DEPARTMENT OF HEALTH
News Release (2007/0200) issued by The Government News Network on 17
July 2007
The Chief Medical
Officer, Sir Liam Donaldson, today published his Annual Report for
2006, On the State of Public Health, in which he reviews key
health problems and developments. He calls for action in five key areas:
improving levels of hand hygiene in hospitals (a key factor in
infections such as MRSA) by giving patients the power to establish
whether healthcare professionals have cleaned their hands and
giving patients a personal supply of alcohol-based handrub
tackling the present crisis in organ shortages for transplantation
by introduction of an opt-out system for donors, as is done
successfully in some other countries reducing the risk of
radiation overdoses during cancer treatment by extending the use
of monitoring devices to all radiotherapy machines in the country
conducting more research to establish the reasons why 500 babies
die each year despite starting the process of birth apparently
healthy ('intrapartum-related deaths') taking steps to
increase the number of women in the most senior positions in medicine.
The Chief Medical Officer is the UK Government's principal
medical adviser. His Annual Reports have championed the need for
action on key public health issues such as smoke-free enclosed
public places. The Chief Medical Officer also highlights the work
in each of the nine public health regions.
The report in more detail: hand hygiene
Sir Liam calls for action on the unacceptably low levels of hand
hygiene in hospitals. Poor hand hygiene is strongly linked to
healthcare infection and incidence of superbugs like MRSA and
Clostridium difficile. Despite improvements, such as the more
widespread use of alcohol-based handrubs, levels of compliance by
healthcare staff with hand cleaning protocols seldom rise above
60%, and are often lower. Experience in some other countries -
notably Switzerland - shows that high standards of hand hygiene
cuts infection rates and saves lives. Studies show that patients
are reluctant to challenge doctors and nurses even when they know
that they have not cleaned their hands.
To tackle this, the Chief Medical Officer proposes that:
patients should be empowered to work with healthcare
professionals and ask them if they would like to clean their hands
before treating them patients will be provided with alcohol-based
handrubs to offer staff
Sir Liam Donaldson said:
"Good hand hygiene should be a natural reflex for healthcare
professionals, yet it no longer has the status it once had. Every
time a patient is touched, several thousand bacteria can be passed
between the clinician and a patient. Yet patients do not feel able
to ask their doctor or nurse if they have washed their hands
before touching them. I believe that by empowering patients to
work with healthcare professionals on this issue we can improve
hand cleaning rates amongst healthcare staff and reduce the number
of infections."
The report in more detail: shortage of organs for transplantation
The report also addresses the grave shortage of organs for
transplantation - on average one patient a day is dying on the
transplant waiting list.
The current organ donor system is based on an 'opt-in'
approach whereby people enrol on the NHS Organ Donor Register to
give permission for their organs to be used in the event of their
death. Recent legislative changes to strengthen this wish -
overriding that of their relatives - has done little to increase
the number of organs for donation. The Chief Medical Officer
therefore proposes an 'opt-out' system be introduced,
similar to that in some other European countries which has helped
improve their supply of organs. An opt-out system would mean
people would register to say they specifically do not want to be
donors rather than they do. Safeguards would be built in to any
new system of donation.
Sir Liam added:
"There are simply not enough organs donated to meet the need
for transplants, with one person dying every day while waiting for
a transplant. Compounding this are issues surrounding consent,
which often reduce this number further. To meet current demand for
organs the number of people on the NHS Organ Donor Register would
need to approximately treble. I believe we can only do this
through changing the legislation to an opt-out system with proper
regulation and safeguards."
The report in more detail: other topics
Launching his 2006 Annual Report On the State of Public Health,
Sir Liam Donaldson also draws attention to:
Preventing harm from radiotherapy
Radiotherapy saves lives in the treatment of cancer and other
conditions. Giving the wrong dose of radiation by mistake can harm
and kill patients. Such errors do occur. The Chief Medical Officer
recommends that the use of in-vivo dosimetry radiation checks
(this is where after a first dose of radiation, it is measured to
ensure it is correct) should be mandatory. He also recommends that
a full analysis of all past serious incidents be carried out by
the National Patient Safety Agency, working with the NHS
Litigation Authority and the Royal College of Radiologists, to
identify common causes and the scope for reducing risk.
Newborn baby deaths
Approximately 500 babies a year start labour apparently healthy
and then die (intrapartum-related deaths), a figure that has
remained unchanged since 2000. It is of concern that the current
national survey on maternal and infant deaths no longer reviews
the causes of intrapartum-related deaths in detail. The Chief
Medical Officer calls for further review of deaths, research and
education to avert these deaths.
Women in medicine
Two-thirds of new medical students are women, yet less than 30%
of consultants, 11% of professors and 36% of senior lecturers are
female. Studies of women doctors' attitudes and experience
show that many regret entering the profession because of the
barriers to career progression that they encounter. Sir Liam calls
for improved flexible working patterns and increased childcare
facilities for NHS staff.
Notes for Editors:
1. A copy of the Chief Medical Officer's Annual Report 2006
On the State of Public Health can be downloaded from the
Department of Health website, http://www.dh.gov.uk/cmo
2. The NHS Organ Donor Register currently has approximately 13
million people on it. The actual figure or potential organs is far
less, as not all people registered die in a manner that makes them
suitable donors. Only 2,794 organs were actually transplanted last
year, so using a simple ratio the NHS Organ Donor Register would
need to recruit approximately 35 million people to meet that need.
[ENDS]