MRSA today

LibDig This!

Richard Branson today outlined things he'd like seen done to tackle MRSA, including coming down hard on hospital managers in 'failing wards'.

There are two truths which the public debate seems to be missing.

It is a horrible reality, but one we have to face up to, that untreatable MRSA is rife through UK hospitals and it cannot be removed. If you enter the average hospital and stay there for five weeks you will almost certainly contract MRSA. If you are in a number of typical vulnerable states MRSA is threatening. Moreover if you are elderly or already in a severely weakened state you are likely to pick it up much more quickly. Despite what Branson says, there's not much that can change this fact, least of all tough penalties on manages who haven't the power to improve the situation.

However there are simple and straightforward changes which could be made to markedly limit the spread of MRSA, and therefore unnecessary and currently inevitable deaths caused by it.

Firstly, it is not always the case that a patient, even on an elderly ward, diagnosed with MRSA is then isolated. This is not through incompetence on the behalf of nurses, managers, doctors or anyone else, it is because there aren't enough beds in isolation. Under Labour beds have been cut and in their place managers employed to haggle over them at a local level, supposedly optimising efficient use of resources. It is currently impossible for managers to justify the isolation of such large numbers of patients with MRSA, even if there are more as a result of their being quartered with other patients, who are often in a vulnerable state. The mechanisms surrounding distribution and the lack of identification of this for investment is at fault. This is a political issue.

Secondly, MRSA presents a classic case of where accountability is not necessarily healthy in all forms in the medical profession. An elderly patient who has been admitted for observation while weak may quite easily contract MRSA, or other even more fatal conditions like pneumonia (essentially through being inactive). After the initial tranche of tests, the value of their continued hospitalisation is actually sometimes questionable, especially considering the risks to themselves and to others if they then contract MRSA. Yet currently doctors might well be unwilling to recommend the patient be released because of the threat of litigation. If the patient dies (a strong possibility) in hospital the doctor cannot reasonably be held liable as the patient was treated properly to the best of everyone's abilities. If they are sent home and then pass away questions may be asked by upset family members. There is currently no provision for doctors to make the decision, without fear, to send a patient home to both prevent MRSA contagion and the onset of conditions like pneumonia. Of course once the patient contracts the conditions the proverbial horse has bolted and the patient is often better off remaining in hospital, even though their chances of survival might by now be extremely slim.

I feel these are justifiably political issues, and ones that appear to have been ignored again.