Visiting a sick relative in a large and rather well-regarded general hospital over a period of many months, I noticed that the wards and corridors were plastered with wash-your-hands messages, including dozens of posters of smiling consultants washing their hands and captioned, 'If I can do it, so can you'.
I cottoned on quickly. I made a habit of washing my hands last thing before I went to the hospital and immediately on arriving in the ward. There was a basin by the door, plus alcohol gel. I used soap and water and the gel, and only then greeted Uncle Demosthenes and sat down for a natter.
The ward was full of incontinent, bed-ridden old chaps, completely dependent on nurses and health care assistants for all their bodily needs. Often, one of them would cry out for a bed-pan, and usually, he would have to wait quite a while. There were frequent 'accidents'.
A doctor or two would usually come round during my visit. Almost every doctor I saw used the basin and the gel before approaching Uncle Demosthenes or any of the other patients.
The nursing staff, however, never did. Never. Are you listening? NEVER. The qualified nurses usually wore gloves and some of the health care assistants did, too, but not once did I see either a nurse (including the sisters in navy blue) or a health care assistant wash their hands or use the gel before or after handling a patient. Not once.
This is negligence. The solution is discipline. Any member of clinical staff approaching a patient without having cleaned their hands should be disciplined. And therein lies the rub.
It does not matter if a nurse does not wash her hands. The only thing that happens is someone dies, but sick, old people die in hospital anyway, don't they? Of course they do.
No-one will notice that the nurse killed old Ron by being a dirty, negligent nurse. No-one will notice that she didn't wash her hands after handling old Fred's faeces-smeared zimmer frame and before turning old Ron. And if they do happen to notice, no-one will reprimand her (or him). Nurses are 'angels', beyond reproach, and that's an order.
And so the whole thing drifts down to the level of the murderous C.diff. catastrophe we now see in Kent.
I hope there are prosecutions in Kent. I hope individual medical and nurse managers, right down to the nurses, are hung out to dry. Fired. Humiliated and disgraced. And the agencies should get hit badly in their profits, for not enforcing standards among their nurses.
I hope hand-washing police are stationed in every ward, with clipboards and clickers; names should be taken and warnings issued. People fired.
And I don't really give a toss what it costs. It would be money well spent, because the first rule of medicine and nursing is 'First do no harm'. Whatever it costs to make sure that nurses are not killing patients under the noses of supine managers and wicked, bullying union politicos, will be worth it. Not killing the patients deliberately or by negligence is the beginning of health care. You would think.
Before my medico commenters go absolutely, indignantly ballistic, do go and read the whole thing: Prodicus does acknowledge some of the problems inherent in dealing with this negligence, including the lack of management in both hospitals and nursing agencies.
UPDATE: the boss of the hospital has had her severance pay put on hold.
The health secretary has told the trust at the centre of a hospital bug investigation to withhold any severance pay to its former chief executive.
Rose Gibb of Maidstone and Tunbridge Wells NHS Trust resigned on Friday after four years in the post.
Please, do not be too impressed: this is simple government spin again. Seriously, does anyone doubt, once this whole thing has blown over, that Rose Gibb will receive her severence pay in full? Really?
It's pure spin, that is all.
UPDATE 2: it is at this points like this that I like to remind people—especially my medical commenters—that I do know what it is like on the front line.