GORDON BROWN CREATING CONFUSION OVER FIGHT TO TACKLE SUPERBUGS - LAMB

8.52.00pm GMT Tue 8th Jan 2008

Gordon Brown was today accused of creating confusion in the fight to tackle superbugs by appearing to contradict his health ministers' policy on screening patients for Clostridium difficile.

The Prime Minister said today that patients entering NHS hospitals will be screened for the superbug C difficile, but health ministers were saying as recently as last month that screening patients for C difficile was not clinically effective.

Commenting, Liberal Democrat Shadow Health Secretary, Norman Lamb said: "The screening of patients for MRSA when they enter hospital is crucial in the fight against superbugs which is why we called for the immediate introduction of a screening programme last year.

"But too often, Gordon Brown talks tough only for the plans to be exposed as ill-considered and undeliverable.

"Doctors condemned the poor scientific basis for the 'deep clean' and now the Prime Minister is acting against the scientific evidence from the Department of Health that a screening process for C difficile would be effective.

"In his desperation for some good headlines, Gordon Brown is creating confusion in the fight against superbugs by contradicting the evidence from his own health ministers."

Notes

1. The introduction of MRSA screening for all elective patients next year, and for all emergency admissions as soon as practicable within the next three years was announced in the Comprehensive Spending Review last October.

http://www.hm-treasury.gov.uk/media/4/7/pbr_csr07_annexd2_197.pdf

2. Gordon Brown said this morning in an interview that Patients entering NHS hospitals will be screened for MRSA and Clostridium difficile as part of a package of measures to cut down on superbugs.

3. As recently as last month, Ministers said there was no scientific basis for screening for Clostridium difficile because there is no evidence that it is clinically effective.

http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm071212/text/71212w0019.htm#07121326000800

4. The Liberal Democrats published their Nightingale Charter for cleaner hospitals last October. It includes a call for screening to be introduced immediately to all hospitals.

It aims to bring into the 21st century her beliefs that healthcare must start with good hygiene, sanitation and a well ordered hospital:

Florence Nightingale Charter

i) Urgent review of extent of ward overcrowding

High bed occupancy rates make it difficult to isolate infected patients and spread disease at a fast rate. There should be an urgent review of the impact of high occupancy rates and the relationship with the incidence of hospital acquired infections. Occupancy rates and levels of delayed discharge need to be carefully monitored - with hospitals consistently showing high levels of one or both facing penalties.

ii) Zero tolerance of failures of infection control

(a) Good leadership is essential to ensure prevention and effective response to infection outbreaks. Responsibility for serious failures must be at Chief Executive and board level - and be treated as gross misconduct justifying dismissal without substantial payoffs.

(b) Compensation must be offered to patients who have suffered at the hands of super bugs - or to their families if they've died where there has been negligence on the part of the hospital trust.

(c) Dutch style approach when an outbreak occurs: isolation, sending staff home, closing down ward etc. Improved use of new technologies would also limit the spread of disease.

(d) Changing facilities provided for staff so that uniforms are not worn outside work.

iii) Quicker and wider implementation for screening

Screening should be immediately introduced into all hospitals. We would also roll out screening to the wider community including GP practises and care homes.

iv) Hospital matrons in charge: promoting a culture of strict hygiene standards and infection prevention

Staff at every level would be trained in infection awareness and prevention techniques. Hospital matrons would have full line management control over all staff - including cleaning staff. Measures would include:

(a) Monitoring: ensuring that all death certificates recorded incidences of super bugs.

(b) Strict compliance and improved dissemination of guidance on anti-biotic prescribing.

(c) Better promotion of hospital hygiene code to staff, visitors and patients, stressing the responsibility of everyone including visitors to maintain the highest possible standards.

v) Giving the patient power to report failure in standards

The patient is often the first to notice any drop in hygiene standards. All patients would be equipped with a copy of the hospital hygiene code on admittance and given the option to anonymously contact the matron with any concerns they may have.