Frontline staff need to be valued if we are to prevent the spread of disease
The role of infection control in improving public health has been undermined since Florence Nightingale first discovered you needed to keep hospitals clean to prevent the spread of disease. Her ground breaking epidemiological work into the preventable deaths of soldiers in the Crimea was banned from army barracks, due to fears it would affect morale. Many more soldiers died in unsanitary military hospitals, and yet we are taught nothing of the hindrances she faced in her efforts to find new ways to improve public health.
Well over 150 years later you would have thought the situation would have improved. We discovered germs (not yet proven when Nightingale was first working in Crimea) and penicillin, but we still aren’t treating the issue seriously enough. Yet, again, we are being warned we are not prepared for a global pandemic.
Many are getting tired of repeated doom mongering. SARS and Bird Flu came and went, and now H7N9 threatens to cause the next global health scare, as outlined in a terrifying report in Time magazine last week. Antibiotic resistance, globalisation, health inequality and lack of suitable testing equipment have all been cited as reasons behind our inability to prepare for the next disease to threaten all humanity; but very few have cited the low pay and value we have for our workers in infection control.
Despite his policies leaving NHS hospitals on their knees, David Cameron had the surprising foresight all the way back in 2014 to initiate a programme tackle the emergence of anti-microbial resistant pathogens. The first world-leader to do so he warned we were returning to a ‘medical dark age’, and kick-started the two year project, headed by leading researchers in the field. The commission’s recommendations were released last year and noted, very significantly, that in order to prevent millions of deaths in the coming decades from the emergence of untreatable pathogens, we would have to start taking infection control a lot more seriously. It included among its many sensible suggestions, that people working in infection control be paid more to make it a more attractive option.
How many of the cleaners in our crumbling NHS hospitals took on their jobs in order to save the world, I don’t know, but their status says everything we need to know about our preparedness for an epidemic. Ever since cleaners and healthcare assistants, somewhat controversially took over the role of nurses in keeping our wards clean, we have merely seen the responsibility of infection control handed from one undervalued group to another.
Many of these staff are migrants, and face not only destitution from their low pay, but also uncertain futures as we prepare to leave the EU. The fact that the responsibility for the most basic aspect of our healthcare is handed over to our most unappreciated and underpaid workers is no surprise; men in suits talk infection control while workers clean.
We need to dramatically change our attitudes as a society if we are to improve the potential outcomes of the next global pandemic. Pharmaceutical companies must be pressured into developing medicines not only for the long-term sick and wealthy, but instead for the many who may be affected by infectious disease. Then we need to be willing to send these medicines wherever they are needed. The recent Ebola outbreak in West Africa showed us all how globalisation can turn a once self-limiting epidemic in a country far, far away, into a full blown global panic. It’s not just their problem anymore; it is ours, whether we like it or not.
The response to the Ebola outbreak took longer than necessary, as time and time again we are overly dismissive of the risk we face. HIV is one of the few infectious diseases that has been the focus of medical breakthroughs over the past 25 years, but despite the millions poured into achieving this we learn that many young people only use condoms half the time. The MMR scandal was the result of one paper, and a million parents hearing what they wanted to. If there is anything that is going to kill us, it is complacency.
We are uniquely positioned in this country to lead the world in preparing for the next global pandemic. The existence of the NHS (at least for now) means that we can introduce and execute population level plans cheaply and effectively, and share our best practice with the rest of the world.
But there needs to be the will to do that. And first we need to start, by taking the issue seriously and making sure we pay our frontline staff what they are worth.
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