Auditor-General: Infection Prevention and Control in Public Hospitals (26.06.2013)

Written on the 1 July 2013

Ms CROZIER (Southern Metropolitan) -- I am pleased to be able to rise this evening and speak on the Auditor-General's June 2013 report Infection and Prevention Control in Public Hospitals. I am particularly interested in this report because this is an issue that is and should be of growing concern for health ministers, governments, hospitals and health services not only here in Victoria but right around Australia and indeed internationally. We know that rates of infection are increasing in some quarters, as is resistance to antibiotics. In some areas resistance to antibiotics is increasing at an alarming rate due to super-drugs. An article published on 24 June reported that a Senate inquiry had heard that the growth of antibiotic-resistant infections is costing Australia $1 billion a year and is threatening a re-emergence of untreatable disease.


We have come a long way in the treatment of diseases in many areas. The advent of the use of penicillin resulted, obviously, from an Australian innovation some decades ago, but we could be under threat of losing the war against infection. This report highlights some very good practices, and I am pleased that Victoria is leading the way, or is on par with South Australia and another state, in relation to hospital rates of infection. In relation to hospital-acquired infections and infections following surgical interventions, the cost of readmission if a patient has an operation and acquires an infection is quite substantial not only to the individual in ongoing recovery time but also to the hospital and in terms of ongoing medical costs.


This report speaks about Victoria's staphylococcus aureas bacteraemia infection rate, and it says, as I have mentioned, that Victoria's rate compares well against those of other jurisdictions.


Between 2009-10 and 2010-11 those rates further improved, so I think a lot of work is being done in our hospital systems, but still more work can be done. When I was undertaking my nurse training we used to carbolise beds and we were not allowed to leave the hospital in our uniforms. We had quite stringent infection control systems. I know many hospitals are undertaking measures such as high-pressure steam cleaning. When I was at the Monash Medical Centre earlier this year representatives were talking about its improved infection rates, which have been achieved through new systems and infection control measures.


This report also highlights the hand hygiene compliance rates on the part of health-care workers reported by occupation, and I am not surprised to see that nurse and midwife health-care workers have a much higher compliance rate than allied and other health-care workers. Accordingly the report says:

... since ... 2009, medical doctor's performance has been improving but is still lower than their nursing colleagues, as seen by the results from compliance audits which are undertaken three times per year.
As I said, I am not surprised that the nurses and midwives have a very high standard of compliance, and I note that allied and other health professionals could do a lot more in that regard. These are all really important measures, as increased infection rates pose an enormous cost to health services. On that point, while more can be done in compliance, I also note that infection is very costly and services will be impacted by high ongoing infection or readmission rates, so it is imperative that we have adequate resources.


Finally I note that as 1 July approaches it is disappointing that the commonwealth has confirmed cuts to funding promised to Victorian hospitals and health services amounting in this coming year alone to $99.5 million and totalling $368.2 million over the next three years. That is going to have a direct impact on the delivery of services; this is exactly what we are talking about in relation to treating people with infections. In my area of Southern Metropolitan Region the Alfred will experience a $7.1 million cut on 1 July and Monash Health $12.4 million. These are substantial cuts being made by the federal Labor government, and they should be condemned.

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