More than 50,000 patients contracted one of the most serious hospital superbugs last year, a rise of more than 17 per cent on 2004, latest health figures reveal. Experts from the Health Protection Agency, the public health watchdog, gave warning yesterday of increasing numbers of Clostridium difficile cases, including rarer infections in patients under the age of 65. The HPA statistics, which showed annual totals of 51,690 cases for C. difficile and 7,087 for MRSA, followed the release of a damning report into superbug outbreaks at one hospital where 65 patients died. The Healthcare Commission, the Government's health inspectorate, said that a culture of poor hygiene and serious inaction by senior managers at Stoke Mandeville Hospital in Buckinghamshire was to blame for many of the deaths.
The commission revealed that a total of 33 people died as a result of two separate outbreaks of C. difficile at the hospital in the past three years. The deaths of a further eight people could also be traced to C. difficile, while complications linked to the bug claimed a further 24 lives. The report detailed a catalogue of serious hygiene offences, including faeces on bed rails, patients' clothes kept on the floor, soiled commodes and a shortage of nurses. The HPA's statistics offered further evidence of the failure of hospitals to address the problem of superbugs, most of which affect the elderly.
Peter Borriello, director of the HPA's centre for infections, said that the 17.2 per cent rise in C. difficile cases could be attributed both to an increased number of cases and improved reporting. He added that more instances could well occur if stronger action was not taken. In the past year 60 per cent of all trusts reported an increase in C. difficile cases. The data revealed a more positive picture for methicillin-resistant Staphylococcus aureus (MRSA), with the number of cases down slightly from 7,233 in 2004-05. However, it fell far short of government targets for a 50 per cent cut by 2008.
Significant decreases were seen in London, previously the worst-affected region, and Yorkshire and Humberside, but there was a slight increase in the North West. The figures also showed that 25 per cent of patients with MRSA had the disease on admission to hospital, 8 per cent of cases were in renal patients and 15 per cent were diagnosed while in intensive or high-dependency care. While older people are particularly at risk from C. difficile, the figures showed a rise among younger age groups. A quarter of all cases occurred in those aged under 65.
Almost 30 per cent of the samples in 2005 were caused by a particularly virulent strain of the bug, known as type 027, which has been associated with several serious outbreaks, including those at Stoke Mandeville Hospital. In 2004 there were 2,247 deaths in which C. difficile was the underlying cause mentioned on death certificates in England and Wales and a further 1,168 deaths in which MRSA was mentioned, according to the Office for National Statistics. Andy Burnham, the Health Minister, said that new powers meant that "improvement notices" could now be served on trusts that still failed to follow government guidelines on hospital infections.
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Australia: A view from close-up of a dysfunctional government health system
For many years I have been working as an emergency nurse at a busy Brisbane hospital. My first few years in emergency nursing were so rewarding. Every day I felt like the team I worked with was not only saving lives but also changing lives for the better. But soon the excitement wore off and the reality hit me of what was happening to the Queensland Health system. For years I have watched staff struggle to even keep their practice safe due to the conditions that we are enduring day in and day out. I have seen first-hand what it's like in the public health system. Let me tell you it's not pretty.
It is a harsh truth that there is a growing demand on the system and the money injected into it is not sufficient. Those who pay the price are not the politicians who decide how much money to allocate to health, but rather the likes of your loved ones and friends. There is increasing pressure on emergency departments due to many reasons:
* People are presenting with ailments that GPs could fix, but there are not enough bulk-billing services or after-hours clinics.
* Increasing lack of skilled staff in areas such as emergency due to high numbers of trained staff who are leaving the field.
* An increasing population, therefore an increasing number of people presenting to emergency departments, which means an increase in the patient-to-staff ratio.
* Not enough operational hospital beds. Hospitals throughout Brisbane have wards that are fully stocked but are empty of patients because there is no funding for staff.
Patients are waiting in emergency departments for up to 24 hours to get a hospital bed. Do you understand the implications of this? I am often forced to choose which patient should come off a trolley so that a more critically ill patient can have a bed. Sometimes I cannot take anyone off a trolley. Sick patients are put in chairs because there are simply not enough resources. I have watched patients have cardiac arrests on ambulance trolleys in the corridor while waiting for a bed in the emergency department. Ambulance officers can wait more than two hours to offload a patient at times.
I have seen nurses conduct cardiac tests on patients lying on the floor because there was absolutely no place to put this patient having a heart attack. Every day, patients wait far beyond their allocated triage time to receive medical treatment. As a triage nurse, it is terrifying to see someone with a potentially life-threatening condition wait up to three hours when they should be seen within 30 minutes.
The patients and their families become really angry about this and I don't blame them. Daily now I am verbally abused and so are my colleagues. It has become a frequent occurrence for an angry patient to threaten my life. I have seen the stress of working in this environment take its toll on many doctors and nurses, including me. Lots of excellent staff have left or are in the process of leaving because it seems the situation is only going to get worse.
Once we just had to deal and cope with the reality of what our jobs involved. Now we are not only trying to save lives, but also trying to do this within a system that is potentially killing our patients. I suggest to the state and federal governments that they send a representative to work a full 10 days straight with an emergency nurse - not just walk through an emergency department when you are campaigning. What true reality will that give you? It is obvious that you are not aware of the extremely dangerous conditions patients are being put in or I simply would not be writing this.
To the public I say, next time you feel like threatening a health professional, maybe instead you should consider voicing your anger in a letter to The Sunday Mail. It is time for you to speak up for your rights before someone you love is hurt by the public health system this State Government has created. I write this anonymously because I am bound to a contract with Queensland Health. A condition of my employment is that I don't disclose any information to the media or public regarding what happens within the hospital I work. So the sad truth is the public really have no idea what is happening behind closed doors - until it's happening to them.
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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?
Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.
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