What would Seinfeld say?

10:54am Friday 23rd November 2007

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I KNOW it's not funny, but the latest saga at Wycombe Hospital put me in mind of an episode from the classic TV comedy Seinfeld.

There's a great scene where the lead character, Jerry, goes to a restaurant for a date with his new girlfriend. The girl's father owns the place and is about to cook them a special dinner.

Jerry pops to the toilet and is horrified to see the dad come out of a cubicle, zip up and walk out of the loo without washing his hands.

His distress grows as he walks back into the restaurant and sees the father with his hands deep in the dough preparing them a meal.

Of course, when the dinner arrives, he refuses to eat it and the relationship with his girlfriend falls apart because he hardly feels he can tell her that her old man is a filthy health risk.

Later on, he tells his friend George: "You know, a chef who doesn't wash is like a cop who steals. It's a cry for help, he wants to get caught."

So what would Jerry Seinfeld say about a doctor who doesn't wash his hands?

What would he say about three doctors who didn't wash their hands at Wycombe Hospital despite a hygiene campaign launched after the deaths, at Stoke Mandeville, of dozens of elderly patients from the stomach bug clostridium difficile?

And what indeed would he say about the fact that the doctors were only handed warnings instead of being fired?

I thought of the Seinfeld hand-washing episode probably as a way of deflecting my own alarm at the Wycombe Hospital story which is really no laughing matter after the furore that broke last year.

Readers will probably recall that Buckinghamshire Hospitals NHS Trust was hauled over the coals by the Healthcare Commission in July 2006 after c difficile was blamed for the deaths of up to 65 old folk at Stoke Mandeville Hospital in outbreaks between 2003 and 2005.

The HCC report criticised senior management, dirty conditions, lack of infection control and the condition of the hospital. The report led to the departure of some senior managers and caused the trust to embark on a campaign of cleanliness.

I personally found the campaign impressive and reassuring when I attended an annual trust meeting last year. We were treated to a demonstration from a senior nurse of how hands should be washed. It was quite an art form and, ever since, I have followed her instructions by always getting the soap into a real lather before rubbing my hands together and using the friction to flick off any bacteria.

I know the trust is serious about it and a report released last week showed there had been major improvements, which is good news. However, a follow-up inspection from the HCC found that three doctors still failed to wash their hands.

Put into some kind of perspective, this is not a major scandal. There are hundreds of doctors, presumably, working at the hospital, so the fact that there were only three errant ones doesn't sound terrible. Also, it's reassuring that the trust is cracking down and has issued disciplinary warnings against the docs. Meanwhile, Stoke Mandeville was given a clean bill of health and all the nurses were found to be following good hygiene practice.

So there doesn't seem to be an endemic problem, does there? To put the icing on the cake, the trust chief executive Anne Eden said there is zero tolerance' towards lack of hand hygiene and she added the trust is now in the top third for lack of infection.

But, in my book, zero tolerance should mean these doctors, whoever they are, were banned from working in our trust.

Might sound harsh, but would you eat pastry kneaded by a chef who didn't wash his hands after going to the toilet? No - exactly.

Then why would you wish to be treated by a medical expert who didn't see fit to follow basic anti-infection hygiene rules on the wards?

This issue was hilarious on Seinfeld, but somehow I think the patients of Wycombe will have a sense of humour by-pass if this kind of behaviour is ever repeated at their hospital.