Political point-scoring over policies to control MRSA confuses real issue

Apr 3 2005

Political point-scoring over policies to control MRSA (meticillin-resistant Staphlococcus aureus) confuses cleanliness with the real failure in UK hospitals - poor hand hygiene and inadequate use of gloves, states an editorial in this week’s 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. Labour 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 staff—providing circumstantial evidence of a link. Importantly, however, comparisons with other countries show that even in US 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: nonadherence to basic infection control.

“Evidence shows that housekeeping programmes are unlikely to have an overall effect on transmission of MRSA unless essential infection-control practices—the use of gloves and hand hygiene—are prioritised. But this is rarely the case.”