Are Government targets undermining the fight against hospital superbugs?

One of the leading clinical organisations has accused the government of putting targets before patients in a damning report published recently. The British Medical Association's Board of Science has said that patients are being put at risk from hospital bugs such as MRSA and C. difficile because of political targets. Pressure to treat too many patients too quickly and keep beds occupied leaves little time for proper cleaning, according the BMA's report.

The report shows the UK second in an international league of hospital infections - just behind Sweden - although the numbers are gradually coming down. However, recent figures seem to back the BMA's report, showing that although down dramatically on last year's figures, numbers of MRSA and C. difficile infections are creeping back up. The claim is that government policy is putting patients in danger because there is neither enough time nor resources to ensure that deep cleaning methods are effectively employed on a regular basis. The report says that short-term solutions are backed by little or no evidence that the methods actually work and that longer-term strategies are needed to ensure the safety of all patients at risk of contracting superbug infections.

Doctors are unanimous in their support for the call for longer term measures to combat the spread of MRSA and C difficile, but are increasingly concerned that hospital targets are getting in the way of devising an effective strategy that will be applicable across the NHS. A 'belt and braces' approach to clinical hygiene by medical staff (both washing hands with soap and water followed by the use of an alcohol gel) is a fundamental aspect of that process.

The problem is that it only takes one incident of a member of staff or, more likely, a visitor to the ward forgetting that process for the infection to claim another victim. Deep cleaning of hospital wards is considered to be reasonably effective but only if all the other measures are put in place as well and it is part of a package of preventative measures, carried out religiously and to the highest possible standards. The worry is that the need to meet targets may undermine the good intentions that pave the way to superbug eradication.

The principle aspect of medical negligence claims is not just to provide compensation to victims of what can be regarded as lapses in the normally high standards set in the NHS. They are also an essential way of highlighting errors and aspects of the running of a unit that may have led to a failure in the duty of care towards patients. It is through repeated exposure to the truth of the situation that has helped prompt the NHS and health authorities to take measures to combat the spread of MRSA. It now seems that the health professionals on the front line feel hampered by pressure to meet targets rather than ensuring that every possible measure is taken to protect the vulnerable from superbugs.

A 1999 study found that infected patients stayed in hospital for an additional 11 days, costing the NHS an extra £3,000 per person in additional treatment. Add to this the mounting costs of patients suing the NHS and it is obvious that this money would be better used in a concerted and co-ordinated effort to produce a long-term solution. Medical negligence cases are spotlights on the failings within a system that is battling hard to provide patients with the best possible care. If they are being scuppered by accountant's calculators and increased pressure to meet government targets that take no account of the underlying price both to patients wellbeing and the cost of maintaining a clean environment, then the battle against the superbugs has a new enemy - the state itself.