Revealed: Scotland's private hospitals virtually free of MRSA superbug Lessons for NHS on how to control infection crisis

Although private hospitals deal with just a fraction of the numbers of patients of their NHS counterparts, the systems and standards they employ could help alleviate the MRSA crisis.

BMI Healthcare, which runs Albyn Hospital in Aberdeen, Fernbrae Hospital in Dundee and Ross Hall Hospital in Glasgow, said it has never had a case of a patient with an MRSA bloodstream infection.

Like the other private hospitals in Scotland, it screens highrisk patients prior to admission, such as those who have been in nursing homes or who have previously had MRSA.

A spokeswoman said that if a patient was found to be carrying the bug, "very diligent" barrier nursing techniques would be employed, such as handwashing and minimising the number of people going in and out of the room. "Our nurse to patient ratios are relatively high, so that gives everybody the chance to have a little time, " she said.

Bupa Murrayfield Hospital in Edinburgh said it had recorded no cases of bloodborne MRSA in the hospital in 2004. Marketing manager Julie Campbell added that if someone was found to be carrying the superbug, their room would also be deep-cleaned when they left the hospital.

"The levels of infection control are very high, " she said. "It is just best practice." Abbey Carrick Glen Hospital in Ayr also claimed never to have had any cases of MRSA infection.

Theatre staff at the hospital wear disposable greens and uniforms are laundered on-site, with staff banned from taking them outside the hospital.

Alison Smith, general manager, said: "I think we have a position of luxury where we can manage our environment more effectively because of the nature of our service delivery. We have a much smaller turnaround than the NHS with much bigger staffing numbers." According to Abbey Kings Park Hospital in Stirling, which also prohibits staff taking uniforms home, none of its patients have caught MRSA during their stay.

At the Nuffield Hospital in Glasgow, a spokesman said they had had one case of MRSA which had been attributable to the hospital in the past three years. He said: "I think the biggest single factor for helping to keep things under control, in my opinion, is the single rooms.

"On top of that we have good nurse staffing ratios. It is hard to generalise, but probably better than most places in the NHS." Shona Robison, SNP health spokeswoman, said: "You can't get away from the importance of adequate staffing levels and that is a huge problem in many [NHS] wards.

"Pre-admission screening is very patchy, yet we know that if you bring someone with MRSA into hospital and they get moved around from one ward to another, the chances of spreading that infection are much higher.

"We know these factors are hugely important and what I want to see is action taken within the NHS to actually respond to that." Methicillin-resistant staphylococcus aureus (MRSA) is a variant of a bug that lurks in the noses of around one-third of the population.

Healthy people can carry the superbug without knowing it, but if it gets into the blood through a cut or wound it can cause serious infection.

The Royal College of Nursing (RCN) Scotland said that research has shown that having inadequate numbers of nurses poses a threat to quality of care.

Pat Dawson, RCN Scotland's head of policy and communications, said: "Having too few nurses leads to longer stays in hospitals, higher rates of infection and ultimately more patient deaths." A recent campaign by RCN Scotland urged the Scottish Executive to adopt 10 minimum standards to combat hospitalacquired infections, including the provision of sufficient uniforms.

"Many NHS staff aren't given sufficient uniforms to allow a clean uniform per shift, " Dawson said. "Many don't have access to access to changing and laundry facilities, forcing them to travel back and forward to work in their uniform.

"All this has to change if we want to seriously reduce the levels of hospital-acquired infections." However Professor Hugh Pennington, a microbiologist at Aberdeen University, pointed out that, unlike the NHS, private hospitals don't have to deal with a "flood of people coming through the door".

He added: "They [private hospitals] tend to discharge their problem cases back to the NHS anyway, so if patients get complications, they won't be resident in the hospital very long.

"That means they are not a source of MRSA for other patients in the hospital, whereas in an NHS hospital, if somebody gets a wound infection, they can't move them on elsewhere." Pennington highlighted the fact that in other countries, such as Holland, screening patients for MRSA and treating high-risk patients in isolated rooms had successfully kept the problem out.

But he warned that the superbug problem was now so established in the UK that trying to introduce methods such as screening in the NHS would be impractical.

He said: "There is so much MRSA about that to do that to every patient that came in with it, or patients that are high risk, the NHS would probably grind to a halt pretty quickly.

"For the NHS at the moment, the problem is so big that the best thing to hope for in the immediate future is a slow reduction in the problem.

"It is a chronic, well-embedded problem which is going to take a lot of work to resolve and there is no quick fix." A spokeswoman for the Scottish Executive said that as surveillance of MRSA rates did not include private hospitals, there was no independent evidence of their infection rate.

She said: "Unlike the NHS, which carries out a huge range of procedures, including emergencies, private hospitals do comparatively small amounts of planned work for selected patients whom they can screen.

"Also, in the main, private hospitals look after less ill patients and have shorter admissions than NHS ones, therefore these contributing factors may lower rates of MRSA.

"Reducing cases of MRSA is a key priority for the Executive and for everyone within NHS Scotland."

judith. duffy@sundayherald. com aideen. mclaughlin@sundayherald. com