comment: Hospital infection fears could be a huge influence on choice

Published: 12/08/2004, Volume II4, No. 5918 Page 15

Many will have dismissed Claire Rayner's views about hospital-acquired infection as naive at best and hysterical scare-mongering at worst (The Big Story, pages 10-11). But the implications of Ms Rayner's statement that she would have to be seriously ill to risk visiting a hospital and contracting MRSA (methicillin-resistant Staphylococcus aureus) should receive careful consideration.

Ms Rayner, as president of the Patients Association, is an influential figure. But, more importantly, she has thrown into sharp relief an issue which could be a defining one in a patient choice-driven NHS.

Offer people the option of being treated at a three-star (or foundation) trust or hospitals with fewer stars but a better performance on MRSA, and which do you think most would choose? The same would be true if stars were replaced with almost any other measure - including clinical or waiting-time indicators.

In terms of influence on patient behaviour, MRSA has every chance of becoming secondary care's MMR (measles, mumps and rubella) vaccine, except that in the case of MRSA there really is cause for concern.

The recent deadline for the HSJ Awards passed, with the patient access category attracting almost four times as many entries as patient safety. This is no surprise: not every problem can be tackled at once, but it is a useful reminder of where patient safety stands on the 'to do' list. Many health service managers would like it to enjoy a higher profile, but find they lack the necessary incentives or policy guidance to help them deliver change as fast as they would prefer.

Our cover story suggests some ways in which this might change, but a further move in the right direction could and should now come with the transfer of NHS Estates' policy function to the National Patient Safety Agency.

The inclusion of issues such as cleanliness and building design in the remit of a patient safety body is likely to produce significant changes to the messages the NHS receives from the centre.

But in the long run, perhaps the greatest change may be driven by the 'democratisation of the NHS' addressed by both Jon Glasby and Richard Lewis (Speak Out, page 17; the Columnist, page 19). Give the public a greater say in local planning and policy decisions and HAIs are likely to achieve the kind of attention councils give to refuse collection and road repairs as elections loom. l