TMP editor, Chuka Umunna, reflects on the Healthcare Commission’s report on the Maidstone and Tonbridge Wells NHS Trust.

No one could fail to be appalled at the Healthcare Commission’s findings that 1,100 patients contracted C difficile at the Maidstone and Tonbridge Wells NHS Trust’s three hospitals between April 2004 and September 2006. A total of 345 patients with multiple medical problems died and the commission concluded that 90 patients “definitely or probably” died as a result of infection.

Though C difficile is on the rise in our hospitals, to some extent the facts are confined to this particular Trust – there were undoubtedly serious failings in management at a local level. The Trust did not adopt the government’s new hygiene code – introduced in October 2006 – until March of this year. Investigators came across contaminated bedpans, overflowing needles and sharp instruments in bins. They even found that staff stored food in medical refrigerators – you don’t need a government code to tell you that is bad practice.

But there is a bigger issue here which public services union, Unison, has drawn attention to – the decline in hospital cleaning staff. Since the 1980s, when the contracting out of cleaning services started, the number of cleaners has almost halved – from 100,000 to 55,000 in 2003-04. These are staggering statistics when one considers that NHS infrastructure has grown and many new hospitals have been built – one would have expected there to have been an attendant rise in cleaner numbers, not a reduction.

So as the NHS has physically grown in size and the number of cleaners has dropped, those that remain presumably have somewhat more work to do. To add insult to injury, with the contracting out of these types of services, often comes less favourable terms and conditions and a wage that one would struggle to live off, as so ably demonstrated by Polly Toynbee in her book, “Hard Work: Life in Low-Pay Britain” (in which Toynbee documents her time working as an NHS porter). It is perhaps little wonder therefore that hygiene standards have fallen.

The Chancellor deserves credit for announcing in the Comprehensive Spending Review that £140million will go into combating C difficile and £130 million will be spent screening all patients coming into hospital for MRSA over the next three years. However, unless we increase the number of cleaners in our hospitals, pay them a decent wage and treat them properly, this extra money may all come to nothing.

Chuka Umunna is editor of TMP.  You can watch him on the latest edition of BBC One’s Question Time programme here.