Dishing the dirt on hospital infections

17 April 2005
Cleaner hospitals won't automatically clean up the problem


The three main parties have been getting low down and dirty over the MRSA bacterium and hospital infection rates.

Labour, the Conservatives and the Lib Dems have all made claims and counter-claims over the state of Britain's hospital wards.

FactCheck has already examined Conservative adverts that make claims over the number of MRSA incidents locally.

But much of the debate has involved emotive statements rather than statistical or substantiated facts. So FactCheck has investigated the research and expertise to find out if dirty hospitals really are killing people. Three questions have emerged from the debate:

Are Britain's hospitals really killing people? Are hospital-acquired infections out of control? Will matron stop the problem?

The science bit

Hospital acquired infections, which doctors define as an infection acquired four days or more after admission to hospital, are caused by resistant bacteria of which MRSA -Methicillin Resistant Staphylococcus Aureus - is the most common.

It's found in most people's skin, and 30 per cent of the population carry it in their nose but it does not present a health threat unless it gets into the bloodstream.

Adding to the current difficulty is the fact that bacteria are becoming increasingly resistent to antibiotics. The effects of resistant bacteria vary from discomfort to permanent disability, or for a small number of patients, death.

The people most at risk are the very old and the very young, who have less effective immune systems. Also at risk are people whose immune systems are having to be repressed as part of their treatment, such as transplant patients.

The longer a person's stay in hospital, the greater their risk of disease. But a study by the London School of Hygiene and Tropical Medicine, and the Public Health Laboratory Service, also found that the highest risk of infection comes in the days after an operation.

So are dirty hospitals killing people?

Most of Britain's hospital buildings were built in Victorian times and are now woefully out of date.

And according to the official figures, the number of deaths from hospital acquired infections has increased. So it would be easy to link the two issues.

But mandatory reporting of hospital acquired infections only began in 2001, which has led to increase in reported infection rates.

Other factors have also contributed, including an increase in the number of NHS operations during that period. Added to this, more people are living longer. As a result, people with weaker immune systems are staying in hospital for longer, increasing the odds of infection.

Contracting bugs after contracting out?

The contracting out of hospital cleaning - where a hospital's own cleaning department is replaced by an external company - has also been raised in this debate. The process started under the last Conservative government, and has continued under Labour.

It has certainly led to a fall in staff numbers. Research by the University of Cardiff for public sector Unison found the number of cleaners in the NHS had fallen to 55,000, from around 100,000 two decades ago.


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