Nadine Dorries used to be a nurse, so David Cameron should sit 
up and listen when she offers him expert advice about cleaning hospital wards. She firmly believes uniforms should be laundered on site, that this would help wipe out infections. What she says makes good sense, and you can read it here.
It made me reflect on my recent personal experiences at the University College Hospital, London with my son David. This is what I observed.
I went to the loo where the seat was soaked with urine and the sanitary bin full and overflowing. I was washing my hands when a cleaner shuffled in, she looked left at the wall, then right. She did not look in the loos. She then turned around and shuffled outside where she had her cleaning trolley, then she shuffled along the corridor with it.
In the ward kitchen, shared by families of kids with cancer, there was an immense pile of dirty crockery. There wasn’t one clean mug and I wanted to make a drink, so I asked a nurse for some rubber gloves to get stuck in. She told me the cleaner would do it shortly. The cleaner arrived, handpicked which crockery to wash (separating anything used by a patient’s family). She left a pile of dirty mugs on the draining board and wiped around them. Suffice it to say that watching her cleaning techniques, I would not have wanted to use them.
My son’s bedside cubicle had a large sample of stale urine left in it when we arrived and he was supposed to place his personal belongings there. It smelt awful. The ward nurse was very cross about it and filed a report. He told me they had great difficulty in recruiting good cleaners.
Parents also described how they offered to move from their bedside seats to give cleaners easier access around the bed, but the cleaner ignored them and said it wasn’t necessary, so the area was not cleaned.
Regarding Nadine’s point on restricting hospital visitors, I saw a very large number of exotically dressed Eastern Europeans in the hospital lobby and my curiosity got the better of me, so I asked one of the woman where they came from. She said they were Polish Romany gypsies, that her mother had been admitted with heart problems. On one day,she told me there were 100 of them of all ages waiting to visit the sick women. There must have been 30 or 40 the day I saw them. She told me they had travelled from around the country, fearing the worst, but thankful to God that she had pulled through. I have no idea how many visited her bedside at any one time.
And why is it not mandatory for everyone to wash their hands with sterile cleaning fluids when they enter a ward? This was mandatory on our cruise last summer whenever we re-entered the ship from a shore visit and ate in the restaurants. The staff were fanatical about it, they were always hovering around with their dispensers.
A main difficulty seems to be in finding dedicated cleaning staff who will do the job properly, their managers should not allow them to get away with shoddy work.
What a horrific experience to find stale urine in the locker. What you observed is truly frightening. But I have to say I blame what were originally Tory policies of “contracting out” and turning hospitals into businesses so that they are managed by non-medical cost-cutters.
Elle,
the thing about ‘contracting’ out cleaning, is that they sounded like a good idea if not necessarily cheaper than in house cleaners.
The problem that a cleaning firm can pick up the contracts by promising the earth, but then struggles to get ‘dedicated’ cleaners, who are regular – because they are not offered the same deal as regular employees are offered, ie: regular hours, good pay, holiday pay or sickness benefits.
Add to that the fact that a lot of the time cleaning contractors have to resort to casual workers – who may or may not turn up for work because they may or may not get paid or fair pay.
The irony is that most of the savings if any that are ever the reason or excuse for contracting out cleaning and other services, soon translate to higher costs and lower standards (caused by cost cutting) it is the nature of the beast.
When we had doctors working exclusively for the nhs, the world may have not been perfect, but privatisation may have offered ‘choice’ the choice to charge more, there is no proof that it has offered the patients a better choice. Except those who can pay now have more people after their money, and there are less doctors to treat those who cannot pay.
Whatever ‘petty’ savings might have originally been envisioned from contracting out cleaning services – ie no guaranteed job, no guaranteed holidays and no guaranteed pensions for the cleaners – has been lost by the increased costs of contract cleaning by cleaning firms. Of course the contracts can be changed and given to a new firm, but all the cleaning firms are faced with the same dilema – not enough regular and committed staff.
Of course the world is not perfect, but shifting responsibility – in this case from hospital management to a cleaning contractor – does not guarantee improved services. Whereas as we know a well paid staff with job security (good holidays, pensions & health insurance) is the secret of any & every successful firm.
I fear what Welshcakes has said is true. Even here in Canada. Cleaning has been contracted out in the hospital where I worked for 18 years and it has suffered the consequences. The workers who took pride in their jobs were replaced by contracted staff at half the wages and so why should they exert themselves for so little. Well they could do it out of pride but apparently not. Consequently hospital acquired infections are on the increase. So you spend the money you saved on antibiotics and longer hospital stays. Total madness.
This is micromanagement.
The real answer is to empower patients, and that means an insurance scheme where patients choose the hospital and the money goes to that hospital. When I can tell a hospital manager that next time, I’ll take my operation and my money elsewhere, then we’ll get cleaner hospitals. The worst hospitals will simply have to sort their act out, or get eliminated.
When my son was in hospital with suspected meningitis the room was so filthy I could have scraped the black muck off with my finger nails, it was that thick. The cleaners came in and dragged a dry brush in an arc around the bed, never under it and never in the corners etc. My toddler wanted to amble on hands and knees around the floor, you can imagine how I responded. As a single mum I had to be there with both my children, I informed ‘daddy’ who, after repeated pleas from me, deigned to wave to me through the door of the ward then backed away when the door was opened; he didn’t want to catch anything and to ask for his help in such circumstances was apparently selfish of me. It was xmas and even father xmas, a stranger, stood at the door of my childs private room and waved to him.
Giving birth to my beautiful boy was so stressful I just don’t want to remember it; generally speaking the midwives seemed to consider any inmate in need as a nuisance. Before the birth I had many scares and it was touch and go whether I would loose him. After one near thing I pulled the curtains and quietely had a little cry. A nurse came behind the curtains and I explained and I was told in no uncertain terms how stupid I was (this view was relayed to another nurse in front of me) and I was told not to break the rules of the ward again. The midwives ignored everything they could and never answered a call for help. When I couldn’t walk I was left in stale blood and after dragging myself to the bathroom found them filthy. I was eventually moved to a private room because I’d developed an infection.
Nursing shouldn’t just be administering drugs or giving injections and the like, it’s caring for people, it’s helping them, gently, to wash and to eat and to get the things in life that are necesarry to maintain health and want to keep living. In my opinion that includes having authority over cleaning staff. The chain of authority over cleaning staff should be with the matron who should have responsibility for a hospital ward. IMHO the matron should see to the behaviour of her staff and that should include cleaning staff.
Why even bother to raise the fact that the large number of women waiting to see their friend were Polish, and descended from the Romany? It smacks of nothing but the most insidious form of prejudice- their nationality is utterly irrelevant to the issue of hospital cleanliness or the number of visitors- both of which are exceptional and worthy issues to address. I wonder, would you have made the same point about a large number of ladies identically dressed in Laura Ashley?
Anon, 2.36, I take your point, and wondered about it at the time of writing. But I was merely being factual, please don’t misinterpret that.
I recently had a knee operation, fortunately on my insurance, the private wing was spotless, the NHS wing was like something out of Scutari. I cannot see why we have to put up with this when French/German Hospitals are spotless.
I suspect management priorities have a lot to do with it, getting patients home without infections they came in with not being one of them
lol Guthrum,
I wonder why the management on the NHS wing can’t hire the same quality cleaning staff as the private wing. Or maybe the joke is that the NHS is paying for the cleaning of the private wing – so there are no funds left to clean the NHS wing. Alas, NHS cuts to pay for privatisation.
One thing is for sure the best way to provide a better service for patients able to pay (and on higher incomes and with careers where the employer subsidises private health insurance) is by reducing the amount the government and the NHS on the NHS, and more on private hospitals – lol
Are privately hired cleaners paid more and treated better? Or are they managed better?
I truly am sick of the constant cry of “but things are better in France/Germany/Scandinavia”- Yes they are, but that is because they very rightly pay more tax. If it weren’t for Conservatives (small and large C) wanting to hold onto all their cash and not pay more tax, then we could have a healthcare system like theirs. Tories moan incessantly about the state of public services, and yet somehow never seem to want to place their hands in their own pockets.