[lettie]

There are a few issues here. TB, HIV, Hep B etc and the migration to this country have been discussed in the alarming health stats thread in the Hints tips and advice section. Hospital cleanliness is a different ballgame.
There are a few issues with that one especially pertaining to MRSA. In the late 80's hospital cleaning services were privatised. Contracts went to the lowest bidders. To be the lowest bidders the company's cleaning staff were paid less and less was spent on equipment ie cleaning cloths. If you are being paid a pittance and made to make one cloth last a set amount of time, would you put your heart and soul into your job? Our cleaners used to be part of the ward team and under the supervision of the ward sister They were valued as a part of that team and therefore worked their asses off. Nowadays a cleaner may have to clean a few wards under the supervision of a domestic supervisor, who the wards will see once in a blue moon. The cleaner has limited time on each of those wards and no longer feels part of any team.
General hand hygiene. Nursing staff are pretty good at handwashing, you only have to look at my hands to see the damage that handwashing with these soaps and gels does. Medical staff are not that brilliant at handwashing and often need to be told to do it. Visitors are even worse. I have worked for the Maternity services for nearly 13 years and have yet to see a visitor wash their hands before handling a baby. When I worked on the surgical unit at BRI I never saw any visitor wash their hands before touching a patient. How many people have you visited in hospital? Did you wash your hands?
MRSA is a common bug. Many people who are not ill carry it and it causes no harm until it infects a wound for example. It is very similar in that way to Strep B (which a quarter of the world population carry) Patients, visitors and staff are not screened for MRSA prior to coming into hospital. If they had to screen all staff they would be short of a workforce in an already understaffed, overstretched system. A mate of mine at Preston was screened after an outbreak and was found to be a carrier. She had to have antibiotics which didn't work until she had had several courses. She ended up with a total of 3 months off work until she was clear. She was never at any time actually sick. If all staff were screened there would probably be a very large dent in the workforce. Screening patients prior to elective surgery would probably delay their surgery in a lot of cases and emergencies would have to be reverse barrier nursed in isolation. Hospitals are public places, therefore we have no control over who enters a hospital, so visitors would still bring the disease in with them.
There have been suggestions from the tories that Matron would be back in charge and would have to power to close ward areas in the event of an epidemic. I can tell you as a ward sister that Modern Matrons and Sisters already have that power. If I am not happy with the state of the ward I work on, I will not only say so, but make sure that something is done ie, heavy duty clean.....