NHS chasing its tail over superbugs

They beat down one problem and another pops up

A big drop in MRSA infection has brought the NHS within reach of the Government's target of halving rates by this year - but infections caused by Clostridium difficile have risen . In 2007-08 the number of MRSA cases fell to 4,438 - 588 above the target, Health Protection Agency data show. However, in the first quarter of this year a trend of falls in C. difficile bloodstream infections was reversed, with a 6 per cent rise: there were 10,586 cases of C. difficile blood infections in patients aged 65 and over.

A total of 966 cases of MRSA were reported - an 11 per cent drop on the previous quarter and an average of 322 cases a month. In 2004 John Reid, as the Health Secretary, said that infections of methicillin-resistant Staphyloccocus aureus should be cut to a monthly average of 321. At the time that was said to be unachievable. Even within the Department of Health, leaked documents last year showed there was serious concern it would not be met. But the recent fall in cases suggests that high-profile initiatives such as the "deep clean" of all hospitals and introduction of a mandatory "hygiene code" may have had the desired [temporary] effect.

MRSA and C. difficile are carried by some healthy people, but the bacteria can cause illness when they grow unchecked, elderly hospital patients being particularly at risk. Annual figures showed a decline for both infections.

Alan Johnson, the Health Secretary, described the decreases as a remarkable achievement. "Our strategy is clearly having an impact, with our challenging target now within touching distance, but this is not an issue we can be complacent about and we will continue to focus our efforts on reducing infections further," he said.

Graham Tanner, chairman of National Concern for Healthcare Infections, said: "It should be remembered that over four years, more than 20,000 patients have suffered an MRSA infection, and in excess of 200,000 contracted C. difficile."

Andrew Lansley, the Conservative Shadow Health Secretary, said that the Government would not have met its MRSA target had it measured the yearly rates to March. To achieve half of the 7,700 MRSA infections in 2003-04, the NHS would have had to limit rates to just 3,850 cases this financial year, he said. "Every case of a hospital infection is one too many, but in four years Labour hasn't even been able to halve MRSA rates, he said. "They have only got round to admitting they have missed the target by moving the goalposts. This shows just how much they've dithered and delayed over tackling hospital infections."

Murray Devine, Safety Advisor for the Healthcare Commission, the NHS regulator, added: "This is great news for patients. There's no question that there has been a very significant turn around, but the challenge isn't over. This improvement has got to be sustained and infection rates brought down further."

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Huge public medicine failure in Australia: Children wait years for ear, nose and throat procedures

HUNDREDS of Queensland children are waiting up to four years for ear, nose and throat surgery, surgeons say. ENT specialists say the long wait puts them at serious risk of behavioural and learning problems. Specialists say the wait for an outpatient's appointment at Mater Children's and Royal Children's hospitals in Brisbane is about two years. Queensland Health's own figures show that as of April 1 this year, 400 children were waiting for category 3 ENT surgery at the two hospitals.

Research has found children who have untreated ear infections in their early years are at risk of becoming truants and doing badly at school. Yet they can be easily treated by inserting grommets - tiny tubes that give the middle ear a chance to recover from recurrent infection. Other children require operations to remove tonsils or adenoids to improve sleeping and concentration at school.

ENT surgeon Chris Perry conceded the State Government had started to make inroads into elective surgery waiting lists for children through its Surgery Connect program public operations performed in private hospitals. Queensland Health figures reveal Surgery Connect has cut the waiting list by about 10 per cent. The Government expects the program to be able to treat about 45 children with ENT problems each month.

However Associate Professor Perry said Surgery Connect was only a BandAid solution. "I don't want to embarrass the Government," he said. "I think they're trying to do something about it. "But we think Surgery Connect is counter-productive to the development of public hospitals. "They should be spending the money to fix up public hospitals."

Professor Perry said he had a "duty to help these kids" by operating on them via Surgery Connect but he hoped Queensland Health did not intend to make the program permanent. "It's work that needs to be done at night time, when everybody's tired, including surgeons, or on weekends, and that cuts into family time," he said. Surgeons would prefer to see the Government set up elective surgery theatres in public hospitals to "quarantine" non-urgent cases from emergencies. Because of the huge increase in demand on public hospital emergency departments, elective surgery lists are sometimes cancelled because of the more urgent cases.

Specialists raised the issue with Queensland Health Minister Stephen Robertson at the Royal Australasian College of Surgeons' annual state meeting at Coolum, on the Sunshine Coast, at the weekend. Mr Robertson acknowledged the Government needed to do better by treating children in a more timely manner. "I want to see an improvement in wait times for children," he said. He said he would consider creating elective surgery only theatres for children but he said Surgery Connect was probably here to stay. "My personal view is that it would be irresponsible ... where we can identify capacity in the private sector, not to use that capacity if it means that we increase our throughput," Mr Robertson said.

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But there's plenty of money for the health bureaucracy

QUEENSLAND Health bureaucrats have spent more than $800,000 travelling the world over the past two years, a budget estimates committee heard. The hearing was today told non-clinical staff made 69 overseas trips in 2006-07 at a cost of $364,546, and 67 trips between July 1, 2007 and May 31, 2008, at a cost of $464,809. The trips included five senior bureaucrats taking an $80,000 two-week visit to US and UK hospitals in November 2006, and a $50,000 trip for two senior bureaucrats to join Health Minister Stephen Robertson on a tour of facilities in the US and Canada in August 2007.

Opposition health spokesman John-Paul Langbroek said Queenslanders on hospital waiting lists were entitled to ask why they didn't come first. "With such an urgent need for new hospital beds to be delivered and for waiting lists to be tackled, Queenslanders will be wondering why senior health bureaucrats are spending so much time touring hospitals in other countries," Mr Langbroek said in a statement.

Mr Robertson said overseas travel arrangements were under review to ensure taxpayers got value for money from health staff attending conferences and recruitment fairs. "I think it's appropriate every now and then to review that travel budget to ensure it is being used appropriately," he told reporters in Brisbane today. "I'm always worried when I see expenditure going into areas that don't have a direct effect on good patient outcomes. "Just as I look at travel every now and then, I look at other areas of administration to see if there are ways that we can save money and redirect those funds into front-end services."

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