Transcript of programme
Why can't our hospitals get a grip on the superbugs that are infecting tens of thousands of patients? Is this turning into the most shameful national scandal since Florence Nightingale exposed and fixed the disgusting conditions in our army wards in the Crimea.
Now this week we were treated to the extraordinary spectacle of the government's top health officer having to advise hospital patients to keep bottles of antiseptic at their bedside tables and instructing all visiting nurses and doctors to wash their hands before touching them. Florence Nightingale must be turning in her grave.
What is happening with hospital superbugs? If Florence Nightingale can deal with them why can't we? In a frank assessment, it was judged that NHS hospitals may never be able to control this effectively. 394 trusts were examined and 99 failed to meet the hygiene standard; 55 were inadequate on reducing infections - this was just a self-assessment. The Healthcare Commission will be sending a team of inspectors to judge which of the other hospitals are as clean as they claim.
Joining Richard and Judy live in the discussion were Derek Butler Chair of the Charity MRSA Action UK; the superbug killed his stepdad in hospital; Tom Snowball who survived his brush with the superbug; and GP Wendy Denning.
Richard - We heard you Derek talking about your stepfather on the radio. One of the reasons we got you in this week is because you speak very powerfully on the subject. What actually happened?
Derek - My stepfather had a massive heart attack in September 2003. The prognosis was very poor they said his chances of survival were probably two percent, so we expected him to die, but not in the manner that he did. In a very simplistic term it was nothing I'd ever been prepared for. But his death wasn't the end of it we were upset at the way he was treated by the hospital. My mother wrote a letter of complaint to the hospital, at a meeting with them, four months after his death, they categorically told her that they had kept her informed of everything that had happened, his condition, everything, she didn't believe them so she asked for his medical notes.
On May 28th she received those notes. They stated that he was profusely infected with MRSA in three places.
Richard - and this was the first time that this had come to your attention?
Derek - Yes. But the killer blow was an entry in his notes at the end which stated that the ward had been informed on the 20th December 2003, my mother asked them that night about the test results for the swabs that were taken, they said they hadn't got them back, that entry was put underneath the entry that said he was profusely infected. He died seven days later.
Richard - Can I ask you I know this is a painful memory, but I don't know much about what happens with this particular bug, how did he die, what did it do to him?
Derek - We went in on the day he died and he was curled up in a fetal position, he was going blue from the feet up, his temperature was about 106-107, his heart rate was so fast that it was virtually uncountable, and his breathing rate, I lost count when it got to 60 breaths per minute. I just couldn't keep up with it.
Judy - We must read out a statement from the hospital where your stepfather died, they say they can't comment on individual cases but they take infection control very seriously indeed and it's the top of their list..... You got MRSA as well Tom, what was it like? Richard - what's it like Tom when it's really got you in its grip?
Tom - For the first two weeks I didn't know anything, I was a very ill person, and when I gradually became compos mentis I asked to be put away to die - Richard, what you just felt absolutely lousy, was this pain, sick or weak or what. A combination of all three, Richard - ... just knocked you for six.
Judy - Dr Denning, people are very worried about going into hospital aren't they?
Dr Denning - they are - particularly the elderly.
Judy - we don't want to be alarmist about this but, they are understandably and justifiably worried. This C.Difficile - Richard - that's a new one, Judy - they are claiming that MRSA rates are being reduced by strict attention to hygiene but C.Difficile isn't. What is that?
Dr Denning - It's a bacteria that's carried in normal people, three percent of the population carry it, around sixty percent of infants carry it, but it has a virulent strain that can be quite damaging and actually fatal to older people.
Richard - Am I right in thinking that this is something that can arise if people with infections are given broad-spectrum antibiotics. Which does the job in knocking the initial infection but it also takes away the natural protection and balance in the body that causes this other thing to arise, that's it isn't it?
Dr Denning - that's exactly right. Richard - so why not give specific antibiotics rather than broad-spectrum antibiotics. Dr Denning - we use broad spectrum because they work the best for many infections, - Richard unless it brings on C.Difficile?
Dr Denning - well it doesn't usually bring on C.Difficile thankfully, because most people have a strong enough immune system to protect themselves against getting C.Difficile. Richard - this particular one, why is this the new killer on the block.
Dr Denning, - well I think we are finding out more about it, but also the particularly virulent strain which is difficult to diagnose, because its no longer diagnosed by taking a stool sample, you actually have to have a colonoscopy. It gives you this terribly watery diarrhea, which is quite resistant to antibiotics and you can be very, very unwell with it.
Judy - can we talk about hygiene, because this is what it all seems to come down to. Sir Liam Donaldson said the other week, that in his opinion all patients should have a bottle of antiseptic hand gel wash by their bed and actually ask doctors and nurses to use it, the idea of anyone, certainly, I would not, trained to be polite etc... the idea of confronting a doctor and saying excuse me before you touch me please wash your hands, that is very hard.
Derek - I would like to answer that Judy, how could anyone ask my stepfather to wash his hands. How could he tell the visitors and the doctors and nurses to wash their hands, when he never regained consciousness, that is totally impossible, I can understand where Sir Liam Donaldson was coming from, you cannot put the onus and the responsibility on the patient. Florence Nightingale said the first duty in any hospital is not to do the sick any harm, now with respect if the hospitals have a duty to treat and look after our loved ones in the manner that we would expect, within an optimum care facility in the 21st Century, with respect to hygiene lets get hygiene and infection control in the 21st Century, it is no longer in the 21st Century, what you've got is medicine there, but they can't even get the basics of hand hygiene right. How can you get the rest right?
Richard - I couldn't agree more. Do you think its time for the matrons to be brought back onto the ward, so they can crack whip. Do you think we should take the cleaning of hospitals and hygiene out of the hands of private companies and put it back in-house? Tom - bring it back in-house.
Dr Denning - that's exactly what I think it's terribly important. Richard - do you think nothing else will fix it? Dr Denning - when I was a young doctor the nurses took full responsibility for making sure their wards were cleaner, they were clean and if the wards weren't clean they were responsible.
Tom - "I agree with Wendy, nurses should be taught how to clean; I did it as a nurse." Judy - you were a nurse?"
Richard - I remember when I was a kid in hospital I saw the nurses doing that, thank you very much we could go on about this for a long time, the Department of Health says they are putting infection control as a top priority - Richard well we know that, they are trying to meet their targets, they say that cases are falling by 10%, those are of course official figures, and that we may be heading in the right direction, but clearly not quickly enough. Thank you all.
IN THE GREEN ROOM
On a lighter note. Richard and Judy sign a photograph for Hayleigh Proctor, our mascot pictured at the Memorial Event last week, they wrote "Hayleigh, you look so pretty". Richard poses for the camera, and blows a kiss - at whom? This time Maria is the other side of the camera with celebrity guest Leslie Phillips.