By Judy Darcy

It’s almost impossible to find a story about health care in B.C. that doesn’t involve either wait times or rising health-care costs. But we rarely, if ever, hear about the role of hospital housekeeping in addressing these issues.

When the B.C. Liberals contracted out hospital housekeeping and dietary work more than six years ago, they used arguments about efficiency and health-care savings to justify the mass firing of more than 8,000 workers.

But a growing body of evidence from B.C., Ontario, and the U.K. shows that support-services privatization—with resulting staff reductions, increased workloads, inconsistent training, and high rates of turnover—has driven up hospital-acquired infections (HAIs), slowed patient turnover rates, and increased costs.

It sounds like common sense; a clean hospital requires staff with the time, training, supplies, and knowledge to do the job right. And an unclean hospital is more likely to see outbreaks of HAIs like C. difficile, MRSA, and VRE. But the research proves it. Prompted by a rash of HAI outbreaks in the U.K., the country’s National Health Services reported that devalued and underfunded health-care cleaning leads to lapses in hygiene standards, which have contributed to rises in HAIs.

Numerous investigations following outbreaks in Ontario, Quebec, and B.C., as well as the U.K. have drawn similar conclusions.

And the costs of HAIs are borne not just by patients and their families. Canada’s own National Infectious Disease Day secretariat called health-care-associated infections an avoidable burden on health-care workers and the health-care system.

The studies once again reinforce what would seem like common sense: HAIs substantially increase patients’ length of stay in hospital and increase health-care spending both in hospital and after a patient is discharged.

A 2007 B.C. auditor general’s report estimated the direct costs of HAIs in Canada to be approximately $1 billion annually. And then there’s the costs borne by home and community care services, as well as by individuals, patients, and their families.

The idea of increased efficiency also starts to fall apart when we look at the impact of privatization on a smooth-running health-care team. In a recent pilot project to reduce emergency-room congestion, the Vancouver Coastal Health Authority cited lack of staff, a chronic problem faced by contracted-out hospital housekeepers, as an issue in the project’s success.

This same health authority negotiated a 15 percent reduction in staffing levels when they signed the housekeeping contract with U.S.-based Aramark. Once again it’s not hard to see how a delay in the process of cleaning beds and rooms slows down the whole process of moving patients through the system.

If the evidence of increased costs and inefficiencies is just starting to pile up here in B.C. and Canada, the U.K.—with its 15-year history contracting out—is buried in it. So it’s little wonder that countries like Scotland and Wales, as well as many jurisdictions in Britain, have decided to halt and reverse hospital housekeeping privatization.

Without a doubt, health care is a complex system. At the same time, the B.C. Liberals’ short-sighted experiment in contracting out has only increased the costs and challenges facing patients and the health-care team.

Judy Darcy is the secretary-business manager for the Hospital Employees’ Union.