Protests mount after 12 die and 300 infected in U.K. public hospital

And the bureaucrats are the real killers

An expert in infection control at a hospital that was stricken by a lethal new bug resigned last month in protest at managers' failure to control the outbreak. Paul Gillett, a consultant microbiologist at Stoke Mandeville Hospital, where 12 patients have died and 300 have been infected, took early retirement after what colleagues said was a long struggle to get the problem of hospital infections taken seriously.

Protests were growing last night that the hospital in Buckinghamshire did not take necessary measures to tackle the infection. The bug, a virulent new strain of Clostridium difficile, which causes severe diarrhoea and can be life-threatening, has resisted all attempts to control it since the outbreak began 18 months ago. As revealed in The Independent yesterday, specialists from the Health Protection Agency and the Department of Health's Recovery and Support Unit have been called in to assist at Stoke Mandeville but the bug is still spreading. The most recent case of infection was last week.

Two years ago, Dr Gillett is understood to have established an isolation ward at the hospital to treat patients with hospital- acquired infections, but it was closed by managers because of a shortage of nurses. "He complained that managers were prepared to make a fuss but not to spend the money. He resigned in protest at the way things were going ," a colleague said. It also emerged yesterday that the hospital ended its cleaning contract with a private company last week and has taken cleaning of the hospital back in house.

C. difficile is endemic throughout the NHS and cases have soared from fewer than 1,000 in 1990 to 43,672 in 2004. Latest figures show there were 934 deaths in 2003, a 38 per cent rise in two years. The new strain of the infection, first identified at Stoke Mandeville in 2003, is more virulent and harder to destroy than existing strains. It is closely related to a type found in the US and Canada and may have been brought in by a patient admitted from abroad to the hospital's world-famous spinal injuries unit, which is supported by Sir Jimmy Savile.

The bug poses a particular threat to hospitals because it produces hardy spores that are resistant to normal methods of cleaning and can persist on hands, clothes, bedding and furniture, transmitting the infection to new patients. Alcohol gels used throughout the NHS to clean hands are ineffective against the spores which can only be removed with soap and water.

The cleaning contract at Stoke Mandeville was held jointly by two private companies but, next year, the hospital plans to second staff under a new type of contract to a different company, Sodexho, retaining responsibility for the staff and standards.

David Lidington, Conservative MP for Aylesbury, the area served by the hospital, said yesterday: "This is shocking news. Thousands of patients will be wanting an explanation and a promise everything necessary is being done to eliminate this." Mr Lidington said he would press local health managers and health ministers to explain why Stoke Mandeville was the only hospital affected and why the outbreak had persisted for almost two years. "If it is true a consultant microbiologist at the hospital has resigned, I would call for a clear explanation from the trust as to what has happened."

Bed occupancy at the hospital had routinely been above 90 per cent, which was too high, he said. "Hospitals have got to treat patients in the minimum time so they can never leave a bed unoccupied or allow a ward to be disinfected. Will the Government now give local managers power to put hygiene first, even if it means breaching national targets for waiting times?"

Managers were accused of failing to inform staff about the outbreak of the new bug. An in-house publication called The Bug Buster, circulated to hospital staff at Stoke Mandeville, failed to highlight the new strain of C. difficile.

In a statement to The Independent last night, Buckinghamshire Hospitals NHS Trust declined to comment on the resignation of Paul Gillett. It said it had set up a dedicated ward for affected patients and had established protocols "for the movement of patients around the hospital, decontamination and deep cleaning of affected areas, hand-washing and surveillance." It added: "The change in our arrangements for our cleaning staff, from contractor to NHS employ, has been planned for more than a year and is part of our PFI scheme, which is due to open later this year."


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