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Cleanliness rules ok

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VOL: 97, ISSUE: 07, PAGE NO: 1

Paul Hateley

Health minister Alan Milburn announced that 'ward sisters now have the authority to crack down on contractors who fail to deliver clean hospitals. They will have the clout that matrons used to have.' Inspiring talk? Not to me. It is in fact a clear admission that removing cleaning from in-house hospital-managed employees to contracting services has clearly failed.

Health minister Alan Milburn announced that 'ward sisters now have the authority to crack down on contractors who fail to deliver clean hospitals. They will have the clout that matrons used to have.' Inspiring talk? Not to me. It is in fact a clear admission that removing cleaning from in-house hospital-managed employees to contracting services has clearly failed.

Many practitioners have been telling managers for years that hospitals were dirty and getting dirtier. That fell on deaf ears in many cases. Perhaps the 'managers' of these services could not see the dirt themselves or felt that cleaning had a lower profile than other services.

So where does the problem lie? Well, first there is the issue of team work. Why are domestics not part of the ward team? The answer is because they are not employed by the same employer as the rest of the team. They are still perceived as contractors, not as health service employees. One cannot blame individual domestic staff for poor standards.

Nationwide 250 hospitals failed to meet core standards when assessed by the Patient Environmental Action Teams. While so much publicity and money is directed towards rectifying the problem, I still wait for someone in 'officialdom' to tell us why they believe it has been allowed to get so bad. The reality is a brutal cost-saving programme, targeted over many years at domestic services.

In the wake of evidence that hospital-acquired infections kill 5,000 people per year and cost the NHS over £1bn annually, are a few extra thousand pounds invested in domestic services to keep hospitals clean really such an issue? However, investment needs to be sustained. More importantly, the culture needs to be changed so that we can once again nurse our patients in a safer environment. We don't need to be told hospitals are dirty. We all know that. What we need is an infrastructure that will help us get them clean.

As for ward sisters, let's empower them but remember that their role is one of clinical leader, not domestic supervisor. Not only must ward leaders be given responsibility but also authority. They must use both wisely and, more importantly, they must demand the resources to ensure that standards are raised.

As for our clinical leaders having the clout of the old matrons - I would prefer us to look forward to clean hospitals where our 'new matrons' can advance the art and science of nursing, affording optimal standards of nursing care to patients, knowing that at least one risk has been reduced. This will never be achieved if other departments' problems are consistently laid at the ward sister/clinical leader's door.

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