Hospital inquiry told of concerns there were ‘systematic issues’ with water

A public health consultant said there were concerns of “systematic issues” with water at a major hospital, an inquiry was told.

Dr Iain Kennedy, a public health consultant at NHS Greater Glasgow and Clyde, told the Scottish Hospitals Inquiry his involvement with infection rates at the Queen Elizabeth University Hospital (QEUH) in Glasgow stopped in December 2019.

The inquiry is currently examining the design, construction and maintenance of the QEUH and the Royal Hospital for Children (RHC) on the same campus, including looking at issues with ventilation and water contamination.

It was launched in the wake of deaths linked to infections.

In early 2018, there were “water supply issues” in the summer and “problems with water and drains”, and in December 2018 two haematology patients died after being infected with cryptococcus, linked to pigeon droppings, the inquiry heard.

Another two patients were infected with cryptococcus in late 2018, and a further two patients infected in January 2019.

In September 2018 a decision was made to close Wards 2A/2B in the children’s hospital and “decant” vulnerable patients to QEUH, which was described as “complex and impacting on paediatric and adult hospitals and a national service”, involving executive level decisions.

In a statement regarding an infection outbreak in spring 2018, Dr Kennedy wrote: “Hospital infections linked to water can happen but the complexity of this outbreak was very unusual, due to the identification of different organisms identified and the positive water sampling results from other parts of the hospital.

“The source of the contamination was unknown. If it had been something like a contaminated tap, you would expect the infection to be confined to one area, but this was not the case and this raised the possibility that there was a systematic issue with the water within the hospital. This was the first time I was aware of such concerns.”

Counsel for the inquiry Fred Mackintosh KC asked if relations were “toxic” within the infection control team.

Mr Mackintosh said: “We’ve had evidence that throughout the period of 2018, back to period of opening, relations had not been as good as they could have been, people were under pressure, there had been attempts to reorganise and restructure it. How much were you aware of these cultural issues?”

Dr Kennedy said: “Not at all.”

Mr Mackintosh said: “You don’t know how toxic it might be?”

Dr Kennedy said: “I had a vague knowledge there were issues. I didn’t have any understanding to what those issues were, other than there were issues in the team.”

Mr Mackintosh later said: “We’ve heard evidence from a number of clinicians who attended IMTs (incident management team) but the broad brush is there was a change in approach, afterwards they felt it was that an unusual pattern had to be positively proved to exist before it could be investigated.”

Dr Kennedy said: “It wouldn’t be my characterisation of it at all. It’s entirely understandable we might only see one of these once every three or five years. That doesn’t mean they’re not valid to investigate.

“If you don’t want to treat it as an outbreak then you must think everything is fine. More than one hypotheses could be true. They are all different things that need slightly different actions or responses, which might not be an outbreak the way 2018 was in terms of water in the drains.”

The inquiry continues in front of Lord Brodie, in Edinburgh.