Lancet slams Brown on hospital hygiene

LONDON (Reuters) - Hospital hygiene measures to tackle superbugs announced by the government this week are populist moves that will have little effect by themselves, a leading medical journal said on Friday.

Prime Minister Gordon Brown stresses a point during a question and answer session at the annual Labour Party conference in Bournemouth, southern England, September 26, 2007. REUTERS/Dylan Martinez

In an editorial, the Lancet said plans outlined by Prime Minster Gordon Brown and Health Secretary Alan Johnson to deal with deadly infections such as MRSA and C Difficile were not based on scientific evidence.

Brown and Johnson announced a clampdown on infections and hospital cleanliness, including a 50 million pound ward-by-ward deep clean of hospitals.

All medical staff, including doctors, would have to abide by a “bare below the elbows” dress code and wear short-sleeved tops. The weekly journal said Brown had “grasped the wrong end of the evidence stick” over deep cleansing of hospitals.

“Disinfection of high-touch surfaces is what is needed, more so than removing visible dirt,” it said.

“The public understandably wants clean wards and crisp uniforms, but politicians must stop pandering to populism about hospital cleanliness and listen to the evidence.”

It said the proven way to stop hospital-acquired infections was to make sure that doctors, nurses and visitors wash their hands properly.

The journal said Johnson’s own working group had found no conclusive evidence that uniforms or work clothes posed a hazard in spreading infection.

The working group resorted to ‘informed common sense’ - a level of evidence just above guesswork,” it said. The Lancet’s criticisms were supported by medical researchers, who said deep cleansing of hospitals would have little effect without other measures in place.

Ron Cutler, a lecturer in infectious diseases at the University of East London, said person-to-person transfer would remain the main problem with MRSA and C Difficile, and deep cleansing would offer at most a temporary benefit.

Richard James, professor of microbiology at Nottingham University said ward-by-ward cleaning would make very little difference to MRSA transmission, although it might have more impact with C Difficile which can be passed through contact with faeces.

The government’s Chief Nursing Officer, Christine Beazley, said the announced moves were just part of a wider set of measures to reduce hospital acquired infections.

“The fact is there is no single remedy,” she said. “Infection control is a complex problem that needs a complex solution.”

Latest figures for 2005 from the Office for National Statistics show C Difficile was a factor in more than 3,800 deaths across the country while MRSA contributed to 1,629 deaths. Infections with MRSA are falling from a peak in 2003 but C Difficile cases are still on the rise.