Health matters - Infection control crisis

Infection control crisis
In FRFI 199 we reported on the spread of MRSA and Clostridium difficile infections which resulted in the deaths of 30 people in Stoke Mandeville hospital in 2004. Now in a further scandal, a lengthy report from the Healthcare Commission on deaths related to Clostridium difficile at the Maidstone and Tunbridge Wells hospitals in Kent found that 1,100 patients contracted Clostridium difficile at the Trust’s three hospitals between April 2004 and September 2006. 345 mainly older patients with multiple medical problems died. The Commission concluded that 90 patients ‘definitely or probably’ died as a result of the infection and blamed the hospital trust board for paying too much attention to balancing the books and meeting government waiting time targets. The Commission said the trust failed to protect patients because the trust board was unaware of the first outbreak and slow to react to the second. Inspectors found contaminated bedpans, overflowing buckets of needles and sharp instruments, and food stored in medical fridges.

In Wales, cleaning is now performed by in-house staff rather than by contractors and the MRSA infection rate is less than half the English rate. In late October a further Healthcare Commission review found that there was inadequate patient protection from infection in 111 out of 394 organisations and that a quarter of NHS Trusts in England and Wales failed to comply with the basic hygiene code introduced in October 2006.

Destruction and privatisation
In his first few weeks as prime minister, Gordon Brown gave the impression that he was slowing down on NHS privatisation. This is not the case, however. In October the government announced that 14 private companies will be advising on or taking over the commissioning of the majority of NHS services. The companies include KPMG, McKinsey, BUPA, Aetna, Humana and UnitedHealth. In the US, UnitedHealth has just paid $20 million in fines for failure to process claims, failure to respond to complaints and delayed payments. Aetna and Humana have repeatedly been fined over recent years for various misdemeanours including the use of unlicensed agents, payment delays, failure to give information and fraud. Simon Stevens, the European president of UnitedHealth was previously adviser to Tony Blair and his health secretaries.

Following his review of London health services, Ara Darzi has called on the remaining nine Strategic Health Authorities in England to prepare similar reports for their areas. A central recommendation of Darzi’s London report was the development of the primary care polyclinic structure, serving populations of 50,000 and replacing traditional GP practices. The likelihood is that polyclinics will become a crucial part of health service delivery elsewhere. Given that Darzi has been one of the main promoters of Independent Sector Treatment Centres run by private companies it is likely too that polyclinics will be privately-provided. A further step will be taken on the road to complete privatisation of health services.

Stop privatising health care!
Defend universal health care provision!

Hannah Caller

FRFI 200 December 2007/ January 2008


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