Monday, March 2, 2009

Scrubbing out the superbug? Yeah...sure....

Today's Straits Times also carried a report entitled "Scrubbing out the superbug". It's no easy task, and we are dealing with a smart bug (Staphylococcus aureus) that's able to develop resistance as fast as we are able to produce drugs against it.

The problem is set to get worse, with no real end in sight. I am not so hopeful it can be scrubbed out.

Reading the report I was particularly struck by the apparent reality that we actually know what needs to be done, and yet mysteriously are not able to do what needs to be done to "scrub out" this bug. NUH says it wants to have more MRSA (methicillin resistant Staphylococcus aureus)-free wards but are constrained by a "tight bed situation". Good hand hygiene of health care providers is paramount, yet compliance is low, and there is no process in place to check compliance. Doctors drape stethoscopes around their necks like ornaments to be brought to public areas. NUH's Prof Tambyah says MRSA infections should be notifiable. But it is not.

It struck as me as odd that hospitals 'try' to tackle this community problem at their level while keeping a half-cocked eye on their bottom lines. The Ministry of Health knows what needs to be done, yet seems to by pussyfooting around with 'guidelines' to the hospitals they 'regulate' - guidelines which nobody reads and nobody enforces. It seems to me more than a bit odd.... a bit like asking Jurong Town Corporation to 'regulate' worker's safety in the factories of their tenants. I was wondering of MOH's apparent softness arise from this 'conflict of interest'.

Perhaps it is time for an external regulator to be overseeing this process. Control of infectious diseases (not only this superbug, but others that affect the community such as SARS and the dreaded and anticipated avain flu) should perhaps be delegated to an authority external and independent of the Ministry of Health. Perhaps then we can see hard decisions being taken without being affected by bottom line issues.

It's a question of our national health and safety.

See other conflicts of interest posts:

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