MRSA OUT OF CONTROL IN NHS HOSPITALS

The hospital where two people, including a previously healthy nurse, died from a new strain of MRSA was named yesterday as it was revealed that three further cases had been identified. The University Hospital of North Staffordshire NHS Trust in Stoke-on-Trent confirmed that a healthcare worker and a patient had died after falling victim to a form of the toxin Panton-Valentine leukocidin (PVL) earlier this year.

The pair fell ill in March and September after becoming infected by a bacterium that had not been seen previously at the hospital, the trust said. Six colleagues and housemates of the health worker were found to carry the bug, after staff who had direct contact with the nurse were screened after the outbreak.

There have also been three further cases, one of which was a former patient. The hospital said: "No current patients have been identified as affected. All those affected have been informed and there is no need for any other patient to be concerned. Where screening swabs from members of staff are positive for this, or any other strain of MRSA, they are being given decolonisation treatment and followed up by the occupational health department before returning to work. "With the exception of one infection, it is not clear at this stage whether transmission has occurred within the hospital or, as is more common, in the community which it serves." The hospital said that it was taking advice from the Health Protection Agency (HPA).

Figures for the first seven months of the year show that up to 47 of the 55 patients treated for MRSA-related illness at the hospital contracted the bug within the 1,200-bed site. The eight other patients are thought to have been carrying the infection before admission. The commonly known "hospital-associated MRSA" strains, which do not produce PVL, typically affect elderly hospitalised patients. But PVL attacks white blood cells leaving the sufferer unable to fight infection and putting healthy people at risk. The HPA said that strains of MRSA that produced PVL had been seen in Britain, but usually in the community rather than in a hospital. It added: "This outbreak is the first time transmission and deaths due to this strain are known to have occurred in a healthcare setting in England and Wales." Andrew Lansley, the Shadow Health Secretary, said: "It is time for us to take on the threat of new and more dangerous bacteria."

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AUSTRALIA: ANOTHER DODGY PUBLIC HOSPITAL DOCTOR

It's a lottery what you'll get when you go to a public hospital. The "regulators" say almost anyone with some sort of medical degree is OK. It's the only way they can find "enough" doctors. Paying more and training more are too hard

Coroner Tina Previtera, inquiring into suicides, will report the actions of an overseas-trained doctor to the Queensland Medical Board. Coroner Previtera said yesterday she would provide information to the board on Errol Van Rensburg, who discharged a severely depressed patient, Patrick Lusk, from Cooktown Hospital in April 2005 without adequate assessment. Lusk, 66, a taxi driver, committed suicide two days later.

Ms Previtera, who inquired into the deaths of Lusk, Yarrabah resident Charles Barlow and Kuranda teenager Emily Baggott (Dr Van Rensburg only treated Lusk), also made strong recommendations that Queensland Health, as a matter of priority, "actively implement" its own policies and guidelines for reducing the incidence of suicide. "What the situation now dictates is that everything cannot stay the same," said Ms Previtera. She said Barlow, 36, who hanged himself an hour after being refused a transfer to the Cairns Mental Health Unit, had not been assessed at all "due to pressure on resources". Baggott, 16, and Lusk had been inadequately assessed.

Ms Previtera said Lusk had gone to Cooktown Hospital with his ex-wife, Cheryl Prigg, on the advice of his GP who also provided Cairns Hospital records of his treatment for a previous major depressive illness. "Not only was Dr Van Rensburg's assessment inadequate, but no written referral to the mental health service was made or actively pursued," Ms Previtera said. She also said Dr Van Rensburg had been unable to recall Lusk's death in a sentinel review less than a month after the death. Ms Previtera said Dr Van Rensburg, appearing in the coroner's court, had been observed to be "disoriented, confused, evasive, obtuse, avoidant and vague during his evidence".

She said Dr Van Rensburg had been granted "special purpose registration" by the Queensland Medical Board after moving to Australia in 2002. He had relocated from Cooktown to Cairns on June 14, 2005. On June 30, a doctor wrote to the Cairns Base Hospital medical director expressing "significant concerns" about Dr Van Rensburg's capacity to practise "competently and safely". A Cairns Base Hospital spokesman said Dr Van Rensburg continued to work there under supervision.

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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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