Health Bill

I was talking about nurses’ and uniforms. Nurses travel to and from home in their uniforms as a matter of routine nowadays. Thirty years ago, in many hospitals, that would have been a disciplinary offence. The code refers to the need to ensure that staff uniforms are clean and fit for purpose, but it does not propose how that may best be achieved, nor does it suggest how to the naked eye a uniform can be judged clean or dirty. To put it at its gentlest, if someone wears a uniform in the street or at home or anywhere outside the hospital setting, you do not know where it has been, nor do you know how it may have been washed. Only a hot wash will destroy some bacteria. A lot of infection is brought into hospitals from outside, and I suggest that rules about laundering and about where uniforms may or may not be worn are robust elements of any robust code of practice on infection control. These are not matters for the Bill itself, which is why I have not tabled specific amendments, but all these issues occurred to me as I read the code. It is a good document, and I do not mean to run it down, but it could benefit from some further tweaking. In the end, good infection control in a hospital is about everybody taking ownership of the issue. Rules and codes are positive steps but they go only so far. Unless the hearts and minds of all employees are persuaded that this issue depends on them, and that sanctions will be felt by them if anything goes wrong, they will not be sufficiently motivated to act. By ““everybody””, we need to remember that we mean everybody. It is almost an afterthought in the code that kitchen and catering staff, maintenance contractors and other people who enter a ward or clean environment where there are vulnerable patients should be aware of what they must and must not do. It is not the aim of the code to lay down detailed prescriptive requirements: I understand that. However, there are various points in the setting out of the code’s headings and ground rules for observers where the emphasis could be adjusted and points underlined with some advantage.