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Last Updated: Thursday, 15 July, 2004, 11:19 GMT 12:19 UK
Is the NHS failing to fight superbugs?
Tina Holbey as Chrissie and Garry Cooper as George Keating in an episode of hospital-based drama series, Holby City
NHS managers have been criticised for failing to tackle infection rates from hospital superbugs, such as MRSA.

The National Audit Office says that although many hospitals have introduced measures to prevent infections, it is proving difficult to get frontline staff to implement them.

Many doctors and nurses still fail to wash their hands between patients - even though this is thought to be the key factor in preventing the spread of infections.

It is estimated that 5,000 patients die each year from infections such as MRSA, and tackling the crisis costs the NHS around 1billion a year.

However, the National Audit Office says it is impossible to assess the extent of the problem because of a lack of data from the NHS.

What can be done to tackle superbugs? Have you picked up an infection while in hospital?

This debate is now closed. Read a selection of your comments below.


Your comments:

As long as the media say that hospitals are failing then the general public will believe they are and then hospital staff, who work hard enough as it is, become demoralised and the whole situation becomes a self-fulfilling prophecy. Why not concentrate on positives rather than creating newsworthy negatives.
John, UK

My wife is a nurse and she says most of the MRSA is brought into the hospitals from old people's homes. The only way to stop it is to go back to basics. Get the ward Sister/matron back. These people ensure that cleanliness does exist on the wards.
Laurence G Mason, Stockton-on-Tees

The problem, as everyone who works in the NHS knows, is that whereas before cleaners were seen as part of the team in maintaining a clean ward, now, due to Conservative legislation from the 1980s/90's hospitals are forced to offer cleaning contracts to private companies. The employees are poorly paid with little security and no longer seen as part of the team so it's no wonder they are less enthusiastic. A similar change in NHS canteens has resulted in expensive low quality food. The solution, bring cleaning staff back into direct NHS employment.
Mark, London

The major factor in the spread of MRSA is bed occupancy rates. Patients and beds are constantly moved around to maintain high occupancy rates. This looks very efficient on a spreadsheet but also means that infection spreads. This combined with contracted out cleaning and lower staffing levels has been a recipe for disaster
Ann Smith, Liverpool

Bring back matrons and properly paid, trained and motivated cleaning staff
L Lewis, London, England
My late father contracted MRSA after being admitted to a leading London hospital following a road accident. The hospital was filthy with congealed blood stains on the floor and the public (and patient) toilets and washing facilities were a disgrace. The MRSA attacked his spinal column causing paralysis and he had a very undignified end to his life as a result. Just like J Davies' mother-in-law, MRSA is not recorded on his Death Certificate - I genuinely believe the problem is far worse than we are led to believe. Bring back matrons and properly paid, trained and motivated cleaning staff...please.
L Lewis, London, England

Gerry, Graham, Michael Fearn, Mary Walsh and Jo have hit the nail on the head. It's all down to privatised cleaning services over which ward nursing staff have no immediate control. Plus contracted-out laundry to companies which do not maintain a barrier between 'dirty washing in' and 'clean washing out'. Simple as that. Remember this next time you vote for tax cuts.
Richard P, Bridgwater, UK

The constant stream of people in and out of wards restricts the opportunity for cleaning
Nina Elmer, Warwick, England
A considerable responsibility lies with visitors too. Having over the past few years experienced both medical and surgical wards when visiting elderly parents it is patent that visiting times are too long and in communal reception areas we have seen families gathered eating, drinking and then leaving their litter for others to clear. The constant stream of people in and out of wards restricts the opportunity for cleaning. It is time to take a step back to creating standards imposed on hospitals when they were managed by the health professionals and not academics.
Nina Elmer, Warwick, England

Everybody is blaming the NHS staff for this and I think the blame should be landed back on the government's lap! They privatised the cleaning services and nurses have no control over those services. They have literally given up asking and putting requests in to have things cleaned! Also nurses are so overstretched they don't have time to properly clean their hands otherwise their work doesn't get done and thus their targets don't get met! To beat this the government is going to have to recruit more staff - it is as simple as that!
Adrian, UK

Cleaning services are not all to blame. Nurses, doctors and other hospital staff no longer wearing all white to show dirt is a contributor. Visitors coming too many at a time and not cleanly attired. Hospital staff not practising sterile procedures as they should. All these things are contributors.
Jane, UK

I have watched a nurse who lives nearby carry her dustbins out whilst wearing her uniform. Also my mother-in-law has died in hospital recently and whilst with her we watched nurses going from one person to another without washing their hands in between.
Cheryl Hill, Salisbury, England

My partner was in hospital for observation overnight a few weeks ago. Before he left the following morning, he thought he'd try and be helpful and started to strip the bedsheets from his bed ready for it to be changed for the next patient. The nurse on duty told him not to bother and proceeded to remake the bed with his used bedsheets - as she did so she said "these will do for the next patient - I assume you're clean". I wonder just how many patients slept on the same sheets as each other!
Tina, Stourbridge, England

A friend recently had an accident and requires a district nurse to change her dressing. The nurse got out of her car, knocked on the door, went inside and changed the dressing before leaving. At no time did she wash her hands, and didn't put gloves on when she changed the dressing. No wonder superbugs are an increasing threat to health.
Dave Bright, Bournemouth, UK

My girlfriend is a very experienced nurse who works in hospitals both in the UK and Europe. She is always horrified about the appalling standards of cleanliness in the hospitals in the UK. She also considers the practise of huge wards is a perfect way to spread infection. Our hospitals need to contract better cleaners to attain basic levels of hygiene - this is fundamental. Our hospital wards should also be designed to fit far fewer patients.
Mr B, Gibraltar

The blame for MRSA lies entirely with the environmental lobby
Pauline Fothergill, Halifax, West Yorkshire
The blame for MRSA lies entirely with the environmental lobby which has caused the banning of bleach as a cleaning agent in many public buildings. It is a cheap, effective means of killing germs and ensuring cleanliness, especially in lavatories, but no, the green lobby prefer we die of nasty infections rather than possibly pollute their precious planet!
Pauline Fothergill, Halifax, West Yorkshire

What happened to the strict Matron who use to inspect the wards? Won't be tied if the ward etc wasn't clean!
Yvonne, Liverpool

Five thousand patients a year? That is outrageous! We should all be screaming about this.
Petra, UK

I know several people who have contracted infections in hospital. It is down to overpaid managers underpaying cleaning staff. All that is needed is a few bottles of disinfectant, bleach, and a bit of elbow grease. Oh yes, and employ good cleaning companies, not the cheapest. As to hand washing: how long does it take to wash your hands? 5 seconds?
Sue Hudson, London, UK

There are no government departments who advise, trail and install new technologies into the system, on a national basis. If there were, a simple yet effective solution may yet be found. Disappointing.
Brett Trafford, Basingstoke

I believe the statistics significantly underestimate the problem
J. Davies
My mother in law died after contracting MRSA in hospital following a routine operation 7 years ago . This is not recorded on her death certificate so I believe the statistics currently available significantly underestimate the problem. Hospitals do not want MRSA recorded as the cause of death , but it should be a requirement to record that the deceased had contracted MRSA.
J. Davies

An NHS cleaner year's ago was considered a 'low status' job. They were in fact the very best cleaners around. As I recall many left the NHS to do the same thing for more pay. I believe what's needed is state employed cleaners to be trained for our Hospitals, and ones that can be described as 'Super Cleaners.' A Super Cleaner to kill off a super bug sounds about right to me.
Rob Bluck, UK

On Christmas eve 1996 my older brother Stuart died from MRSA at the age of 22. He was born with a congenital heart defect and my parents were advised that he would have to undergo a routine heart valve replacement operation is his twenties. In March of 1996 Stuart went to hospital for this 'routine' operation, and during this time he contracted MRSA. 3-4 weeks later, we had to rush him back to hospital with severe pain and headaches. We discovered that the bug had attached itself to the valve and had begun to vegetate. He was operated on immediately to replace the valve, but the same thing happened again and again so finally after 5 open heart major surgeries later suffering 2 strokes he passed away on Christmas Eve, 1996.

My mother is to have a minor operation in hospital tomorrow morning and I'm very worried that I might have to endure a 1996 all over again. I have no confidence in the NHS after the mistake and mess they made of our lives in 1996. Please lets get this bug sorted out before people lose loved ones for the sake of washing hands and being clean.

(In loving memory of Stuart F Wall 18/9/74 - 24/12/96)
Mr CJ Wall, England

My Wife is recovering from this infection four months after her 'routine' operation
Mike Blowers, USA
My Wife is recovering from this infection four months after her 'routine' operation (in a Houston hospital - we're expats). She is now on a recently developed antibiotic which is very expensive but is now the only one the infection will respond to. However it is not just the cost of treatment that should be considered here, the recovery process is slow and as we have found it can fade and return - each time becoming more resilient to the drugs available. The time lost at work by the patient and spouses/relatives is also significant, especially here, where treatment is mostly conducted at home. In the UK it is likely the more seriously infected patients are hospitalised - taking up valuable beds.
Mike Blowers, USA

I can't help but be angered by the attitude of the public and the media towards hospitals and MRSA. While it is true that almost all cases of MRSA infection are detected in hospitals, this is because it is only tested for in hospitals. The main pool of MRSA infection is in fact out in the community, in residential and care homes, in the homes of chronically ill patients and in doctors' surgeries. The problems with the spread of infection occur when infected patients are admitted to hospital unaware of their status. There is no point in trying to place the blame for MRSA on any one area of the healthcare providers, as this in unproductive. What we need to do is to recognise the root cause of the problem and treat it. This requires a commitment from both the NHS and from patients, as non-compliance with treatment has been proven to increase the problem. Let's stop trying to play the blame game and get together to find a solution.
Brian McAllister, RGN, Glasgow

My former wife was operated on at Queen Elizabeth Hospital, Birmingham, in 1996, to repair a heart valve. The operation was successful but she was infected with MRSA and subsequently went into a coma. She recovered from the coma and was apparently on the road to a full recovery, when a massive stroke hit her on Christmas Eve 1996, and she died on Christmas Day.
Mike Fleming, UK

The day after my father had heart artery surgery in Leicester, 2 years ago, one of the other 4 chaps in his ward got MRSA. However, they moved the other 3 out immediately and my father recovered well.
Marianne Crisp, England

It was almost impossible to get many of the nurses to use the sink
Tony Jarvis, United Kingdom
My son was receiving treatment for Leukaemia in the John Radcliffe Hospital in Oxford. At times he was undergoing chemotherapy treatment in an isolation room during which his white blood cell count, and thus his ability to fight infection, was reduced to almost zero. The ventilation system in his room was operating incorrectly, drawing in air, potentially contaminated by other patients, visitors and staff, from the corridors, rather than fresh air from outside through the filter system.

It was almost impossible to get many of the nurses to use the sink in the lobby to his isolation room. When approached we had replies like "It makes no difference as all of the isolation patients get infections anyway". We also had many experiences of nurses coughing into their hands and then handling his Hickman line to apply drugs. It is good to see that these basic issues are at last coming into the public domain.
Tony Jarvis, United Kingdom

A friend of mine picked up MRSA during a hospital stay in May of last year. He died from complications arising from CLL but MRSA was listed as a cause on his Death Certificate. On checking with the haemo-oncologist, it turned out he was only carrying MRSA in the groin and nose - where most carriers have it. This alone is completely distorting the figures as it is being reported as a cause of death when it wasn't!
Fi, UK

Following an insect bite that seemed to become infected my husband had his hand lanced at our local hospital on a Saturday morning. The nurse left him to let his hand drip over a basin that was already covered in blood, presumably from the Friday night before. No attempt had been made to clean it up, presumably because the cleaners had not yet arrived! The nurse didn't seem bothered by this risk of cross infection.
Linda Massey, England

John Reid should take the blame over this scandal
Peter Hill, UK
The department for transport say 3,500 are killed on our roads each year, despite a lot of spending on initiatives to reduce this. Yet when 5,000 die in our hospitals from MRSA related infections, we do nothing over years and only belatedly talk about 'action plans' when pushed. John Reid should take the blame over this scandal and resign for not taking the responsibility for action.
Peter Hill, UK

My father contracted the MRSA bug in a large, West London teaching hospital. He was elderly, in the old buildings, and the levels of hygiene and cleanliness were obviously bad - even to my untrained eyes. Bit of swabs etc left lying around, no hands washed between patients etc. If it was obvious to me, why isn't it to the hospital staff? Or are the elderly not worth the bother?
SK, Bath, UK

Where are all the smart clever folk who privatised the cleaning of hospitals against all the advice of every one connected with the NHS. Astonishingly silent!!
Gerry , UK

In the old days an experienced matron would impose spotless hygiene on her wards with a firm hand. In today's NHS of new management techniques and targets, discipline has gone out the window and hygiene is relegated to a balloon on a flow chart.
Graham, Milton Keynes, UK

How on earth did we manage to turn back the clock on advances in medical care so quickly
Ray Gray, London, England
Thirty years ago I laughed at old people for being scared of hospitals because they thought "hospitals were places you went to die." Who's laughing now? How on earth did we manage to turn back the clock on advances in medical care so quickly? Perhaps because administrators are more interested in "efficiency" than hygiene? Give doctors time to wash their hands and they'll do it!
Ray Gray, London, England

Hospitals can only do so much in regards MRSA as most of the cleaning is contracted out that means that the ward sister as no direct control over the cleaning staff and has to go through a system of control which means that the sister has to report problem to a cleaning manager who then get on to the cleaning supervisor the who gets on to the cleaner on the ward - it is such long-winded way to get simple tasks done and that's why hospitals have these problems.
Michael Fearn, York

A friend of mine now in her early 40s who has suffered from rheumatoid arthritis since she was 14 years old had her seventh hip replacement operation this year in a London hospital. After she was discharged her wound still had not healed. A few weeks later it was confirmed she had MRSA and she was re-admitted for six weeks in isolation to deal with the infection. Because she has to have joint replacements regularly due to her condition she is now deeply worried about the next operation she will undoubtedly have to have. It is a national disgrace that patients' lives are put at risk because of poor hygiene in the 21st century. It seems to me Florence Nightingale knew more about infection and implemented stricter measures in Victorian times!
Hilary Hicklin, UK

Is it any coincidence that as a microbiology student on a hospital placement 10 years ago I saw the early specialist tests for these bacteria at the same time that I was reading articles on privatisation and massive cuts in hospital cleaning services?
Jo, UK

I have yet to see any blame for the frankly hysterical media reaction to this public health problem laid at the overuse of the antibiotics, which caused MRSA to evolve in the first place. Hospitals do need to continue its policy of simple hygiene measures to prevent infecting new patients, but we should be paying just as much attention to making sure new antibiotic resistant bacteria are not developed by the inappropriate use of antibiotics
Dr Jamie Cassidy, Aberdeen

Give the NHS the same staffing levels that other countries have, and the NHS may be able to deliver low levels of MRSA
Dr J, Huddersfield UK
All GP's received, a few months ago, detailed instructions from the National Institute of Clinical Excellence (NICE) about how to wash our hands between seeing patients. I reckon that to do so according to the instructions would take between two or three minutes. I run on ten minute appointments, this includes waiting for often elderly and slow patients to walk from the waiting room, take coats off, etc and, and also includes writing adequate notes afterwards. As it is, I already run very late most surgeries. If I followed the advice about hand-washing, I would never finish.
NHS staff have so many things to juggle, they cannot keep everything in the air at once. Give the NHS the same staffing levels that other countries have, and the NHS may be able to deliver low levels of MRSA.
Dr J, Huddersfield UK

If cleanliness is an issue, then maybe someone should go around after the contract cleaners and see how many bedside cabinets don't get moved as the cleaners try to get the job done in the allotted time. The next time you visit a hospital, take a look in the 'out of the way' places and see just how much is 'overlooked'.
J Pemberton, UK

Cut back on management, install a matron and employ cleaners to work directly for the hospital and not use contracted cleaner
Mary Walsh, UK
My father died last October from MRSA. He was admitted to a major London Hospital for three days to have a CT Guided Biopsy into his liver, but ended up staying for three weeks. He was extremely ill but nobody seemed to really care. The ward he was in was Victorian, filthy and depressing. I often watched the cleaner glide dreamily around the middle of the floor with a dry mop, never once attempting to go under beds or furniture. The obvious answer is to cut back on management - install a matron and employ cleaners to work directly for the hospital and not use contracted cleaners. As in the "good old days" these cleaners could be allocated say, two wards each, and they could take pride in keeping them in tip top condition.
Mary Walsh, UK

My mother died 3 years ago after an operation in a leading London cancer hospital. While it was not clear whether she caught the infection there or in another hospital in South London, one month earlier, the level of hygiene in both hospitals was appalling. Certainly in the case of the hospital in South London hospital, untidiness and dirt prevailed everywhere one looked. One does not need teams of experts, at great expense, to tell staff to apply simple housekeeping rules of regular thorough cleaning of wards, tidiness and personal hygiene. Once this principle is adopted, the need for the indiscriminate use of antibiotics (that causes resistance) will drop.
Mr. Jean-Marie Bassett, Netherlands

Modern day "glove culture" is partly to blame, wearing them has replaced hand washing. When the same gloves are worn to clean toilets and wards for instance, cross-infection is bound to occur.
Dominic Hayes, UK

It's time for the NHS to wake up and utilise this technology to fight these problems
Edward Collins, UK
It is typically that there are solutions to the super bug and MRSA, but the NHS refuses to utilise them. The technology is already used by hospitals in France and Holland to clean infected wards. It's time for the NHS to wake up and utilise this technology to fight these problems, but in its typical bureaucratic style it will be some time before they see the light.
Edward Collins, UK

My Gran went in for a hip operation, everything went well. During her recovery she began to feel sick and developed a temperature. My mother examined her wound to find that it had gone septic and discovered that nursing staff had not been changing the dressing and keeping the wound clean as they should have been. Had my mother not spotted the problem early on the infection could have had serious consequences to an elderly patient. I don't know why this happened and I'm not trying to criticise the work that nurses do, I believe they do a fantastic job in most cases, however this was basic patient care which was being neglected and could have proved fatal for my Gran.
Tamlyn Scott, UK

You can set up the most elaborate of systems for the prevention of hospital acquired infections but they will all fail until you achieve the most basic requirement of medical staff washing their hands between patients. Simple prevention is better than any cure.
NHS Worker, England

As an ex-nurse, I can honestly say that hospitals are taking the MRSA problem seriously. Unfortunately the problems are many, the lack of permanent nurses means a reliance of often under-trained agency nurses. This lack of nursing staff along with the increased workload expected of them means that there is often little time to undertake anything but the most basic hygiene measures. The lack of hospital beds also results in a forced mixing of MRSA positive patients along with those not infected.
Tom Reynolds, UK

As a healthcare worker, I am obliged to deal with MRSA on a daily basis. The hospitals are under investigation - but the general public also have a responsibility. It only takes one patient to come into the ward, with MRSA already present, to cause an infection risk to others, and yet we are not always told that they are carrying the "super bug" until too late. Should we, therefore, require a clear MRSA screen from every patient before hospital admission? This issue appears to have escaped the Government's notice - or is it easier to blame the NHS than to publish figures of infections acquired outside Trusts?
Elizabeth, England

My mother, who worked in Tetbury Hospital, believes that one of the possible causes of infection has been created by cost cutting made several years ago, this being nurses and staff always changed into clean uniforms when they arrived at the hospital and the laundry carried out by the hospital. Now the staff drive to work wearing their uniforms in cars that possible have had children, dogs, etc. in them. The list is endless, all possible sources of cross infection could be carried on the uniform. This area should be looked at by the hospital authorities.
Adrian Ball, England

Yet more targets for medical staff to achieve
James, England
Yet more targets for medical staff to achieve, just to try and convince the public that the government has things under control. Why don't we let health care professionals get on with the job to the best of their abilities and stop holding them back with red tape? By the way- get used to drug resistant bacteria, they're here to stay. The cleaner we make hospitals, the more we select the resistant bacteria-giving them free reign of the wards. Bacteria have been here a lot longer than we have. The more we try and control nature, the more it will bite back.
James, England

I think that open visiting also contributes to the spread of infection. Most wards now have open visiting hours and there seems to be very little control over how many visitors are allowed to sit at the patient's bedside. This surely can not be conducive to maintaining a sterile environment. At present the mounting number of patients is being blamed as one of the contributing factors to the spread of MRSA but nothing is said about the mounting number of visitors.
Lee Didcock, Dubai.

It is no surprise to me that we should have these serious problems in our hospitals. When I visit people in hospital it is not uncommon to find that there is no soap in the toilets, also there is sometimes even no running water in the taps in those rooms. It looks like everything we learned about hygiene and health in the 19th century has been forgotten. I have travelled extensively in some third world countries, and seen first hand how they are far more conscientious about hygiene than we are. Our worries about Aids are ridiculously overblown given that 5,000 people a year die in hospitals from infections they catch there.
Bernard Devlin, England

My mother contracted MRSA about 6 years ago now. She was admitted to the A & E Department of a South London Hospital with a burst abscesses. A doctor removed the dressing covering these abscesses (she suffers from diabetes which wasn't helping the curing of her problem). She asked the doctor for a clean dressing. The abscesses were in an embarrassing position and she was in her 70s. The doctor put the old dressing back on to the wounds. My mother came out and was treated by District Nurses but she didn't heal. They ordered tests to be done and she was found to have MRSA. My mother survived thanks to the District Nurses who were amazingly clean wearing gloves washing hands before and after touching her. What a disgusting way to treat someone in a hospital to simply slap on an old dressing to open wounds. We should have claimed for compensation against the hospital but 6-7 years ago there was not a great mention of MRSA as there is now.
Miss Christina West, England

I had a heart attack some months back and whilst recovering was amazed at the people visiting their relatives - many were dressed in unclean clothes. I remember the time when one dressed in clean and 'Sunday' clothes when you went visiting. Just another nail in the coffin of hygiene.
Patrick O'Clee, South Lincolnshire England




SEE ALSO:
NHS failings hit superbug fight
13 Jul 04  |  Health
Superbug league tables published
13 Jul 04  |  Health
'My baby son got MRSA'
22 Mar 04  |  Health
Q&A: MRSA 'superbugs'
13 Dec 02  |  Health



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