HEART BEAT Maurice NeliganSo help me God; I had hoped to move away from writing about MRSA. However, the recent report from the committee representative of the Health Protection Surveillance Centre (what the hell is that?) and the Irish Society of Clinical Microbiologists, among unspecified "others"; states that while improvements in controlling the antibiotic resistant super bug are possible, that current resources are "inadequate to achieve this".
We get the usual and very commendable warning that everybody must wash their hands before and after patient contact. This will make ward rounds, surgeries and out-patient clinics and teaching sessions extremely lengthy. There may only be one hand basin in the ward or out patients. This may be difficult to access because of overcrowding and lack of space between beds and other fittings.
It should be done of course but sadly it won't be easy. Basic facilities are required, sufficient hand washing facilities and clean towels are required also. The Minister was clearly enthusiastic as she launched guidelines on hand hygiene in health care settings. She stressed that it would cost nothing for health care professionals to wash their hands and that this would minimise the spread of infection. Wrong, Minister; although it will help and may reduce the spread of infection it certainly won't eradicate it, and I would suggest that the use of the word minimise, is unduly optimistic, considering that about 40 per cent of the population carry this organism, inside and outside the hospital system.
I have said all this before and the reason that I am returning to it, is that the report also makes many other recommendations.
It recommends the appointment of more infection control personnel and clinical microbiologists. That'll cost money. How about it Minister?
Hospitals should have a sufficient number of isolation rooms to assist in the control of infection. That'll cost money. How about it Minister?
The report states that patients in intensive care units with MRSA should be isolated, and if possible, those in other units so affected should be isolated also. Guess that'll cost money too. Will it be forthcoming Minister?
Lastly as I do not wish to go on about this forever; "each hospital must take steps to prevent patient overcrowding and ensure adequate space between beds".
Does my memory fail me completely or were you not the Minister who instructed hospitals to put up extra beds in wards to alleviate the problems in A&E departments? I presume that as we are now into the "cleanliness is next to Godliness" school of healthcare, you will now wish to wash your hands of any responsibility for encouraging ward overcrowding.
Elsewhere in this magical world of our health service, we read of a hospital ward recently built, being filled with patients for a formal opening by a political figure. It was emptied again when the cameras had moved on.
Official denials that this had happened followed as a matter of course. Yes indeed. In my own experience in hospital, I can recall grass being specially laid for an official sod turning as the original ground was not considered suitable. I can remember a temporary brick wall being constructed to facilitate a symbolic brick laying. Is it any wonder that so many health professionals are disillusioned and cynical about the priorities and understanding of those who run and administer the service?
Would it not be better all round to let Prof Drumm and his team get on with their supremely difficult task, without the interposition of conflicting views by those who have signally failed to deliver in the past. Many of the groups with whom the professor will have to deal are already alienated by what has gone before. Give him time and space. I am firmly of the opinion that often Ministers are like little boys; they should be seen and not heard. We have always had a good civil service; in its attempted politicisation lies the root of administrative disaster.
We have seen this in the health service and in the cavalier attitude to spending the citizens' money, with scant accountability, so noticeable throughout Government today. I weep, gnash my teeth, and assault what is left of my receding hair, as I try to grasp the latest revelations about the National Treatment Purchase Fund. Patients from the fund being operated upon in their original hospital of referral, despite the fact that the hospital apparently could not treat them as they were entitled in the first place. Some spokesperson for the fund stated that these were patients who required treatment over and above the amounts agreed in the hospitals service plans. Who agreed these plans? I always felt that the sick came through the doors and were treated according to need, not according to some zany unaccountable rationing scheme. Hence we wind up paying twice for the same service. This iniquitous mysterious scheme, paying different rates for the same procedure to various institutions, is then held up as a success by the Minister.
God help us all. I am conscious that I have called upon the Deity, a lot in this column. Please Lord deliver us from those who have destroyed and continue to destroy our once proud health system.
Maurice Neligan is a cardiac surgeon