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The NHS will miss its target of halving superbug infections by 2008 and may never be able to control the problem effectively, the Government has admitted secretly.
A leaked Department of Health memo has revealed that officials believe that government pledges to cut cases of MRSA substantially are not achievable, while the even more deadly Clostridium difficile is now “endemic throughout the health service”.
More embarrassing still, much of the memo is devoted to “spinning” the failure to meet the targets so as to minimise its public impact. The memo was sent last October by Liz Woodeson, director of health protection at the Department of Health, to ministers. Politicians and health campaigners said that it deepened the sense that ministers and department officials were more interested in spin than substance.
The memo, leaked to Health Service Journal, states that the target to cut cases of the superbug methicillin-resistant Staphylococcus aureus (MRSA) by 50 per cent by April 2008, set by the former health secretary John Reid in November 2004, is unlikely to be met. There were more than 7,000 cases of MRSA in patients’ blood-streams recorded in 2004, since when the number has dropped only slightly.
“Although the numbers are coming down, we are not on course to hit that target and there is some doubt about whether it is in fact achievable,” the memo said. “The opinion of infection experts is that we will succeed in reducing MRSA bloodstream infections by a third rather than half — and that, even if we had a longer period of time, it may not be possible to get it down to half.”
The memo adds that C. diff is now endemic throughout the health service, and poses an even greater threat to patient health. It gives warning that it is harder to tackle than MRSA, and that some techniques used to cut MRSA, such as alcohol rubs, do not work for C. diff.
The leaked memo sets out six ways of handling the failure to meet the MRSA target, including driving at the target as it is and face the consequences (a policy favoured by Downing Street), extending the target or accepting that it is unworkable and dropping it completely. Another tactic suggested is to enlarge the target to include C. diff, or even all hospital-acquired infections without specifying which ones.
Ms Woodeson admits in the memo that the battle to combat MRSA “doesn’t seem to be having much impact on C. difficile, which is a far bigger problem”. The note quotes figures from 2004 showing that while MRSA caused 360 deaths, C. diff was responsible for an estimated 1,300.
A Department of Health spokesman said of the memo: “We deplore this leak. This paper confirms that from the Prime Minister and Health Secretary downwards, the Government is determined that the NHS should get on top of the problem of MRSA and other infections.” He admitted that progress had been slower than anticipated and that faster progress is needed to meet the target. “We have always said the target is challenging; that is why we set it. We remain committed to this target.”
The memo is the second damaging leak to the HSJ from the department in successive weeks, suggesting that there are disgruntled civil servants prepared to risk their jobs to reveal what is going on.
Andrew Lansley, the Shadow Health Secretary, said: “The Government needs to get a grip. Gordon Brown’s target culture has increased costs with little improvement in care.”
Six ways to fudge a target
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