THE frank admission about the risks to patients in a major hospital, outlined in a confidential letter to a watchdog, was sent in advance of a new series of inspections which re-started this year.
Beaumont Hospital chief Liam Duffy perhaps anticipated it was going to be badly marked in the new round of "name and shame" reports by HIQA. He made clear the difficulties faced by outdated and inadequate facilities before anyone with a clipboard and checklist arrived on the wards.
But the blunt admissions about patient safety in the letter are in contrast to the more guarded statements which are normally issued by Beaumont and other hospitals. If hospitals can spell out the unsafe conditions for patients in private correspondence, they should also be as candid in public comments.
When the inspectors did eventually visit the north Dublin hospital during the summer, the harshest criticisms were less to do with the state of cleanliness they were told to prepare for – but focused instead on many of the doctors who do not wash their hands.
It was this lapse in basic infection-control rule, which comes at no cost to the hospital, which had Beaumont on the defensive. In fairness, this is the same breach that a raft of other reports from other hospitals subsequently revealed was widespread.
Overcrowding, lack of isolation rooms and poor quality surfaces undoubtedly create hazards but the war against superbugs will never be won if hand-washing rates remain so poor.
It is also interesting to learn that, while sanctions for junior doctors who did not attend hand-washing training were in place, no such disciplinary action was taken against other staff.
It is the senior consultants and nurses who may be in most need of some penalty in order to change the culture for the better.