A government infection control drive turned-out to be more about public relations than hospital hygiene, writes Paul Burstow MP

"If you're in hospital and there is any chance you can get home, you should be campaigning tirelessly for your release" Michael Foxton, Junior Doctor

The idea that you can go into hospital and come out more ill than you went in, or even be killed through an infection acquired during your stay, is enough to terrify any patient. Ever since the National Audit Office published a report into hospital acquired infections in February 2000, there has been intense pressure on the government to improve the situation.

In 2001 rates of Staphylococcus Aureus (one of the most common infections) were almost 50 times higher than in 1992. Also the percentage of antibiotic resistant bacteria (MRSA) has increased by 2000 per cent. According to voluntarily reported statistics available for the first half of 2002, this trend shows no sign of abating.

In the light of these shocking statistics, I decided to investigate the government's record on combating what are now called "healthcare associated infections". In response to the NAO report, the government trumpeted a "clean-up drive" for hospitals in Autumn 2000. This turned out to be more about public relations than hospital hygiene.

This spin campaign kicked off with a sum of £60 million to finance the clean up of NHS hospitals. Patient Environment Action Teams (PEAT) were formed to inspect wards, comprising NHS volunteers and patient groups. Their responsibility was to grade the trusts on a traffic light system as red (poor), yellow (acceptable) or green (excellent).

To do this the teams looked at 19 categories, but only one was relevant to controlling infections. The other standards were made up of such arbitrary subjects as the appearance of linen and décor, the tidy state of public areas, and even CCTV in car parks.

We now have a situation where MRSA can spread almost unchecked and the taxpayers' £60 million has been spent on making hospitals look pretty. A one-off allocation, there has also been no long term campaign to keep hospitals hygienic and to stop the spread of infections. The second tranche of the government's approach was to publish guidelines for trusts on how to combat infection.

With very little information on how well the trusts are complying with these guidelines, I decided to conduct a survey of infection control teams in 212 NHS trusts. I received 69 replies, a response rate of 26 per cent. Unfortunately my efforts were hampered by the Department of Health press office, who tried to discourage staff from responding. It produced some very worrying findings. I found that many infection control teams did not have the resources to carry out their roles effectively. They were often not consulted in major decisions, such as equipment purchase, and were even sometimes not involved in training cleaning staff!

There were also alarmingly low ratios of infection control staff to beds. In February 2000, the NAO found an average of one nurse for every 535 beds, and concluded that this was unacceptable. Many infection control teams responding to the survey had much lower ratios than this.

The survey also asked about the hospitals' performances in combating infection. One key area in reducing the spread of infection between patients is hand washing. Government guidelines recommend that staff wash their hands after every patient contact. I was told in a parliamentary written answer that compliance with these is "audited by infection control teams". The survey therefore asked the teams if they were satisfied with hand washing in their hospitals. Almost a third were either "quite" or "very" unsatisfied that staff were washing their hands as often as was recommended, with evidence that nurses were more conscientious than doctors.

Another major factor in infection control is the cleanliness of staff uniforms. Six out of 10 trusts responding to the survey admitted that their staff wore uniforms to and from work, thus increasing the risk of infection. The reasons cited were a lack of laundry and changing facilities and not enough uniforms.

Based on my research I have serious doubts about this government's ability to tackle this problem. To date ministers seem to be more interested in spin control than infection control. What is needed is a concerted drive at all levels in the NHS to ensure that the most basic hygiene precautions are being taken.