British public hospitals ignoring new killer superbug

They would be sued for millions if they were private facilities

A winter superbug that kills as many people as MRSA is being routinely neglected by hospitals, the Government's health watchdog gives warning today. More than a third of hospital trusts are failing to follow basic guidelines that could prevent the spread of the deadly hospital-acquired infection Clostridium difficile which kills 1,000 people a year.

The Healthcare Commission described the revelations from its survey of 118 hospitals as "deeply worrying". Sir Liam Donaldson, the Chief Medical Officer, has now written to every trust chief executive to give warning of the need to monitor and treat effectively the infection, which was linked to the deaths of 12 patients at Stoke Mandeville Hospital earlier this year.

In the survey, released today, nearly 90 per cent of trusts admitted that they did not have a ward for isolating patients with C. difficile while more than a third said that they were unable to isolate routinely such patients. In the case of an outbreak, 40 per cent of trusts admitted that they did not routinely follow government guidance, which recommends that they should inform the local consultant in communicable disease control. Thirty-eight per cent said they did not have restrictions in place to prevent the inappropriate use of antibiotics, which would help to minimise the risk of C. difficile spreading.

Marcia Fry, head of operational development at the Healthcare Commission, said it was "deeply worrying" that many hospitals were not doing enough. "We recognise outbreaks are not easy to control, but trusts must do more to ensure that they have systems in place to protect patients from this potentially lethal infection."

Older people are most at risk from the bug, which causes diarrhoea and can lead to serious illness and death. Those who have undergone surgery are also vulnerable. In 2003, 934 people died from C. difficile in England and Wales, compared with 321 who died from MRSA. There were 44,488 cases of C. difficile reported in the over-65s in England. Last year 1,219 people died from enterocolitis because of C. difficile.

Professor Graham Medley, an infectious disease epidemiologist at Warwick University, said: "We understand all about these infectious diseases and how to control them, but what we lack is the political and economic will to change the current situation and reduce the incidences of these diseases. "This is because a change would require restricting hospital visiting hours and having hospital beds free in case there is a need to isolate patients. That would result in an increase in waiting lists."

A new strain of C. difficile has recently been detected in a number of NHS trusts in England. Outbreaks of this strain were first reported in Canada and the USA and have been associated with more deaths and relapses. Infections with this strain caused 109 deaths over a six-month period in Quebec last year and it was later identified at an outbreak at Stoke Mandeville Hospital.

Andrew Lansley, the Shadow Health Secretary, said: "It is very concerning that trusts are not following guidelines to reduce infection rates. What's the point of guidelines if they are not implemented? "Hospitals should take every possible measure to prevent outbreaks of C. difficile. There is no clear line of accountability, there is no requirement for access to 24/7 cleaning, there is no measure for the availability of isolation facilities and there is no requirement to reduce excessive bed occupancy rates." Today's report is an interim study. A more detailed version will be published in the spring.

Jane Kennedy, the Health Minister, said: "Some trusts still have work to do. The new hygiene code currently under scrutiny in Parliament will make it a statutory duty for trusts to have all these systems in place; and the Healthcare Commission will have the power to issue improvement notices if hospitals are failing to carry out these measures. "The Chief Medical Officer has written a firm reminder to all trusts today, to help ensure that they have all the relevant practice in place to minimise the risk of C. difficile infection

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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