FactCheck: pesky questions of cleanliness
Updated on 06 August 2008
The Conservatives believe levels of pest infestation reported in hospitals mean Labour is failing to clean up. FactCheck spots the fly in the ointment.
The claim
"Labour have said over and over again that they will improve cleanliness in our hospitals but these figures clearly show that they are failing. It is difficult for health service estates to maintain a completely pest free environment but the level and variety of these infestations is concerning."
Andrew Lansley, Shadow Health Secretary, 6 August 2008
The background
The shadow health secretary, Andrew Lansley, has been quoted in most national newspapers today after the Conservative party released the results of their research into pest control by hospital trusts.
The research shows that 70 per cent of NHS trusts who responded to their request, under the Freedom of Information act, had called in pest controllers over 50 times between January 2006 and March 2008.
The list involves some grimy examples of rats, mice, cockroaches, biting insects, and even maggots in a patient's slipper. But does this show that Labour is failing to clean up hospitals?
The Analysis
Maybe, maybe not - it is almost impossible to know from these statistics. As Andrew Lansley himself acknowledges, this is the first time the information has been collated and published.
He told the BBC Radio's Today programme: "We're not claiming that there has been some change over time because there is no previous data."
However, his press statement implies that the situation has not improved, which is not possible to show on these figures alone.
It is also not so straightforward to equate the number of times pest control experts have been called out with hospital cleanliness.
For one thing, as John Simpson, director of estates and facilities management at Nottingham University Hospitals, which topped the Tory poll, said: "These figures must be put into context. It goes without saying that, as the fourth largest trust in the country, our hospitals are bigger than most others around the country and therefore our figures should be compared with trusts with similar-sized estates rather than smaller acute trusts."
For another, the statistics seem to show little correlation to the ratings given by the watchdog which monitors hospital hygiene, the Healthcare Commission.
Before this year, the Healthcare Commission carried out a survey where NHS trusts provide self-assessments and were spot-checked against the Hygiene Code - a list of duties of the trust which were outlined in the Health Act 2006.
Each trust is then given a rating as excellent, good, fair or poor on their cleaning and decontamination arrangements, including hand-washing, linen and clothing.
Under this measure the "top 10" hospital trusts who called the pest control experts out most often vary more widely in their ratings.
Nottingham University Hospitals NHS Trust, who called pest control out 1070 times, received a good rating for their quality of service, including safety of patients and cleanliness.
In contrast, Queen Mary's Sidcup NHS Trust called pest control 26 times, but only received a fair rating from the Healthcare Commission and even declared themselves as non-compliant with infection control standards.
According to Christine Braithwaite, head of the healthcare associated infection programme at the Healthcare Commission: "Cleanliness and hygiene are issues of critical importance to patients and the public. We receive a wide range of information on hygiene from different sources. However, concerns around pest control have, to date, been negligible."
It's worth noting that from this year the Healthcare Commission will be carrying out site visits to assess all hospitals.
So how much concern should there be over what Mr Lansley termed the "level and variety of these infestations"?
The word "infestation" may imply an exaggeration of the situation. The list of pests that hospital trusts called for pest control experts to handle include rabbits, pigeons and dead foxes or cats - perhaps not considered by most people to be on a par with swarms of flies, or rats.
Secondly, the extent of infestation in clinical areas where patients are treated is unclear. NHS hospital trusts, particularly in rural areas, are often responsible for outdoor space as well as buildings, and at the lower end of the list of reasons for pest control, dead foxes and cats are more likely to be found in the grounds.
Mr Lansley himself told Channel 4 News at Noon that "clearly in a small minority of cases these infestations are actually impacting directly on the areas where patients are present."
Put another way, Mr Lansley acknowledges that only around 20 of the 127 trusts who responded showed that the infestation was in a clinical or sterile area, and even then, he asserts, it is only in a small number of cases.
The verdict
The figures for the number of times hospital trusts have called pest control may make shocking reading, but they do not really show that Labour is failing to improve hospital cleanliness.
As there is no historical data on past performance, the statistics released today cannot show whether the number of times hospital trusts have called pest control is up or down.
The measure cannot be directly equated to hospital cleanliness either, as they do not take into account the nature of the infestation or the proximity to patients.
However shocking the examples given by Mr Lansley may be, equating pest control to standards of cleanliness is at best misleading and fail to show whether Labour is achieving its great hospital clean up or not.
FactCheck rating: 3.5
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Every time a FactCheck article is published we'll give it a rating from zero to five.
The lower end of the scale indicates that the claim in question largerly checks out, while the upper end of the scale suggests misrepresentation, exaggeration, a massaging of statistics and/or language.
In the unlikely event that we award a 5 out of 5, our factcheckers have concluded that the claim under examination has absolutely no basis in fact.
The sources
Conservative Party website: 20,000 cases of pests in NHS hospitals
Health Act 2006
Healthcare Commission: information for healthcare providers
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