HC Deb 14 September 2004 vol 424 cc1109-12
4. Bob Spink (Castle Point) (Con)

If he will give the most recent rate of hospital-acquired infection for (a) the NHS and (b) private sector health care providers. [188504]

The Minister of State, Department of Health (Mr. John Hutton)

It is estimated that hospital-acquired infections affect 9 per cent. of NHS in-patients, which is broadly similar to the level in other European countries. For example, estimates for the Netherlands and Spain are 7 per cent. and 8 per cent. respectively, and it is estimated that rates could be as high as 10 per cent. in France. There are no estimates available for rates of hospital-acquired infections in the independent sector.

Bob Spink

What is undeniable is that these superbugs are growing like Topsy. They are afflicting more and more people, and will continue to do so unless we tackle the issue. Does the Minister, who is an excellent Minister, agree that one way to tackle it would be to publish clear statistics for every single hospital in the country, and to give patients the right to choose? That would put the onus where it ought to be, and force the system to correct itself. The right to choose is the way forward.

Mr. Hutton

The hon. Gentleman is an excellent Member of Parliament, too. I agree with him both in relation to publishing this information and giving patients the right to choose. Those are the Government's policies. In relation to publishing rates of MRSA infections, we have been doing that, and that information is available. In the case of Southend hospital, for example, which serves his constituency—it is also an excellent hospital, because both my mum and two of my sisters have worked there—last year, the trust reported an improvement in its MRSA infection rates. Obviously, there is more to be done, but it is equally true that many parts of the NHS are engaging properly with that debate right now.

Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)

When my right hon. Friend considers infection rates, will he take into account the fact that a significant number of patients entering hospital already have such an infection? Research shows that something like 17 per cent. of patients in nursing homes are infected, and University Hospital Birmingham NHS Trust found that something like 40 per cent. of patients had it in their blood culture. So the figures are not necessarily a direct reflection of the hospital's performance, but of a much wider picture.

Mr. Hutton

My hon. Friend is right, for the simple reason that, as we all know, MRSA is widespread in the community at large. It is not a bug that is simply manufactured and cultivated inside hospitals—obviously not. What we record are incidences of bloodstream MRSA infections, which is important if the national health service is to have a proper understanding of the nature of the problem. There is concern on both sides of the House, which I share, and we need to do more. I understand that, and we are trying to do that. It ill behoves Opposition Members to point the finger of blame at us for not doing enough, given that they were the ones who refused to collect the information in the first place.

Mr. Peter Lilley (Hitchin and Harpenden) (Con)

Can the Minister explain why, in the years during which I have been pursuing the issue of hospital-acquired infections, an increasing number of consultants, doctors and nurses have contacted me to say that in their hospitals the problem is made worse by the fact that clinical priorities are overridden by Government targets and bureaucratic priorities? Could that be the reason why the situation is worse in this country than in most countries of Europe, and according to the European Commission, is getting worse faster in this country than in the rest of Europe?

Mr. Hutton

I pay tribute to the right hon. Gentleman, who has been clear in his concerns, which he has raised over several years, but there are no data connecting waiting times targets with levels of HAIs. Bed occupancy rates in the US, for example, are very much the same as here, and it has similar rates of hospital-acquired infections. We need to focus on initiatives that we know work: the hand hygiene campaign, for example, will make a significant difference. It is not the case, however, that all those unfortunate infections can always been prevented. We estimate that up to a third can, and it is important that the NHS does all that it can to focus on those cases on which it can do more. That is what we are doing.

Mr. Stephen McCabe (Birmingham, Hall Green) (Lab)

Obviously, I am interested in the views of consultants who write to the right hon. Member for Hitchin and Harpenden (Mr. Lilley), but can we contrast those with the views of trade union leaders and nurses who write to me saying that the problem has got worse since the contracting-out of cleaning services, for which his Government were responsible?

Mr. Hutton

I am grateful to my hon. Friend, who has restored a bit of balance to this debate. We have raised such issues with the right hon. Member for Hitchin and Harpenden (Mr. Lilley) previously, and we differ from him and his colleagues on this matter. I do not believe that the pursuit of compulsory competitive tendering led to an overall increase in standards of cleanliness in our hospitals—and the buck for that policy, I am afraid, rests entirely with him and his hon. Friends.

Mr. Andrew Lansley (South Cambridgeshire) (Con)

If the right hon. Gentleman is an excellent Minister, he will have taken steps to identify and investigate the circumstances reported by the National Audit Office in which infection control teams recommended bed and ward closures. What practical steps has he taken?

Mr. Hutton

The guidance on ward closures still exists. It dates from the time when the hon. Gentleman's party was in government, and the Cooke report. We have made no changes whatever to the guidance that the hon. Gentleman—I assume—supported, as an active Conservative.

When the hon. Gentleman referred to the NAO report figures last week, he spoke of about 12 per cent. of cases in which ward closures did not result from the advice of local infection teams. That is a matter for concern. It is not clear from the report—the hon. Gentleman has no data and nor, unfortunately, have I—where the decision was countermanded. Was it countermanded by, for instance, clinical directors or other medical staff in the hospital?

What the NAO report does say—I am surprised that the hon. Gentleman did not confirm this—is that in nearly 90 per cent. of cases the advice was followed. I think that that is progress in the right direction.

Mr. Lansley

It is precisely in regard to that 12 per cent. that the Minister has told us that he has no information—no data. What steps is he taking?

It is true that when infection control teams make recommendations, they do so on the basis of risk assessments. It is in patients' interests, and necessary for their safety, that the recommendations be followed. Ninety per cent. is not a good enough result. In 12 per cent. of cases, the advice was not followed: it was countermanded by hospital management. The NAO said that in 2 per cent. of cases it was advised against by the strategic health authority, which is directly under the Minister's control. Will he now tell us that on no future occasions when infection control teams have made the appropriate risk assessments and recommended a bed or ward closure will that recommendation be ignored for the purpose of pursuing the hospital's waiting list targets?

Mr. Hutton

As my right hon. Friend made clear in last week's debate, we have always believed that these are matters for clinical judgment and clinical priorities, which should always be dealt with on that basis in the national health service.