Hunter New England Health believes that up to 14 people a year die in its hospitals and clinics each year as a direct result of poor hygiene. One a month. Many more die after contracting septicaemia, or blood poisoning, as a result of poor hygiene but they are deemed to have died of other causes, presumably the illness that has them in hospital in the first place. The figures are in a report by Alison Branley in the Herald yesterday - 350 patients in the region's hospitals and clinics get septicaemia a year, 70 die, 35 die as a direct result of the septicaemia, and up to 14 of those deaths could be spared with better hygiene. One of my close friends died in John Hunter Hospital several years ago after developing septicaemia in hospital, and it has troubled me that his death may have been avoidable, and those figures don't help.

The health service has found that staff wash their hands, or use an alcohol rub, only 65 per cent of the occasions they should, occasions that in this survey early this year include before and after touching patients. Sure, washing hands is only one of the hygiene practices that prevents septicaemia, but failure to wash hands does can lead to septicaemia and therefore death.

I believe that few people accept that failing to wash our hands, especially after using the toilet, can have dire consequences. The Hunter health service used faeces specimens from restaurant workers more than a decade ago to, for example, establish that three outbreaks of food poison in the Hunter that year had been caused by food handlers not washing their hands after going to the toilet. Later it found in a survey of restaurants' food handlers that one in seven admitted to not washing their hands after using the toilet. Given the embarrassment of such staff, the real figure would be much higher. In Canberra a few years later observers stationed in the toilets of a shopping complex found that only one of 13 identifiable food handlers washed his or her hands properly on that day.

Hunter Area Health hopes to increase its staff's hand-washing rate to 80 per cent, from the current 65 per cent, and even that increase will leave, presumably, people dying unnecessarily of septicaemia.

Most of us have grown up to the cry of "wash your hands", and apart from the risk to health there is the simple filth of it all. What more can be done?