Ward Mike: Inquiry into Hospital-Acquired Infection — Consideration of Report of Health Committee 
Ward Mike: Inquiry into Hospital-Acquired Infection — Consideration of Report of Health Committee 
[Volume:619;Page:14656] 
MIKE WARD (Green) 
:  
The Greens support the recommendations of the Health Committee inquiry into hospital-acquired infections. There are three recommendations of which the standardisation of reporting procedures and the insistence on district health boards posting their rates of infection are the two major ones. 
So what is the problem? Well patients and staff entering our hospitals rest homes and places of healing are likely to acquire new diseases. In fact they could wind up much sicker than when they entered spend longer in hospital and take much longer to recover because of bacterial infections picked up in hospitals that are antibiotic resistant. 
Any infection is potentially a problem. Infections acquired during periods of illness when the body’s own immune system is depressed are serious. When those infections as a consequence of bacteria that have mutated are resistant to most of the antibiotics in the pharmacist’s armoury they are life-threatening. 
How serious is the problem? Because of failures in the national surveillance system including variations in the standard of data collection and variability in the accessibility of data we cannot know for certain—hence the recommendations of the committee. But when 120 elderly and vulnerable residents in 10 Dunedin rest homes are infected by methicillin-resistant  
Staphylococcus aureus 
 the superbug it is serious. E. coli the most common cause of urinary tract infections has mutated so that gentamicin the main drug used by hospitals to fight such infections no longer works. If that and the other resistant strains including the methicillin-resistant  
Staphylococcus aureus  
are no longer affected by the available drugs we need to ask why and what we can do to protect ourselves. 
The “Why?” and the “Are they resistant?” questions are not too complicated. We are over-prescribing. All too often antibiotics are the first line of defence frequently against viral infections to which they offer no protection and all too often before our own defences—the lesser therapies such as rest—have been given a chance. We are feeding very similar products to livestock including to many tens of millions of chickens prophylactically not because they are sick but because intensive farming methods such as battery chicken farming dramatically increase the likelihood of infection so we medicate to stop them from getting ill. We also use the medications as growth promotants. Bacteria exposed to the same enemy over and over again will quickly develop resistance. 
To the second question of why we are seeing such high rates of infections I suspect as simplistic as it may appear that the answer is underfunding. Not only has funding for rest homes not kept pace with inflation there are instances where funding levels have actually fallen. At a meeting at the Whare Aroha Home and Hospital in Rotorua I heard yet again about the funding difficulties that face people charged with caring for our elderly. The most serious were the funding constraints on the care of dementia sufferers. The amount allocated for the care of those most vulnerable people has fallen from $104 per patient per day in 1987 to $97 per day today. Those people require a much higher level of supervision. Although the level of disability may vary all are likely to be at substantially greater risk of infection than their peers in the wider community. 
If the professionals charged with their care are unable to afford the optimum level of staffing then for many infection is only a matter of time. Their removal to a hospital is similarly inevitable and the risk of infection not just to the patients but to anyone entering our hospitals—particularly the staff—is heightened. Those people who are likely to be affected must be tested before they enter hospital so that we can take greater care to avoid infection. We are talking about a life-threatening disease—septicaemia. We are talking about an infection that may be the consequence of injury or operation. More important we are talking about the infection of people when they are at their most vulnerable when their own defences are likely to be depressed and when they are already traumatised by the processes and illnesses for which they are in care. 
Avoiding infection is hardly a new science. Lister Pasteur and Fleming are not new names. But avoiding infection requires extreme cleanliness and extreme care and it would help if we took steps to avoid any escalation of the incidence of resistant bacteria by avoiding the excessive prescribing of antibiotics as growth promotants. As I said before we are talking here about a threat to the most vulnerable in our community. The Greens support the recommendations of the select committee and we look forward to other measures to avoid continued escalation of the resistant bacteria in the future.