Posted by: Witch Doctor | September 28, 2007

Citizens’ juries – superbugs



You asked the question, Mr Brown. The Witch Doctor is a special kind of citizen. I suspect your Citizens’ Jury did not have a witch representative, so I will act in that capacity and give you my answer.

Firstly, you need some background, Mr Brown:

Each hosptital has microbiologists and infection control staff. Or should have.

They are well able to give hospital managment/governments early warning of problems that may arise. And they do.

They are well able to give sound advice to hospital managment/governments. And they do.

And its free. It’s part of their job. No consultancy fee necessary.

Managment/government can take this advice or leave it.


Take MRSA for example:

In the UK in the early 1990’s managment/government did not heed the advice. They did not want to spend the necessary money.

In the Netherlands in the early 1990’s managment/government did heed the advice. It seemed like a good investment.

So, there was a fundamental problem a long time ago which was partly responsible for MRSA setting up home firstly in UK hospitals and then in the community.

Basically the government did not fund an early “Search and Destroy” policy.

Now, with a Search and Destroy policy, you only get one bite at the cherry. If you procrastinate, it is too late. An organism like MRSA can easily take advantage. It did. An now it has a nice comfortable niche colonising patients in much the same way as its little old fashioned brother MSSA has colonised humans since the beginning of time.

So, this battle you have lost.

Search and destroy will not work now. It is too late. Far too late. It will be too expensive. Even if all of all of the national budget was thrown at this clever little beast, search and destroy probably would not work nationwide. Because, you see, it is firmly bedded in. It is part of the ecology. MRSA will now only go away when another organism pushes it out of its niche.

You must have great respect for these tiny micro-organisms. In some ways, they are much cleverer than humans. This largely relates to the their rate of reproduction which gives them an evolutionary advantage over the human race. You could argue that the speed of their natural selection is more potent than the power of the human brain.

So far, so bad.

However, although patients should be concerned about MRSA, they should not be morbidly concerned.

It is a pest, and yes it can be a killer. Many organisms are killers, some more so than MRSA. Usually MRSA does not kill, it just co-inhabits or causes minor infection.

Because of its resistance to the commoner antibiotics, it is a bit more of a pest than MSSA. But this sensitive staphylococcus has been a killer too, since the beginning of time. But for most people, it too co-inhabits.

So, Part 1 of The Witch Doctor’s reply to your question is as follows:

1. Listen to the trained staff that you employ within the NHS. They are much better value than external consultancies. However, they may not always say what you want to hear.

2. Tell management in each hospital in the land, that they must listen to their local microbiologists and infection control staff. Continually. Day by day.

3. Pay particular attention at the beginning of an outbreak or any new phenomenon regarding micro-organisms and act early on that advice. Do not procrastinate.

4. Remember, not only do your microbiology/infection control staff know what to do, they are also linked professionally with a huge international network of expertise.

5. Remember the staff can only advise. They do not carry the purse. Nor are they in a position to decide how to spend the money contained in the purse.

As citizens, I think we’ll have more to say on this question. Don’t you, My Black Cat?

The Witch Doctor – Link to a random page





Leave a Reply

Please log in using one of these methods to post your comment: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s


%d bloggers like this: