Deep Clean? More Like a Whitewash.

Dr Rant has finally seen evidence of Gordon Brown’s ‘Deep Clean’. And he is not impressed.

The idea behind the ‘Deep clean’ is a false one to begin with. In order to reduce ‘Hospital acquired infections’, el Gordo has proposed giving every hospital ward in the country a good clean. He has proposed removing ingrained dirt, assuming that it will lower nosocomial disease, such as MRSA, and Clostridium difficile.

It will not. MRSA is spread by a contaminated carrier either sneezing on you, or touching you. Staphylococcus aureus acquires resistance when a healthy individual is given unnecessary antibiotics. One in three of us have several million Staphylococcus hiding up our nostrils, with no ill effect. And of those, one in ten will have assymptomatic MRSA. Patients who develop MRSA septicaemia either catch it from their own body, or from someone else’s nose. They do not catch it from a bit of dust on the floor.

Likewise, ‘C diff’, or Clostridium dificile is not an organism that you will catch from a dirty door-handle, unless someone has shat on it first. Human faeces is full of bacteria. And average turd will have millions of E coli bacteria, millions of bacteroides bacteria. And also a large amount of Clostridium. C diff infections usually start when a course of antibiotics is given to an unwell person admitted to hospital, and those antibiotics kill off the rest of the bacteria present in the bowel. Unopposed, C diff then starts to cause problems, such as pseudomembranous colitis and really shitty diarrhoea. This shitty diarrhoea gets everywhere. Especially onto other patients’ beds, which are usually 18 inches away from affected patients.

So, the ‘Deep clean’ will not affect the two well known ‘super-bugs’. What will it achieve?

Well, today, Dr Rant saw some of the deep clean team at his local hospital. He knew that they were the deep clean team as they had bright yellow tee-shirts with ‘Deep clean’ on them. He watched one of them push dirt from one part of a window to another. And watched a large number of them wait by a lift, speaking what sounded like an African language.

Quite simply, the ‘deep clean’ team is simply a collection of migrant floor-cleaners, who are mopping hospital floors rather that the local McDonalds. They are not highly trained infection control workers. They are not using state of the art cleaning equipment (Dr Rant does not consider a mop to be ‘state of the art’). And they do not appear to be doing anything more than a routine hospital cleaner would be doing.

Except for the bright yellow tee-shirt, of course.

The problems with hospital acquired infections is that NHS hospitals require far more than a simple mop and bucket. Washing a layer of dirt of a twenty year-old Skoda car will not hide the fact that it has a crap engine.

Perhaps El Gordo and his postman pal would like to address some of the following problems?

• Increasing the number of nurses per patient, so that overworked nurses have time to wash properly.

• Reduce the number of beds on each ward, so that patients do not share every last fluid ounce of vomit, faeces and piss.

• Reduce bed turnover to a safe rate. If your bed is still warm from the last patient, then something is wrong. Instead, give wards a chance to clean the bed, the floor around the bed and the bedside cupboard.

• Encourage hospital to have ‘in-staff’ cleaners. Most hospitals employ outside cleaning agencies, who go on to employ staff at the cheapest possible wage, with as little encouragement as possible. These agencies are prepared to take as few risks as possible, so tell their cleaners to have as little patient contact as possible. So as a result, hospitals end up with poorly motivated immigrant cleaners, who refuse to clean up vomit from under a patient’s bed.

• Banning relatives from wards. Other countries such as Japan do not allow visitors to wards unless they have washed their hands. In the UK, we sometimes have a sign saying ‘please use the handwash gel’. Visitors with colds and obvious infections are not prevented from entering wards. Until there is some sort of barrier, friends and relatives represent a vector for all manner of infections.

• Screen staff for MRSA. As detailed above, one in thirty people will have MRSA contamination up their nose. This is probably higher in hospital staff. This can be removed with eradication programs, using nasal creams and facewashes for two weeks. However, can the NHS afford to have over one in thirty of its workforce take two week’s enforced sick-leave?

Until all these are done, the NHS will continue to be ‘dirty’. Telling doctors to remove their ties and watches will make fuck-all difference when patients are practically shitting on each other because of ward over-crowding. Four hour A+E waits force patients onto wards that have not yet been cleaned. And existing cleaners are neither motivated nor encouraged.

Gordon Brown is a second hand car salesman. He can polish his twenty year-old Skoda as much as he likes. But his ‘Deep clean’ is nothing but a shallow, ineffective, vote-massaging exercise.

He should be reminded of an old Swedish saying:

You cannot polish a turd.