For many years now hospital patients had suffered an unacceptably high incidence of serious, sometimes fatal, hospital- or healthcare-associated infections. Only now have these been brought under some degree of control but nobody has been held responsible for the many failures which had occurred.

Without doubt there was a considerable degree of complacency, and some incompetence. Later on, those who should have managed infection prevention and prevented the explosion in preventable infections were actually rewarded when things when wrong, with additional resources and extra funds to correct a situation that was in some great part of their own making.

It is thus somewhat refreshing, though rather surprising, to read of three microbiologists at the Maasstad hospital in Rotterdam who are to face disciplinary proceedings for failing to tackle an outbreak of infections caused by a superbug in 2010/2011.

Hospital inspectors say the three are fully responsible for the failure of the hospital to get infections related to the Klebsiella bacteria under control.

Three patients died after becoming infected with Klebsiella, a multi-resistant bacteria, and a further 10 others may also have died because of it, an independent report into the outbreak last year showed.

It seems that in the Netherlands the law is not entirely straightforward – is it ever? – and though hospital hygiene experts are also ‘directly responsible’ for the hospital’s failings they will not face disciplinary procedures because the law does not allow this. The inspectors have recommended the law be changed on this point.

The same might be true for each of those errors resulting in sharps injury to an ancillary or laundry worker, or to a waste handler consequent on unsafe sharps disposal. The individual directly responsible may never be identified though if they can be found they must face disciplinary proceedings from a relevant professional body, and perhaps criminal proceedings also. Using the Netherlands example, it may be appropriate also that another senior team member responsible for overseeing the safe use and disposal of sharps and more broadly responsible for the management of clinical wastes is held responsible. They might, for example, face disciplinary and possible criminal sanctions due to their failure to manage effectively sharps and other waste-related safety issues.

This should not normally be the waste manager, who might otherwise be made into a whipping boy for all sharps-related safety problems, but a more senior healthcare team member, a microbiologist or other infection control professional, or perhaps the Director of Infection Prevention and Control (DIPC). These roles are supported by a not insubstantial salary but apparently little real responsibility when things go wrong.

Perhaps the time is right, and like the bankers these healthcare professionals must be held to book for serious failings. Just don’t hold your breath.