Thomas Sutcliffe: A simpler way to keep our hospitals clean

NHS administrators and hospital directors have been warned that they could face prosecution for manslaughter if their negligence is proved to have led to a death from MRSA or any other hospital acquired infection. This seems fair enough, from the public perspective. As the old saying has it, "a fish rots from the head" and, even if the chief executive's office is as spotlessly clean as an operating theatre (if they can still serve as a benchmark for hygiene), there is an argument for saying that the infection starts there. Whether it's the only place that a solution can come from is another matter, though, given the almost innumerable ways in which a superbug can get into a hospital. And, with that in mind, I would like to name another guilty party – me.

I don't mean by this that I am personally responsible for the Russian roulette aspect that has been added to any contemporary visit to a hospital (will I come out more ill than I went in?). I mean that, reading that report about manslaughter prosecutions, I felt a little guilty about a hospital visit I made only last week. I went to see a friend who had just had brain surgery and, tracking down the ward where he was, I passed several of the wall-mounted dispensers of sterilising hand rub that hospitals now encourage everyone – staff and civilians – to use before going on to the wards, and didn't use any of them. I actually did on the way out (when the gesture might, rather shamefully, be construed as self-preservation rather than social consideration, and found myself wondering why I had not done it earlier. After all, I read papers and know that it matters. I have no objection to the procedure, and I would be appalled to think that I had inadvertently introduced an infection. So why did I default?

Simple fluster may be part of the explanation. I was about to see a friend who had had serious surgery and did not know how I'd find him. I also – literally – didn't know how I'd find him – so that most of my processing power was being applied to navigation. But there was also something odd in there too – a reluctance to appear over-punctilious and prissy about the observance of a rule that no one else seemed to think worth following. Ridiculously, I didn't want to appear more sterilised than thou.

What was striking too, though, was that there was no way for the hospital to insist on this very simple way of preventing bugs, super or otherwise, from being trailed through the wards. And that change had to do with the openness of current NHS culture.

There were no set visiting times, as there used to be, and I wasn't challenged as I wandered in and out of wards looking for the right bed, as would once have been the case. There wasn't even an obvious nurse's station at the end of the ward to ask for permission to enter or directions as to where to go. The atmosphere was open, permissive and relaxed to the point of insouciance – all huge improvements on the starched hostility to outsiders which would have been the norm 50 years ago, but not unconnected, I would suggest, to a rise in infections.

I doubt anyone would have felt they had the duty or the authority to tell me to do what I failed to do myself. From the public perspective, this is something for hospital administrators to sort out, or else. From their perspective, sorting out the public might be a good place to start.

So where is Hillary when we need her?

It seems that Sarah Palin has decided to abandon actuality altogether now that the attack phase of the Republican campaign has started. Defending the smearing association between Barack Obama and a former Weatherman, she said that it was important to talk about how the Democrat candidate "kicked off his political career in the guy's living room".

The phrase conjured an image of Obama hunched over several sticks of dynamite and a cannibalised alarm clock, which was presumably the intention – and never mind that no amount of "folksiness" could explain the gap between her description and that "truth" thing that gets the mainstream media so worked up.

What I want to know now, though, is where is Hillary? She appeared to have no trouble getting in touch with her inner redneck when she was still fighting for the nomination – but now there's a candidate who really deserves a mauling she's gone quiet. And probably only Hillary could stick it to Sarah without risking accusations of sexism. I'm aching for the cat-fight.

How to stay abreast of the credit squeeze

Walking round the Royal Academy's new exhibition about Aime and Marguerite Maeght, I encounter the most bizarre caption I've ever seen in a museum show. It sits under the catalogue Marcel Duchamp designed for the Expo Internationale de Surréalisme in 1947, which featured a lifelike woman's breast mounted on black velvet and the title "Priere de Toucher" (Please touch). The caption reads: "Duchamp had bought a supply of breasts from an army surplus shop in America, where they were made to boost troop morale".

This opened a dizzying field of speculation. Were the breasts issued to GIs along with their C Rations and extra ammunition? Did each man get a standard issue pair, or did they have to make do with one each? And, most crucially, wouldn't such an item, so sadly inadequate as a substitute for the real thing, tend to lower your morale rather than raise it?

I suspect that if this fact were examined a little closer it would turn out not to be a fact at all, but a Duchampian joke. But I hope nobody is crass enough to correct it. I cherish the idea that these items might have gone before the Senate Committee on Appropriations some time back in 1943 and that the falsie moulding machines would have been set to run until they were red hot.

The exhibition, incidentally, is a perfect antidote to credit crunch gloom – though it's possible my mood was coloured by the caption.

* In Margaret Atwood's timely little book on debt, Payback , you will find this, from Samuel Johnson, writing about debtor's prisons. "We have now learned that rashness and imprudence will not be deterred from taking credit: let us try whether fraud and avarice may be more easily restrained from giving it... Those who made the laws have apparently supposed that every deficiency of payment is a crime of the debtor. But the truth is that the creditor always shares the act, and often more than shares the guilt, of improper trust".

A modest financial regulation might be to insist that the last two sentences have to be displayed in every banker's office in the land.

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