The importance of hygiene

Thanks to Curly's Corner Shop we can read that:

"I am just about heartily sick and tired of the “nanny state” that we are living in, the regulation, the overbearing health and safety rules, the maternalistic approach to risk, the fear of the compensation claim etc., etc., etc.

I’ve just returned from my local South Shields newsagent aghast, next to the display of sweets and confectionery there was a bottle of hygienic hand wash gel with a notice attached to it advising customers to cleanse their hands before choosing from the merchandise!

* Scared of spreading bugs, diseases, and other nasty things?
* Don’t want to be the source of an outbreak of a stomach disorder in little children?
* Another reason to work hard and remove risk from our daily lives?
* When are these people going to stop “nannying” and start to concentrate on being normal?

Then they go and hand out dirty money in our change which has already passed through countless grubby fingers!"

You can read elsewhere in my blog for some of my recent experiences in NHS hospitals.

Dirty NHS

I have blogged previously about how dirty NHS hospitals are and how Gordon Brown's "deep clean" initiative is little more than a piece of froth and spin.

Now I read in The Telegraph that:

"More than a quarter of health trusts in England are failing to meet basic hygiene standards, official figures show today.

The Healthcare Commission reports that no improvement has been made on a year ago.

In total, 103 out of 391 trusts admitted they did not achieve the minimum requirements, brought in by the Government to help combat the hospital superbugs, MRSA and Clostridium difficile.

Patients groups and politicians said that it was "shocking" that one in four still did not meet the standards, despite ministers' pledges to tackle cleanliness.

More than 8,000 deaths were related to MRSA and C. diff. The report shows that
26 per cent of trusts failed to keep facilities clean, did not have adequate infection control or follow guidelines
on decontaminating reusable equipment.

Only 40 per cent of trusts claim to have met all the Governments standards, which include patient care and confidentiality as well as hygiene, a slight fall on last year.

The commission warns that even fewer trusts may be deemed to have met all the criteria by the time it finishes spot checks this year.

The failings come despite a £50 million "deep clean" of every hospital in England, designed to curb superbugs. "

The telegraph article does include an "excuse" and an "explanation" from Ben Bradshaw but I am tired of Ministers like him who are just a walking excuse for the mismanagement of the country and so if you want to read his pearls of "wisdom" you'll have to read them in The Telegraph as they wont get house room here.

Deep-cleaning the NHS (update)

The BBC are "reporting" as I blogged recently that some NHS Trusts will miss Gordon Brown's deep-clean deadline. Of course the BBC start the article with a piece of pro-Labour spin "The NHS is likely to narrowly miss its target to deep clean all the hospitals in England by the end of March. Ministers expect 93% of trusts to have completed the process by the end of Monday. The rest have all started the cleans and will finish soon, they say."

Deep-cleaning the NHS

Do you remember Gordon Brown promising to have every hospital in the deep cleaned over a period of a year? I wrote soon after that "There are no plans to centrally monitor the deep cleaning of hospitals." and reported that the Department of Health had said that "no specific date has been set for either the commencement or completion of the deep-clean programme." and that "There are also no plans to assess the effectiveness of deep-cleaning."

Today I learn that the money to fund the "deep cleaning" hasn't even reached all of the hospitals. The Telegraph reports that "Primary care trusts across the country admitted yesterday that they would fail to hit Monday's deadline, while others have hastily scheduled cleaning programmes for the weeekend. Figures show that only a quarter of the £57 million allocated for deep-cleaning has reached hospitals."


Something for David Cameron to bring up at PMQs on Wednesday? If he did, I wonder what fraudulent statistics Gordon Brown would counter with?

John Prescott's deep clean

The Herald inform us that "Tory HQ last night berated the "exorbitant" cost - more than £3000 - of deep cleaning John Prescott's former grace-and-favour flat in Whitehall, famous as the scene of his romantic assignations with Tracey Temple, his diary secretary.

Parliamentary answers to Conservative questions revealed the "deep clean" of the former deputy prime minister's two-bedroom flat at Admiralty House cost £3320.

The Tories pointed out this was despite the fact commercial contractors normally charged just £200 to clean such a property when tenants moved out.

They also noted that the cleaning bill was on top of the £173,000 yearly cost to the public purse of the flat.

Parliamentary answers also revealed that refurbishing the flat, now occupied by Lord Malloch-Brown, the Foreign Office minister, cost £1030 for new curtains plus £9322 for a washing machine, tumble dryer, freezer, new taps and repainting the bedrooms, bathroom and corridor."


What John Prescott did in the flat to make it that dirty is not something I want to think about over the coming weekend.

Deep Cleaning the NHS

A progress report from Dr Rant.

"Quite simply, the ‘deep clean’ team is simply a collection of migrant floor-cleaners, who are mopping hospital floors rather that the local McDonalds. They are not highly trained infection control workers. They are not using state of the art cleaning equipment (Dr Rant does not consider a mop to be ‘state of the art’). And they do not appear to be doing anything more than a routine hospital cleaner would be doing.

Except for the bright yellow tee-shirt, of course.

The problems with hospital acquired infections is that NHS hospitals require far more than a simple mop and bucket. Washing a layer of dirt of a twenty year-old Skoda car will not hide the fact that it has a crap engine...

Telling doctors to remove their ties and watches will make fuck-all difference when patients are practically shitting on each other because of ward over-crowding. Four hour A+E waits force patients onto wards that have not yet been cleaned. And existing cleaners are neither motivated nor encouraged."



Do read the rest of the article.

Gordon Brown on hospital cleanliness

It would seem that Gordon Brown has moved on with his cleaning of hospitals, the same hospitals that he has been in charge of funding for the last 10 years.

"All patients entering NHS hospitals in England will be screened for MRSA and Clostridium difficile, the PM has said. Gordon Brown told BBC One's Andrew Marr Show that tackling hospital-acquired infections was an "absolute priority". A programme of deep cleaning hospitals had begun and would continue across the country in the coming months, he said."

The deep cleaning programnme has started has it, what hospitals have been deep cleaned so far?


"Mr Brown said the government was setting aside £50m to pay for the deep-clean programme. It had doubled the number of matrons on NHS wards, and introduced stiffer penalties for hospitals where cleaning is not done properly, he added."

I don't know but I just don't believe either of those statistics, I wonder why? Is this £50m new money or coming from existing budgets? If it is from existing budgets then which ones and what will be unfunded as a result? Could it be that Gordon Brown has fiddled so many figures and double or treble announced so many increases in funding over the last 10 years that his credibility is at approximately zero. The man is a fraud and thankfully the rest of the country is finally catching up with those of us who worked this out years ago.

Someone who has been telling us this for longer than most isGuido Fawkes who writes today that "However much Brown smiles manically in front of the cameras, the public believe he is a grumpy, defensive, brooding control freak - because after ten years we know the truth. You can't fool all of the people for such a long time. Recognition of his mincing, finger-chewing, snot-eating, greasy haired, foul tempered nature and weird dark ways has broken out of the confines of the Westminster Village and is seeping into a wider popular consciousness."

How's "deep cleaning the NHS" going?

A lovely heartwarming story in the Daily Mail today, it would appear that "Joan Horne ... a tape recorder in her hand, she marched off to Barnsley Hospital in Yorkshire and forced managers to admit that not only had Edwin (her husband) contracted a lethal infection called Clostridium difficile (C. diff) as a patient, but that doctors failed to declare the truth on his death certificate." The whole story is shocking and disgusting but no more than anyone who has visited an NHS hospital recently would expect.

It looks as though this is yet another example of a dishonest, incompetent government fiddling the figures to try and hide their incompetence. Can anyone think of any other examples?

Deep cleaning the NHS

Do you remember reading that "NHS hospitals are to be ordered by Prime Minister Gordon Brown to conduct a "deep clean" to tackle the spread of infections such as "superbug" MRSA. He wants the cleaning to be pre-emptive rather than a reaction to outbreaks." There was plenty of criticism at the time of the pointlessness of the exercise at MRSA is carried by humans - staff, patients and visitors - rather than the building.

However, having been into three London NHS hospitals over the past few years they could definitely do with a good clean; Mrs NotaSheep walked into a visitors toilet at St Mary's Paddington and found a swarm of flies, I witnessed a nurse changing a drip and wiping the spilt blood off the back of her hand onto her apron before moving straight onto the next patient, The dirt in one of the corridors at Hammersmith Hospital was not pleasant, I could go on and on.

So six weeks later has the "deep cleaning" started? Maybe it hasn't started but there must be a serious plan in place. It appears not.

David Cameron in his speech today replying to the Queens speech spilt the beans:
"Let me take just one example: the Prime Minister’s pledge to “deep clean” our hospitals. Here is the headline from one newspaper—it is just what he wanted:

“I’ll wipe the wards clean—PM’s amazing pledge on MRSA”.

When we look at it more closely, it certainly is amazing. The Prime Minister said that “deep cleaning” would happen in “every hospital”, but listen to what the Department of Health said:

“There are no plans to centrally monitor the deep cleaning of hospitals. Arrangements for the programme are entirely a matter for local determination”.

[Interruption.] Wait. The Department of Health went on:

“Undertaking deep-clean is just one of a number of approaches trusts may take in tackling healthcare infections.”

It gets worse. The Prime Minister said that deep cleaning would happen “over the next year”, but the Department of Health said that

“no specific date has been set for either the commencement or completion of the deep-clean programme.”

The Prime Minister said deep cleaning would be repeated “every 18 months”, but the Department of Health said:

“The success of the first programme of deep cleaning will be fully evaluated before a decision is made about whether to repeat.”

Then it said:

“There are also no plans to assess the effectiveness of deep-cleaning.”

Therefore, all the things that the Prime Minister told us—that it would happen in every hospital, start immediately and be repeated every 18 months—turned out not to be true.

What a complete shambles. People are worried about going to hospital and catching a disease that might kill them, and all they get from the Government are short-term tricks. I will tell you, Mr Speaker, what needs a deep clean: the culture of spin, deceit and half-truth that we get from the Government."


That's Gordon Brown's Government for you...

Do you think the BBC covered that part of David Cameron's speech? What do you think... Of course not, the only reference to health in the BBC's coverage of the debate is this "Other bills announced include a Health and Social Care Bill which introduces a single regulator for the health and adult care services who will also have the power to fine hospitals for failing to meet hygiene standards." BBC up to the usual standards of impartiality there.

UPDATE:
My humble apologies, there is a reference on the page describing David Cameron's speech it is "He also criticised the government's plans to "deep clean" hospital wards as a "complete shambles"", that covers it, no? No it doesn't. BBC bias "present and correct"...

The NHS is the envy of the world

A panelist on "Any Questions" or "Question Time" only has to utter the phrase "the NHS is the envy of the world" for there to be a smattering of self-satisfied applause from some of the audience, add some comment about the dedicated workers in the NHS and it makes intelligent criticism all but impossible.

Frank Dobson promised to make the NHS the envy of the world in 1997, "When the Health Secretary Frank Dobson unveiled the government's Health White Paper for England in December 1997, he called it a new beginning for the NHS. He said his aim was to promote fairness and efficiency while eliminating waste and unnecessary bureaucracy. The Paper announced a reduction in the number of NHS trusts and health authorities and a limitation on the role played by the internal market system introduced by the Conservatives in 1990. In total, Mr Dobson claimed the changes would save £1bn by cutting unnecessary red tape." Have you noticed the reduction in red tape and bureaucracy? One of the new services promised was "The NHS is to get its own information superhighway. It will be called 'NHSNet' and allow on-line booking of out-patient appointments and speed up test results. The government wants demonstration sites up and running in 1998." Remind me when that came on-line... You can read more about Frank Dobson's plans here.

In October 2007 a survey across all EU member states plus Switzerland and Norway ranks Britain 17th out of 29 countries for patient satisfaction. You can read more about this survey here. Here are some key points - "Its rating was dragged down by waiting lists, MRSA infection rates, access to cancer drugs and dentists as well as cancer survival rates." "The Euro Health Consumer Index, which has been compiled for the past three years by the Health Consumer Powerhouse, a Swedish think-tank, is the only survey that compares European health care systems from a consumer point of view. It assessed 27 indicators in five categories: patients' rights and information; waiting time for treatment; outcomes measured by certain death rates; the range of services offered by health systems; and the availability of drugs. In five categories, the UK scores just 581 points out of 1,000 compared to top place Austria's average of 806. This puts Britain behind Estonia and just above Italy and Portugal." "the report concludes: "Despite substantial funding increases, the UK is still a mediocre overall performer."

Gordon Brown and his Labour apparatchiks still believe that throwing large sums of money at a problem will solve it, especially if you pay most of that money to Consultants who can use long words and produce pretty charts. However a recent study in The Lancet said survival rates in Britain were among the lowest in Europe.
"Survival rates are based on the number of patients who are alive five years after diagnosis and researchers found that, for women, England was the fifth worst in a league of 22 countries. Scotland came bottom. Cancer experts blamed late diagnosis and long waiting lists. ."

"A second Lancet article, which looked at 2.7 million patients diagnosed between 1995 and 1999, found that countries which spent the most on health per capita a year had better survival rates. Britain was the exception. Despite spending up to £1,500 on health per person per year, it recorded similar survival rates for Hodgkin's disease and lung cancer as Poland, which spends a third of that amount." This Government has wasted more money than you would believe, one day it will be totted up and the public will not believe it possible.

"Well would you want to be ill in America" is the cry when anyone suggests that maybe some form of payment for health care might be called for. Well it appears that "Patients who have major operations on the National Health Service are four times more likely to die than Americans undergoing such surgery, according to a new study. The difference in mortality rates was blamed on long NHS waiting lists, a shortage of specialists and competition for intensive care beds. The joint study, carried out by University College London and a team from Columbia University in New York, found that patients in Britain who were most at risk of complications after major surgery were not being seen by specialists and were not reaching intensive care units in time to save them. The study followed 1,100 patients at the Queen Alexandra Hospital in Portsmouth and compared them with 1,000 patients who had undergone similar major surgery at the Mount Sinai Hospital in Manhattan. The results showed that just under 10 per cent of the British patients died in hospital after major surgery, compared with 2.5 per cent of the American patients. Each year, more than three million operations are carried out on the NHS and about 350,000 of these are emergencies which carry a higher risk of complications. Professor Monty Mythen, head of anaesthesia at UCL who led the British side of the research, said: "The main difference seems to be in the quality of post-operative care and who cares."" Read the rest of the article and plan to be in the US if you want to survive treatment.

But what about the cost of US treatment, at least the NHS is free. True it is free (mostly) at the point of use - if you ignore taxation, see note at end of this article -, but you do risk contracting MRSA, Clostridium difficile etc. Maybe that is why "Record numbers go abroad for health".
"Thousands of "health tourists" are going as far as India, Malaysia and South Africa for major operations – such is their despair over the quality of health services. The first survey of Britons opting for treatment overseas shows that fears of hospital infections and frustration with NHS waiting lists are fuelling the increasing trend. More than 70,000 Britons will have treatment abroad this year – a figure that is forecast to rise to almost 200,000 by the end of the decade. Patients needing major heart surgery, hip operations and cataracts are using the internet to book operations to be carried out thousands of miles away." What's the most popular country to go to for surgery? India. Why? "Almost all of those who had received treatment abroad said they would do the same again, with patients pointing out that some hospitals in India had screening policies for the superbug MRSA that have yet to be introduced in this country." You might have an 8 hour flight to Delhi or Bombay but once there the hospitals are actually cleaned properly every day, not as part of a special "deep clean". For more on the "deep clean" idea, you can read Dr Rant and Devils Kitchen. The point being that it isn't the building that is harbouring MRSA, it is the staff, patients and visitors who carry it. Roy Lilley, a former NHS trust chairman and the author of a book on healthcare management, told the BBC he thought the "deep cleaning" idea was "irritatingly populist". He said: "This will get a huge round of applause from the Labour Party conference floor and everyone will say 'yes, he's the man that's cleaning up the hospitals'. "But at the end of the day, the infection control systems are about handwashing; it's about clinical discipline and it's about screening people before they come in. "You can clean a hospital on Monday and on Wednesday, you'll be back where you started." ... " That was from Democratic Deficit.


For more on NHS stupidity take a look at the NHS Blog Doctor, Health Matters and Right for Scotland.


The NHS is free at the point of use. Yes it generally is but a 2005 estimate put the British workforce at 30m people and an unemployment rate of 4.7%. That means that just over 28.5 million people legally work in this country and pay tax. The “free” NHS was costing each worker £2,105 per year or £40 per week on average. How much would a decent private medical plan cost? Less than £175 a month I would have thought and I don't believe anyone has died from MRSA or Clostridium difficile in a BUPA or PPP or WPA hospital.