Health authorities are expecting to see a drop in the rate of infection - including the superbug MRSA - once the move to the new hospital is completed.

"We would be very disappointed if the move does not have a positive effect on infections," Infection Control Unit consultant Michael Borg told The Times yesterday.

Although health officials are not expecting perfection, they are hoping for a "substantial improvement", he said.

Overcrowding, considered as one of the main culprits in the spreading of germs, should be a thing of the past once Mater Dei Hospital starts running.

"Even if there are enough staff members to tend to the increase in patients, the lack of space makes their life extremely difficult," he said.

The added pressure, he continued, makes it even more likely that staff members do not wash their hands before touching patients.

The lack of hand washing among doctors came under the lens following an article in the Malta Medical Journal. Medical students observed doctors' hand-washing habits and reported that they washed their hands in less than one-fourth of the time before touching patients. On only one-third of the occasions surveyed did doctors wash their hands following contact with patients.

When contacted, Dr Borg, who co-authored the report, said that although the study put the spotlight on doctors, the onus lay on all staff members. Nurses, for example, have even more contact with patients, making it very important for them to wash their hands frequently.

But St Luke's Hospital, he continued, did not make this easy. "The structure of the hospital is not devised to help staff wash their hands. For example, there are big wards with just one wash basin in the corner, and you cannot imagine a nurse running back and forth to wash his hands before tending to the next patient."

On the other hand, Mater Dei is specifically designed to make hand-washing easier. "There is a wash basin and alcohol rubs in every room, and even in rooms which have four beds there will be additional hand rubs next to the beds."

Dr Borg said the fact that Malta has only one acute hospital might exacerbate things. "Abroad, when a hospital is full, patients will be sent to another one but here we cannot do that."

A third issue, which Dr Borg has raised in the past on a number of occasions, is the misuse of antibiotics, which can give rise to bugs that are resistant to antibiotics.

Asked how Malta ranks when compared to other countries, Dr Borg said we have roughly the same incidence as Britain, but fare much worse than Scandinavian countries, which are the gold standard that every country tries to aspire to.

When contacted, the general secretary of the Medical Association of Malta, Martin Balzan pointed towards overcrowding as the main problem. He said that social cases are more prone to infection because of their prolonged stay in a hospital environment.

Earlier this year, the president of the Malta Union of Midwives and Nurses, Paul Pace, had told The Times that, although the importance of washing hands before moving from one patient to another was highlighted, the burden on nurses was so big they would simply be too busy to do this.

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