Health Minister Shane Reti fronts the media before the first reading of the Pae Ora (Disestablishment of the Māori Health Authority) Amendment Bill.
Video / Mark Mitchell
An early briefing from officials to Health Minister Dr Shane Reti was ordered after he raised concerns about hospital cleanliness including a dirty toilet.
The National-led Government was sworn in on November 27 last year, and embarked on a first 100 days that included major changes to ahealth system struggling with entrenched problems including staff shortages and growing wait lists.
Reti met the chief executive of Health NZ/Te Whatu Ora, Fepulea’i Margie Apa, soon after taking the reins.
Issues discussed included cleanliness at Auckland City Hospital, and Reti mentioned one account he had received about a particularly filthy toilet.
Subsequent inquiries into the dirty dunny determined that a cleaner had found a blocked toilet, in the men’s public toilets outside Ward 42, which treats cardiothoracic patients.
They locked it and logged a maintenance job. The facilities team unblocked the toilet but left it in a dirty state and unlocked.
The cleaner wasn’t notified to return, but sorted the mess on their next run - however, in the meantime it was discovered by a member of the public.
Apa communicated this to Reti’s office, and said Auckland Hospital had been told of its procedural error, and that the bathrooms on Ward 42 were now in an excellent state.
The Health Minister asked for more information about the toilet cleaning audit process at the hospital, and for cleaning audits for the past 90 days across all wards.
Health Minister Shane Reti says before becoming Health Minister he received reports from health workers concerned about cleanliness in hospitals. Photo / Mark Mitchell.
Reti’s office told the Herald his concerns went wider than the one toilet, as in Opposition he’d “received concerns raised by health workers regarding some of the operational practices in hospitals including cleanliness, and committed to inquiring once in Government.
“High standards of cleanliness and hygiene are essential to the safe operation of our hospitals, and deficiencies can be indicative of other operational issues – it is appropriate for the Minister to inquire into matters where concerns have been raised.”
Reti’s request resulted in a December 13 briefing to him, signed off by Fionnagh Dougan, Te Whatu Ora’s national director of hospital and specialist services.
Auckland Hospital, Starship and the Greenlane Clinical Centre are covered by 240 cleaners, and audits are done to the “Victorian cleaning standard”, the document explained.
Very high-risk areas like intensive care units are audited weekly, and need a 100 per cent pass mark with any issues fixed immediately. Other patient areas are audited fortnightly, and need at least 92 per cent compliance.
The average monthly cleaning audit scores at Auckland’s 17 very high-risk areas were 99 in August last year, 100 in September and 98 in October. Average scores for the 52 high risk areas were 93 in August, 95 in September and 94 in October.
“Audits are conducted diligently. For instance, an audit of a very high-risk area may not meet the required 100 per cent mark if there are a few smudges on windows,” explained the briefing, released to the Herald under the Official Information Act.
Toilets are frequently cleaned, and if they are dirtied in between the cleaning team can be contacted through a 24/7 number or a staff notification system.
“If the complaint has any potential infection prevention and control implications, the cleaning service and the infection prevention and control service work closely together to stop the spread of infection (as was the case during the recent vancomycin-resistant enterococcus outbreak).”
Vancomycin-resistant enterococcus (VRE) are bacterial strains that are resistant to the antibiotic vancomycin. VRE isn’t widespread in New Zealand like other countries, but there has been an increase in hospital patients colonised with VRE (more than 400 in 2023).
