Page last updated at 06:02 GMT, Tuesday, 1 July 2008 07:02 UK

Matron gives modern NHS a check-up

By Graham Satchell
BBC Breakfast News


Hazel Halter was a figure of authority on the wards

There's something about Matron. Perhaps it is the iconic image of Hattie Jacques from the "Carry On" films. Something powerful, domineering and above all large.

As hospital infections have spiralled in the NHS the call has gone out: "Bring back Matron". So that is we what did.

At 83 Hazel Halter has lost none of her authority.

We went to Addenbrookes hospital in Cambridge where Hazel was Matron in the 1970's.

Although she doesn't have the physical presence of Hattie Jacques she admits she can still strike the fear of God into hospital staff.

"I think you had to be a bit scary," she said.

"I think it is like when you're at home you have to be a little bit frightened of your parents.

"I think they looked up to you in those days as a figure of authority - but I think they also saw you as a sort of mother figure of the hospital."

Critical eye

Matron has come back to cast a critical eye over the NHS.

In our day we had a block of carbolic soap and a scrubbing brush. We scrubbed and scrubbed and scrubbed our nails and our hands until they were almost raw
Hazel Halter

She will see whether the much vaunted fight back against the super bugs adds up to much.

First stop: the sink.

"Why are you using that particular soap?" Matron asks an unsuspecting nurse.

"It's the one recommended by the Trust for infection control," comes the answer.

"And the other one ?"

"That's for general hand washing."

Hazel meets her modern equivalent
Hazel found the modern NHS was very different

All very different from Matron's time.

"In our day we had a block of carbolic soap and a scrubbing brush. We scrubbed and scrubbed and scrubbed our nails and our hands until they were almost raw."

Today in hospitals there's a combination of soap and alcohol gel.

"I thought it was confusing" says Hazel.

"I saw several people walk by and not use it.

"I saw other people using it quite a lot and I don't think people understand when they're supposed to use it and when they're not supposed to use it."

Disapproving of uniforms

It's not the only thing Matron isn't sure about. She thinks visiting hours are too long and she is unhappy about uniforms.

I don't think you can bring back Matron in the way it was in my day
Hazel Halter

Nurses used to have starched collars, aprons and hair pinned up.

"I don't like the modern uniforms they all seem very tight."

But that is not Hazel's main concern.

"They told me that they took them home to wash," she said.

"I'm not happy about that. Some will be very conscientious, others won't be bothering."

When Hazel first trained in 1946 nurses did most of the cleaning.

Cleaning rot

Hospital infections were rare and, of course, MRSA was not a problem - the Staphylococcus aureus bug had not developed a resistance to antibiotics by then.

Today most cleaning in hospitals is contracted out to private companies.

Hazel does not blame individual cleaners, but says when nurses stopped cleaning the rot set in.

"They'd got very slack and I think it's a reflection of society as a whole that people don't pay the same sort of attention to things today like hygiene."

At Addenbrookes - and across the NHS - rates of MRSA and Clostridium Difficile have started to fall.

NHS graphic
As the NHS turns 60, BBC News is giving it a health check. Watch out for reports, features and analysis on TV, radio and the web.

The government has made hygiene a priority.

There have been a number of high profile initiatives like deep cleans and the screening of patients.

Dr Nick Brown, consultant medical microbiologist at Addenbrookes, says the culture has changed.

"In the not too distant past there was an acceptance that infections were inevitable and there wasn't much that we could do about them.

"I think that attitude has changed and the results recently have shown that that is the case."

The old-style matron often inspired fear

In the NHS in England today there are 5,000 so-called modern matrons.

They are responsible for a smaller number of wards than the old style matron but they still have control over all nursing and cleaning staff on those wards.

So should we bring back the old style Matron? Would it make any difference? Hazel isn't sure.

"I don't think you can bring back Matron in the way it was in my day.

"But I think personally seeing those girls this morning I thought they were doing a very good job."

The reality is hospitals today are probably too big for one person to look after.

The days of Matron have gone.

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