ONCE AGAIN, the public is being reassured that hospital-acquired infections, such as Clostridium difficile, are being managed appropriately and should not become a cause of particular concern. Why should we believe such guff when the Health Service Executive (HSE) itself is unaware of the full extent of the problem?
Mandatory reporting of this life-threatening infection will only begin next month. Twenty-one of the 46 patients affected by the "superbug" at Ennis General Hospital in the first six months of 2007 were dead by December and the bug was a factor in 13 of those cases. The HSE says the situation there is now under control.
Clostridium difficilecauses diarrhoea and normally occurs following treatment by antibiotics. A virulent strain has emerged. Toxins can cause death in elderly patients or those with underlying illnesses such as cancer. Spores are resistant to heat and chemical disinfectants and they survive in hospital wards and toilet areas. But its spread can be contained through proper hygiene controls and handwashing.
Unsanitary surroundings, poor management and a lack of accountability have contributed to unacceptable levels of infection and death within our health system. An official hygiene survey of Ennis General Hospital, at the time these deaths occurred, awarded it a "fair" rating, similar to 34 other acute public hospitals. In all of them, management weaknesses were identified along with a failure to establish clear lines of responsibility for hygiene and for effective monitoring. Does that mean patients in these other hospitals are equally vulnerable? And what about the risks being run by patients in those nine hospitals that received "poor" hygiene reports?
There appears to be an almost casual attitude by senior health officials towards the risks involved, particularly where elderly people and those receiving treatment for cancers are concerned. A statement from the HSE outlined the steps taken at Ennis hospital to deal with the situation, mainly involving "deep cleaning" and staff training. But have management and clinical staff at other hospitals also failed to appreciate a real and growing threat? There is a serious and extensive infection problem within the healthcare system. Coroners complain about the number of cases where "superbugs" have contributed to patient deaths. And there is growing public disquiet. In spite of that, progress in improving standards of cleanliness has been dreadfully slow. If hospital managers fail in their duty of care to patients and put lives at risk, prosecutions should follow.