A hospital where 16 patients have died in the last six months as a result of contracting Clostridium difficile harboured a catalogue of major hygiene failings, it was disclosed last night.

Nicola Sturgeon, the Scottish Health Secretary, told the Scottish Parliament that many commodes in the Vale of Leven Hospital were not fit for use and needed replacing, there was a lack of hand basins in patient and clinical toilets, and protective cloths and aprons were not readily available. She also said that bed spacing throughout the hospital fell short of health and safety recommendations.

The minister told MSPs that she had ordered an inquiry into what she described as a shocking state of affairs at the hospital and that she was instructing health boards throughout Scotland to ensure that surveillance systems for C. diff were fit for purpose in every hospital under their control.

In all, 54 patients contracted the superbug at the Vale of Leven. Ms Sturgeon said that the cases had only come to light as a result of a retrospective investigation by Greater Glasgow and Clyde Health Board. Twenty-three of those patients have died, with the infection directly responsible for eight of those deaths.

Ms Sturgeon said: “The safety of our patients is paramount. A thorough review will take place over the coming weeks to identify the circumstances that led to the situation at the Vale of Leven and I am determined to ensure that the lessons to be learned from this exercise will help us to drive C. diff infection rates down and indeed reduce the risks to patients.”

The review, to be led by Professor Cairns Smith, the professor of public health at the University of Aberdeen, will examine the circumstances surrounding all 54 cases. It will also consider the surveillance systems and infection control procedures in place at the Vale of Leven, as well as the facilities, procedures and systems now in place at the hospital.

Ms Sturgeon said that the reports she had received from NHS Greater Glasgow and Clyde raised “serious cause for concern”. She told MSPs that these suggested the surveillance system in place at the hospital was “inadequate” and did not alert health board bosses to the number and pattern of cases. She said that an examination of the hospital by the infection control team had identified “serious issues about infection control”.

She added: “These issues had been raised by staff over a number of years.”

The Health Secretary said that the health board was taking action to address these issues. She told MSPs that systems had been stepped up and there was a “concerted drive towards improving hand hygiene”. There would also be an “urgent review” of the use of antibiotics - which are known to reduce the body‘s natural defences against C. diff. Greater Glasgow and Clyde health board has also given a commitment to refurbish and upgrade facilities at the hospital, and is opening an extra ward to improve bed spacing.

The board has also invited Health Protection Scotland - the body set up to strengthen and co-ordinate health protection in Scotland - to review its infection control procedures to ensure they meet national standards.

Ms Sturgeon said: “While I am pleased that these steps have now been taken, and indeed to have the board‘s commitment to refurbishing and upgrading facilities at the hospital, it is nevertheless my view that the case for an independent review is overwhelming.

“The public need to know why the surveillance systems and infection control procedures did not work as they should have done. They are also entitled to assurances that the actions being taken are adequately addressing the key problem areas and don't fall short in any way.” She added that she had asked for the report and its recommendations to be completed by the end of July.

The Health Secretary said that the situation at the Vale of Leven raised wider questions about the surveillance of C. diff within the NHS. A series of measures were being taken, she said, including: infection control managers being asked to review their data on C. diff over the past six months; health department officials contacting all other NHS boards to make sure their surveillance systems were working; and Health Protection Scotland collaborating with government officials to prepare new guidelines on C. diff.

Ms Sturgeon said: “Taken together with the results of the independent review, this action will allow us to determine how procedures could and must be improved across Scotland.”

Health chiefs at NHS Greater Glasgow and Clyde announced that they would co-operate fully with the review team. A spokesman said: “In the meantime our own outbreak control team, chaired by Dr Syed Ahmed of the public health protection unit, will continue its investigations.”

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