MRSA: Vaccine Development (Hansard, 3 April 2001)

§ Lord Hunt of Kings Heath
My Lords, a research advisory group has reviewed needs in the field of antimicrobial resistance. It has recognised the importance of vaccine development. Recommendations that further detailed consideration be given to this area, in collaboration with the Medical Research Council, industry and other funders will now be taken forward.

§ Baroness Masham of Ilton
My Lords, I thank the Minister for that rather vague reply. Is he aware that MRSA has spread to most hospitals in the country? People are becoming fearful of going into hospital for routine operations. This problem is costing the National Health Service an immense amount of money, as well as exacting a high toll on human resources.

§ Lord Hunt of Kings Heath
My Lords, the Government regard the matter of MRSA and hospital acquired infection in general as one of great concern. Indeed, two reports from the Select Committee of your Lordships' House have drawn attention to the challenges we face. We have issued guidelines to the NHS. We have introduced a system of controls assurance which makes the chief executive of every NHS trust report to the board on the measures being taken to ensure that everything possible is done to reduce the incidence of infection. I also believe that we need to ensure that preventive measures are adopted. Some of those measures are as basic as ensuring that simple hand-washing is undertaken by all staff in hospitals.

§ Lord Clement-Jones
My Lords, in January this year the Government announced what they described would be the biggest ever hospital clean-up and stated that they would launch a series of unannounced visits to every hospital in the country by the end of March. What are the results of that hospital inspection process and how prevalent is MRSA in those hospitals?

§ Lord Hunt of Kings Heath
My Lords, MRSA is prevalent, but the data we hold at present are not sufficiently robust to enable me to give definitive answers to the noble Lord's questions. That is why we have introduced a new data collection system from 1st April this year. It will establish a baseline from which we shall be able to monitor the progress being made and, potentially, then issue targets to the NHS to ensure that the incidence is reduced.
Having launched Operation Clean-Up, I can tell the noble Lord that we established patient environment action teams which have made regular visits to over 400 hospitals in NHS trusts over the past few months. The teams have graded the hospitals into green, yellow or red groups. Those hospitals which are seen to be in some difficulty over cleaning have been told in no uncertain terms exactly what improvements need to be made. We shall announce the overall results of that initiative in due course, but the indications are that it is having a considerable effect.

§ Lord Rea
My Lords, will the new database mentioned by my noble friend in his last response be based on a national surveillance scheme to measure the extent of microbiological antibiotic resistance in all hospitals in the United Kingdom? Furthermore, can he tell the House whether the Government envisage introducing a scheme so that residential care homes and nursing homes will also be covered, perhaps on a sample basis? They often act as reservoirs for MRSA infection.

§ Lord Hunt of Kings Heath
My Lords, I can confirm to my noble friend that the new data collection scheme will embrace all the NHS trusts in England. So far as residential care homes and nursing homes are concerned, such information would be covered by the PHLS Piloted Communicable Diseases Surveillance Centre, which is based on capturing and collating the results of all antibiotic susceptibility tests performed on routine specimens in microbiology laboratories. That scheme will be rolled out to other regions over the next two years.
The other way in which residential care homes and nursing homes can be covered is through their regulation, at present undertaken by health and local authorities, but in the future to be undertaken by the national care standards commission. I am sure that the commission will wish to look at rates of infection in individual homes.

§ The Countess of Mar
My Lords, in view of the fact that it has been reported that each year more than 5,000 people are killed off by the National Health Service through infections and that many thousands 726 more are made seriously ill, perhaps I may make the following recommendation. As no one has yet died from eating unpasteurised cheese in this country, perhaps the Government should move those environmental health officers currently employed to watch what we do to work in hospitals?

§ Lord Hunt of Kings Heath
My Lords, that seems to be an extremely helpful suggestion and I am sure that it will be given every consideration. We have to be cautious about the estimated figure of 5,000 deaths. That estimate was based on a 1980 study undertaken in the United States which used 1970s data. However, we have to be extremely concerned about any potential deaths arising from MRSA or wider hospital-acquired infection. This stresses the importance of ensuring that the new data collection scheme is effective. We shall then be able to make future judgments and set targets against that data.

§ Earl Howe
My Lords, is it not time to bring back matron?

§ Lord Hunt of Kings Heath
My Lords, the noble Earl knows that I am very keen to bring back matron. We have introduced modern matrons as part of the NHS Plan. Those staff will be real matrons because they will have the authority to deal with issues in relation to cleaning, linen, catering and the feeding of patients, which the previous government disempowered ward sisters from undertaking. That is why we are reintroducing the whole concept of clinical nurse leadership in our hospitals.