Canada’s universal health care is a financial and service trainwreck. We are now officially spending over 40 cents of EVERY tax dollar at federal and provincial levels combined with 28 percent of those dollars directed to “administration” not direct care.
We’re spending more per capita than just about every other industrialized nation with a similar tax base offering universal coverage, yet as recent CIHI surveys indicate the health providers are dissatisfied and discouraged, the patients are dismayed and losing confidence in the system and the administrators have all their fingers in the dikes without a hope of near time addressing the tsunami of baby boomer health issues soon to be the eight hundred pound gorilla in the waiting room.
My information is sourced from Ministry of Health documents and the Canadian Institute for Health Information a publicly funded non-profit organization monitoring the effectiveness of our health care system. It’s abundantly clear the system is failing at every level from waiting times for tests, referrals and treatment, to insufficient availability of diagnostic equipment, inadequate home care, high readmission rates following primary in-hospital treatments. In summary, the bang we expect for our tax buck just isn’t being delivered.
Today, I’m focusing on the very costly area of hospital acquired infectious disease that has a very inexpensive cure.
According to CIHI, about 8-10% of admitted patients re enter hospital within one month of release, half for recurrence of the original problem but the other half for an infectious problem acquired in hospital or after a procedure.
About 10% of all surgical patients develop a postoperative infection but the source is shocking. The culprits? Doctors, visitors, patients and nurses still not properly washing their hands.
The most recent province wide study in British Columbia in revealed a mere 54% of physicians practicing pre-patient hand washing. For nurses it was 74%, other health professionals 65%.
According to international studies by W.H.O. the occurrence of C. difficile in hospitals is controlled with soap and water (hand sanitizers are ineffective). About ten thousand hospitalized Canadians die annually from this virulent intestinal bacteria and a myriad of other infections.
In the past, we have relied on science to build a better antibiotic but the bacteria mutate and acclimatize so efficiently that now we have the hospital acquired antibiotic resistant infections seeping in to the community.
We’re running out of science and need to focus on fixing problems with common sense. We’ve all had the midwinter experience witnessing the gowned hospital patient in his/her paper slippers, IV pole and IV in arm braving the elements for those precious drags on their cigarettes. The same patient then trundles through the public areas back to their shared accommodation bringing with them the cigarette residue permeating their hospital garment plus whatever other germs they encounter in their travels.
At this same hospital you will see hospital staff standing on a carpet of discarded cigarette butts defying the posted smoking bans. It is not just that they are smoking but its how they do it that represents the risk issue to me. All four seasons, they’ll take a hospital blanket for a seat, park their hospital scrubs on the nearest ledge and once satiated, return to whatever recovery room or intensive care unit where they work.
How many times have you witnessed a health provider in hospital attire on break in a store, transferring money, examining consumer goods other people have handled, riding public transit then directly entering critical treatment areas? There’s a reason doctors used to wear white lab coats in the hospital and office
Compliant health workers will take umbrance with my observations. My comments are meant for the noncompliant percent.
Being that we’re all potentially part of the problem, we need to address the need to be part of the solution. Hospital administrators need to police the periphery of their domain more diligently, visitors with any infections need to stay away, hospital personnel need to rethink their workplace personal hygiene and patients need to assertively enquire if their provider has washed their hands that visit.
There’s a great deal of handwringing in the system today, it could do with a greater focus on hand washing.
Dr. David Carll