Name and shame dirty hospitals

PEOPLE go to hospital hoping to be cured — not to be put at risk of infection from life-threatening bugs like MRSA which thrive in dirty environments.

So, patients could be forgiven for anticipating a marked decline in MRSA or the winter vomiting bug following the significant improvement in hospital hygiene reported in the second national independent audit of the country’s main hospitals.

Incredibly, despite the big clean-up, no appreciable reduction in hospital-acquired infections is expected soon, according to Dr Mary Hynes of the Health Service Executive (HSE), who concedes that better hygiene alone will not root out such infections.

There is good news, nevertheless, in the latest HSE report which shows that 85% or better of the 53 acute hospitals examined now adhere to good hygiene standards. Overall, 32 were rated as good compared to five in the first audit while 19 ranked as fair compared to 23 initially. Only two were deemed poor compared to 26 in the first investigation. The dirtiest hospitals in the country are the South Infirmary in Cork and Monaghan General Hospital.

This scenario is in stark contrast with the first audit last November which found 48% of hospitals had bad hygiene. Some 43% had fair cleanliness and only 9% were at a good level. There could be no excuse for the shocking conditions exposed in that damning league-table of Ireland’s dirty hospitals.

Obviously, the naming and shaming of hospitals has been the key factor behind the visible improvement. Presumably, if the same policy applied across the public service, there would be less bungling of the kind witnessed in the recent statutory rape crisis at the Attorney General’s office where an unnamed official was blamed by an internal report widely regarded as a Government cover-up.

While there is a tangible culture-shift in the way staff and management look at hygiene, the high number of hospitals rated as ‘fair’ gives cause for concern. Such basic things as hand washing facilities have been upgraded. Rusty bed lockers have been thrown out. More attention is being paid to cleanliness but not enough.

Though hand-hygiene is vital to prevent the spread of infection, it seems elderly or very sick patients will continue posing an infection threat.

But according to Dr Hynes, practical steps to improve hospital control procedures are planned, as well as measures to upgrade health-care education among clinical staff and the public.

This goes to the heart of another serious problem involving many patients and relatives who complain they are not being given enough information about the effects and implications of the super bugs now endemic in the hospital system.

Doubtless, Health Minister Mary Harney’s threat to shut down hospitals that fail to reach acceptable hygiene standards will concentrate minds right across the health service. Arguably, if restaurants were found to have such appalling conditions as those revealed in the first hospital audit last November, they would be closed long before now.

Presumably, Minister Harney has the public interest rather than political capital in mind. She should not hesitate to grasp the nettle and shut down failing hospitals where hygiene conditions consistently fall below standard.

The clear implication of the second hygiene report is that naming and shaming is the only way to achieve results. The more open a health system becomes, the better it will be for the public and, psychologically, also for the patients who go to hospital to be cured, not to get sicker.