MRSA Infection: Control (Hansard, 1 February 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the Department of Health issued guidance to the National Health Service in September 1994 on the control of MRSA and in March 1995 on the general control of infections in hospitals. Although MRSA is an uncommon cause of infection in the community we shall shortly be issuing further guidance to health authorities and social services departments.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that reply. Will she tell the House whether she feels there are enough side wards in hospitals to cope with patients with resistant infections? Does she agree with me that the world has become small in terms of travel? Is she aware that during the summer I met an Australian girl who had travelled to Africa and then had come to London and who became ill and was taken to St. Mary's Paddington where, after many hours in the casualty department, she was admitted to a bathroom which happened to be the only place available?

§ Baroness Cumberlege
My Lords, when MRSA is prevalent in a hospital it is up to the local management to deal with it. Sometimes that means having to close an entire ward in order to do so. Screening is available for travellers entering the UK. If found to be suffering from infectious diseases clearly they receive appropriate treatment and immunisation if that is necessary. With regard to beds in London and in other parts of the country, we are aware that there has been pressure through the winter on accident and emergency departments. My honourable friend the Minister for Health is taking action to address that problem.

§ Baroness Hayman
My Lords, is the Minister aware that the action that is being taken on the staffing in A&E 1555 departments, although welcome, does not help the situation regarding beds? Is she further aware that the high prevalence of MRSA in acute hospitals at the moment is not only a risk to individual patients but also to the capacity of those hospitals to deal with their patient workload? Further, is the Minister aware that the intense pressure on bed occupancy at the moment is not only a contributing factor to the prevalence of MRSA, but also the infection exacerbates the problem by lengthening stays and by making it difficult to discharge patients? Is there not mounting evidence that the squeeze on beds has simply gone too far?

§ Baroness Cumberlege
My Lords, as I said, it is up to local trusts to deal with a situation where there is infection in a hospital. I appreciate that there has been pressure on beds, especially during the winter, and we have seen an unexplained rise in accident and emergency admissions. In addition, coupled with the incidence of influenza among staff, there has been a problem in staffing some of the wards. We are taking action on that. The noble Baroness as the chairman of a trust will be well aware of the action that is being taken.

§ Lady Kinloss
My Lords, can the Minister say whether there are sufficient trained nurses in control of these infections? Could she also comment on the report on Radio 4—I think it was early Tuesday morning—that the Heriot Watt University hopes it has found at least a treatment, perhaps a cure, for some of these infections and that it is contained in seaweed?

§ Baroness Cumberlege
My Lords, the staffing of wards is a matter for the local management. The new treatment that is being developed at the Heriot Watt University, is, of course, very interesting, but at this moment it is a little too soon to say whether it will be effective. However, we are cautiously optimistic.

The Earl of Clanwilliam
My Lords, does my noble friend agree that the shortage of beds in the NHS is largely as a result of people contracting diseases caused by the side effects of existing drugs which are provided by the pharmaceutical companies? Would there not be great benefits to be gained, in terms of the bed situation, if we could arrange for drug companies to produce less dangerous drugs, and perhaps if the health service paid attention to complementary medicine?

§ Baroness Cumberlege
My Lords, I know of my noble friend's great interest in complementary medicine. The pharmaceutical industry of this country is a great success. Indeed, it produces a positive trade balance of £1.7 billion a year and I believe that Glaxo is one of the most successful pharmaceutical companies in the world. As regards hospital infections, we have not seen an increase since the survey was done in 1980 and despite the increasing numbers of patients who are being treated the levels are still about the same.

§ Baroness Jay of Paddington
My Lords, is it not disturbing that senior microbiologists with whom we have discussed the question say that one of their problems with MRSA is that new managers in the health 1556 service require them to measure their performance in output units? That seems a rather difficult background against which to do the kind of research which is necessary to try to combat the problem.
In addition, is the noble Baroness aware of the reported comment of a doctor at St. Thomas' hospital that the understanding of the nature and extent of the infection was being minimised because hospitals were in competition with each other? Is that not another example of the NHS managers perhaps putting market values above their clinical responsibilities?

§ Baroness Cumberlege
My Lords, perhaps I may respond first to the noble Baroness's point about research. We are doing a lot of research on MRSA. There are two research projects specifically on this particular bacterium, totalling £46,000 a year. A further £2 million a year is being spent on other studies on hospital infection control generally. The noble Baroness must see the management of the health service in the light of the fact that never before have we treated more patients and never before have we had shorter waiting times. Clearly managers are concerned, because if there are infections the performance of their trust will be reduced. Therefore, managers will be as anxious as anybody else to ensure that infections are kept to a minimum.

§ Baroness Robson of Kiddington
My Lords, is the Minister aware that last year at Addenbrooke's hospital 183 operations were cancelled and wards were closed for 263 days due to the incidence of MRSA? Since then the position has deteriorated somewhat. Therefore, does she not agree that the microbiology services in hospitals become of increasing importance? Can we have an assurance that those services will not be cut under any circumstances, despite the problems of finance in the health service?

§ Baroness Cumberlege
My Lords, I agree with the first part of the noble Baroness's question. With regard to the second part, that is a matter that has to be left to local determination.