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Political point-scoring over policies to control methicillin-resistant Staphlococcus aureus (MRSA) confuses cleanliness with the real failure in UK hospitals -- poor hand hygiene and inadequate use of gloves, states an editorial in this weeks issue of The Lancet.
With a general election looming, all major political parties in the UK have seized on public fears about the health implications of unclean hospitals to fuel arguments over the rising rates of infection with MRSA. The Labor party has pledged to give power to patients to monitor cleanliness of NHS hospitals, the conservatives want to give matrons the power to close unclean wards; and health minister John Reid is now considering proposals to charge hospital bosses with corporate manslaughter if patients die from infections acquired in hospital. But the focus on pleasing the public means these policies are missing the point, states the editorial.
Critics of the UK government policy point out that increases in deaths from MRSA have occurred simultaneously with outsourcing of hospital cleaning staffproviding circumstantial evidence of a link. Importantly, however, comparisons with other countries show that even in U.S. and Japanese hospitals, which are prized for their cleanliness, MRSA thrives.
The Lancet comments: This tit-for-tat political posturing has certainly helped keep health in the public eye. But none of these policies reflect the real failure in UK hospitals: non-adherence to basic infection control.
Evidence shows that housekeeping programs are unlikely to have an overall effect on transmission of MRSA unless essential infection-control practices -- the use of gloves and hand hygiene -- are prioritized. But this is rarely the case.
Source: The Lancet