ONE of Scotland's most senior doctors has called for alcohol gel hand-rubs to be removed from hospitals because they are ineffective against the deadly C diff superbug.
Alcohol hand-rub dispensers have been placed in wards and clinical areas throughout the country at a cost of more than £1m, largely to combat another superbug, MRSA. However, they do not provide a defence against C diff, which has killed hundreds of
patients in Scotland in recent years.
But Dr Charles Saunders, head of the British Medical Association's Consultants' Committee in Scotland, said most doctors, nurses and other healthcare professionals are unaware that the gels were ineffective and they must wash their hands with soap and water between dealing with each patient.
He said the dispensers should be scrapped because they are causing confusion about the best method of infection control.
However, the Scottish Government has insisted that the dispensers – introduced to most hospital bedsides over the past three years – will remain on wards as part of the strategy against hospital-acquired infections.
Lack of knowledge among healthcare staff about the ineffectiveness of the gels may be one of the reasons for Scotland's appalling C diff figures. It was cited this month as being among the factors behind the outbreak which killed 18 patients at the Vale of Leven hospital in West Dunbartonshire earlier this year.
Saunders said: "In terms of preventing the spread of infection, the most important and effective method is hand-washing, whatever the organism. People should be washing their hands after touching each patient. The problem is that some hospitals do not have adequate facilities for handwashing, which is one of the issues highlighted in the report into Vale of Leven."
The gels, designed to remove potentially harmful bugs from the skin surface, had become a substitute. "Staff have been told that they could use alcohol gel instead of washing their hands," said Saunders. "That is not a good message to give people. They should be told they should wash their hands, but a lot of wards have dispensers when they should have more hand-basins.
"What would make sense would be for hospitals to remove the dispensers and replace them with adequate hand-washing facilities in wards and clinical areas."
Studies have shown that the gels are effective against MRSA but cannot tackle C diff, which forms tough spores highly resistant to damage.
Asked if staff were aware that the gels were ineffective against C diff, Saunders replied: "By and large, no. I suspect it's because staff have been told that they can use alcohol gel rather than washing their hands and they have come to the conclusion that they are being told that because it is effective."
The previous Labour-Lib Dem Executive allocated more than £1m to the NHS in Scotland in 2005 to help hospital managers install alcohol gel dispensers beside each bed.
A spokeswoman for the Scottish Government said studies have proved that alcohol hand gels were "very effective at disinfecting hands and killing a whole host of bugs and germs".
She added: "Hand gel provides healthcare workers with a quick method of decontaminating their hands between healthcare interventions and facilitates higher levels of compliance with hand hygiene."
She acknowledged that the gels were less effective against C diff. However, the Government had no intention of removing the dispensers. "It is important that staff, patients and visitors not only wash their hands with soap and water but combine this practice with the use of alcohol-based hand gels," she said.
Labour's health spokesman, Richard Simpson, said he would not support the removal of the dispensers because of their role in tackling MRSA. However, he said ministers must make sure that staff comply with targets that stipulate that they must hand-wash at least 90% of the time when moving from patient to patient.
The investigation into the Vale of Leven outbreak found staff did not know that soap and water, rather than alcohol gel, were required to prevent the spread of C diff. Although there were plans to upgrade hand-washing facilities, investigators heard the work was expected to take 20 weeks to complete.
