The politicisation of hospital bugs

By Nick Triggle Health reporter, BBC News

C difficile rates have started to fall

There is probably no subject in health that has dominated the headlines as much as hospital infections.

In the late 1990s and early parts of this century, readers could be forgiven for thinking the NHS was facing Armageddon, as reports suggested MRSA was threatening to over-run the wards.

Within a few years, C difficile had joined the superbug as a permanent fixture in the public consciousness.

So it is hardly surprising that politicians have tried to use the issue to gain favour with voters.

In 2004, the then health secretary John Reid announced - much to the surprise of experts in the field - that MRSA rates would be halved within four years.

The government is struggling to achieve this target - with many saying it was unachievable and only meant to take the pressure off when MRSA fear was at its height.

We get a lot of reannouncements on this issue Professor Hugh Pennington Aberdeen University

The Tories got in on the act at the last election when their leader, Michael Howard, tried to win over voters with a leaflet drop about the high level of MRSA rates.

But he ended up being forced to apologise after suggesting the problems were much worse than they were.

And it has been noticeable that Gordon Brown has made it a priority since he replaced Tony Blair.

Indeed, Mr Brown has been quick to hit the airwaves with various initiatives to curb the threat from hospital infections.

First it was deep cleans, then C difficile fines and now MRSA screening. In fact, most of the infection strategy unveiled on Wednesday had been trailed in the preceding months.

Unimpressed

The approach has left experts unimpressed.

The Lancet recently criticised the deep clean programme that all hospitals have been told they must implement by March as lacking scientific evidence, and accused the government of "pandering to populism".

Joyce Robins, of Patient Concern, agreed.

"The government keeps making announcements, but never makes sure they work.

"I don't think patients have confidence that it is being tackled properly, and don't believe extra money will be available and nurses employed.

"We have had promises before that have not been delivered."

And Professor Hugh Pennington, a microbiologist from Aberdeen University, added: "We get a lot of reannouncements on this issue. And on deep cleaning, I am pretty sceptical.

"It grabs the headlines, but the risk is that you clean the wards and then they get dirty again. This needs a sustained effort."

Quick guide: Hospital infections

But Professor Pennington does acknowledge that the political focus has had an effect.

Latest figures suggest both MRSA and C difficile rates are falling.

Professor Pennington said: "Before there was such an interest there was a lot of complacency in the health service about this.

"Some did not think it was such a risk. Others said there was nothing that could be done about it. But infections are not an act of God. They can be prevented."

It is a theme which Health Secretary Alan Johnson took up when he was being criticised at a press briefing to launch the latest infection strategy.

Mr Johnson came under fire for reannouncing schemes and adopting initiatives which had little scientific basis, according to some.

But he said until ministers took up the fight, there had not been the same level of concern within the NHS about infections as there had been among the public.

"This is where the political input in the NHS really works."

But that input can also have unintended consequences.

The MRSA target is to reduce infection rates to just below 4,000 across England - a figure which is still much higher than many European countries.

Imperial College London expert Dr Mark Enright said progress had been made.

But he added: "There is still an ethos that once you've met your target, you are 'allowed' to have some infections each month.

"Trusts need to move to a different culture whereby they consider every infection avoidable."

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