David Clegg - Dundee Courier - 2nd February 2010
A Public inquiry into hospital superbugs, which has been widened to include a fatal outbreak of Clostridium difficile (C. diff) in Dundee, will not examine the causes of the five deaths at Ninewells last autumn, it emerged yesterday.
Instead the inquiry, which will focus on an outbreak at the Vale of Leven Hospital in Alexandria, West Dunbartonshire, which resulted in 18 fatalities, will look only at the way the Dundee outbreak was handled by NHS Tayside.
Speaking at the preliminary hearing at Dumbarton Sheriff Court yesterday, Lord MacLean, who is leading the inquiry which starts on June 7, said the terms of reference would not permit an investigation of how the Dundee deaths occurred.
He said, “They do not permit me to look at other outbreaks in depth, and the inquiry’s current standing timescale would not be achievable if they did. However, the inquiry will consider the handling of other instances of C. difficile infection and these will include the outbreak at Ninewells Hospital last year.
“I will not look at the causes of that outbreak or the circumstances of deaths at Ninewells, but rather at the way in which the outbreak was handled.”
Last night Liberal Democrat health spokesman Ross Finnie hit out, saying, “We said right from the start that the inquiry at the inquiry, saying its remit was ‘too narrow.’
“We warned that the remit set by the health secretary was too narrow—the chairman’s comments suggest that he feels the same way.”
He continued, “The health secretary had to be dragged into ordering an inquiry, but there is now a danger that its effectiveness has been compromised by her failure to respond to our call to amend the terms of reference.”
Opening statements were made by lawyers representing the Vale of Leven victims’ families and the Greater Glasgow and Clyde Health Board, as well as other bodies, to confirm their participation in the inquiry.
NHS Tayside did not make any official representation, and it is not yet known if anyone from the health board will be called to give evidence.
Labour health spokeswoman Jackie Baillie said the outbreak in Dundee showed “much more” had to be done to fight superbugs.
“It has taken months of pressure from the families of those who lost loved ones to get us to this point.”
She added, “I have been proud to support them and will continue to press so that they get the answers they deserve.”
A spokesperson for NHS Tayside said, “It is extremely important the public know and can understand all the circumstances of what happened,” she said.
“We also welcome the opportunity to learn any lessons which can be applied in the future to help us reduce healthcare associated infections in our hospitals.”
Dundee West MSP Joe FitzPatrick said he was “not surprised” the inquiry would not focus on the cause of the Ninewells outbreak.
“Unlike Vale of Leven, the outbreak (at Ninewells) was identified very quickly,” he said.
“There was no mystery about what it was.”
An inquiry into the Vale of Leven outbreak was ordered by health secretary Nicola Sturgeon last year, but the remit was extended last month to also consider the Tayside situation.
Earlier investigation found the bug had been directly responsible for the deaths of two patients at Ninewells last autumn and had been a contributory factor in another three cases.
A total of 55 patients at Vale of Leven were struck down by the bug between December 2007 and June 2008.
C. diff was blamed for nine of the deaths and was said to be a contributory factor in the other nine.
Speaking after the date for the hearing was set, Michelle Stewart, whose mother-in-law Sarah McGinty was one of those who died, said, “We feel as though this is the first step—it’s become a reality now.
“Things are actually starting to happen.
“The last two years we’ve fought for this—going in today, sitting in court, hearing Lord MacLean speak, makes it a reality.”
Ms Stewart’s mother-in-law, Mrs McGinty, died two years ago yesterday.
She said, “This inquiry started on October 1, 2009—which was her birthday—and then today we’ve got the first preliminary hearing, which is her anniversary.
“Hopefully it sends out the message that we are going to get what we want out of this.
“It is really hard and things are happening on her anniversary.”
Ms Stewart, who is a member of the C. diff Justice Group, said despite the upset the inquiry may cause to relatives, stopping another outbreak was “worth it.”
The oral hearings for the inquiry will last four weeks, followed by a second block at the end of August for around eight weeks, it was confirmed.
Lord MacLean told the filled courtroom for the preliminary hearing to forget what they had seen on television about court cases.
He said, “There will be no dock, no accused, no jury. No pitting of one side against the other—an inquiry is inquisitorial in nature.
“So, our questions will be about finding out what happened, why it happened and, importantly, how to make a difference for the future.”
Angela Grahame QC, representing Greater Glasgow Health Board, told the court evidence about the “considerable changes” that had been made since the outbreak at the Vale of Leven Hospital will be presented to the inquiry.
She said changes included more isolation facilities, improvements in staff training and improving hand-washing facilities at the hospital.
She added, “As a result of these improvements the Health Protection Scotland national report, published in January this year, shows that the rate of C. diff infection in Greater Glasgow and Clyde in the over-65s is well below the 2011 national target and almost 65% lower than it was between January and March 2008.”
She said the health board also expressed its “deepest sympathies” to the families of those who died in the outbreak.
Lord MacLean said the hearings would be open to the public “wherever possible” and he hoped to publish a report on the inquiry by the end of May next year.
The inquiry will take place at Maryhill Community Central Hall in Glasgow.
See also:
C.diff families plan legal action
Scots hospital superbugs cost £183m a year
Scourge of vermin in our hospitals
NHS hospital superbug outbreak kills 331
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