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Support services such as laundry, food services and housekeeping are critical to patient health and safety. The evidence shows that where these services are contracted out, standards fall and turnover soars, leading to sicker patients, a fragmented system and additional costs to the health care system.

In hospitals and other health care facilities, support workers are working on the front line and behind the scenes in the fight against antibiotic-resistant ’superbugs’ and other organisms that prey on patients with weakened immune systems. They provide sterile linens for operating rooms, and make sure patients on special diets get nutritious meals.

Where support services are privatized, low wages lead to high turnover. Staffing levels tend to be lower and other corners are cut to ensure profits. The evidence speaks for itself.

  • In the US, where privatization of cleaning and housekeeping is more widespread than Canada, a recent investigation found that cuts in cleaning and infection control standards contributed to 103,000 patient deaths in 2000. The Chicago Tribune establishes a link between soaring infection rates and a 25 per cent cut in hospital housekeeping staff since 1995, combined with poor training and a transient low-wage workforce. The Tribune concludes 75 per cent of these deadly infections were preventable.
  • The same study points to a US Centers for Disease Control and Prevention report that deaths linked to hospital germs are the fourth leading cause of death among Americans – after heart disease, cancer and strokes.
  • In Britain, the National Health Service was forced to invest more than CDN $77 million in a crash program of hospital cleaning after an audit revealed that most of the hospitals relying on private contracts failed to meet national cleaning standards. In addition, contracting-out has fragmented the health care team and created obstacles to integrated patient care.
  • In his 2000 hospital review, Scotland’s Auditor General found that turnover among private cleaning contractors was twice as high (40 per cent) as in-house cleaning staff. The report also found contracted out cleaning led to less service flexibility and lower quality of service.
  • In Australia, contracted-out cleaning has meant lower standards and higher infection rates. Experts warn of the dangers in handing control over cleaning to outside organizations, resulting in “uncoordinated and inconsistent cleaning protocols.” Inflexible contracts make it hard to quickly alter cleaning standards to respond to new hazards, and hospitals are spending scarce time and money resolving disputes.

Background on the dangers of contracted-out cleaning:

Live webcast of the release of the Romanow Commission Report (Canada Newswire)

CUPE Manitoba’s Submission to the Kirby Commission

Privatization virus attacks health system

Fraser Institute study doesn’t check out

Literature review on the relationship between cleaning and hospital acquired infections


Abbotsford: For-profit hospital endangers community’s health

November 2002