including to Parliament, on many occasions so handling would be an issue."

The document goes on to discuss six options for "handling" the target.

Of the six, just one recommends simply trying to meet the current target - the other five discuss ways of changing the target or timescale, or dropping the target altogether.

Shadow heath secretary Andrew Lansley
Tory MP Andrew Lansley MP wants to see "effective hand hygiene"

The memo also warns that another bug, Clostridium difficile, is now "endemic throughout the health service, with virtually all trusts reporting cases" and shows that 2004 saw twice as many deaths from the infection as were related to MRSA.

And it warns that efforts to combat MRSA, such as alcohol handrubs, have had no impact on C. difficile, which it describes as a "far bigger problem".

C. difficile forms spores which means it can survive for long periods in the environment, such as on floors and around toilets, and spread in the air.

Rigorous cleaning with warm water and detergent is the most effective means of removing spores from the contaminated environment and the hands of staff, say experts.

Dr Peter Carter, general secretary of the Royal College of Nursing, said: "NHS deficits are forcing Trusts to reduce staff and cut services, so it comes as no surprise that priorities such as MRSA have been allowed to slip."

And shadow health secretary Andrew Lansley called on the government to "get a grip on these infections".

More thorough cleaning would certainly delay this onset as long as possible
Leah Ronaldson, Edinburgh

He told News 24 the government should follow the example of other European countries, such as Denmark and the Netherlands where employ a "search and destroy" policy is tackling the bug more successfully.

"You have got to have hand hygiene that is really effective," he said.

"Hard-working NHS staff have been set a target which the Department of Health privately admits is unachievable."

And Liberal Democrat health spokesman Norman Lamb said: "It is time that infection control became a top priority in the NHS rather than just another item on a long shopping list of targets.

"The government seems to spend more time worrying about how to bury bad news rather than stopping the rise of deadly infections."

But the Department of Health spokesman said: "We deplore this leak. This paper confirms that from the Prime Minister and Health Secretary downwards, the government is determined that the NHS should get on top of the problem of MRSA and other infections.

"Only last month we made an additional 50m available for infection busting measures."

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