§ Dr. Evan HarrisTo ask the Secretary of State for Health when he will answer the letter from the Chairman of the CJD Incidents Panel to the Chief Medical Officer. [15298]
§ Jacqui Smith[holding answer 15 November 2001]The Deputy Chief Medical Officer replied to Professor Banner on 23 November.
§ Dr. Evan HarrisTo ask the Secretary of State for Health what studies have been conducted into the adequacy of cleaning and sterilisation of dental surgical instruments(a) before and (b) after the meeting of SEAC on 17 July which analysed the risk of person-to-person transmission of CJD arising from dental surgery. [15293]
§ Jacqui Smith[holding answer 15 November 2001]As part of a snapshot survey of decontamination practices at some national health service hospitals and other health premises, a small number of general dental practices were visited prior to the meeting of the Spongiform Encephalopathy Advisory Committee on 17 July 2000.
Visits have been made to dental hospitals and dental departments of NHS trusts as part of the comprehensive review of current decontamination practices in NHS hospitals which began in October 2000.
§ Dr. Evan HarrisTo ask the Secretary of State for Health if the report by Dr. David Hurrell on hospital sterilisation procedures was made available to(a) the Economics and Operational Research Division when they compiled their report, Risk Assessment for Transmission of Variant CJD via Surgical Instruments: a modelling approach and numerical scenarios, in December 2000 and (b) the Spongiform Encephalopathy Advisory Committee. [15300]
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§ Jacqui Smith[holding answer 15 November 2001]A snapshot survey of some hospitals and other health premises was undertaken last year by the NHS Estates Agency of the Department. An advisory panel, which included members of professional organisations as well as Departmental officials, was established to oversee it. Mr. David Hurrell acted as technical co-ordinator. As a result of that limited survey, a more comprehensive one was announced in October 2000.
The findings of the snapshot survey were readily available to the Department's Economic and Operation Research Division, as they were part of the overseeing advisory panel.
The Spongiform Encephalopathy Advisory Committee was not provided with results from the initial survey. But the Committee was informed at its meeting of 28 November 2000 that a major initiative had been launched to improve standards of washing, decontamination and general hygiene, earlier identified by the committee to be key steps in reducing the risk of transmission of variant CJD.
§ Mr. Evan HarrisTo ask the Secretary of State for Health if he will make a statement on the major research programme into instrument decontamination referred to in paragraph 2.52 of the CJD incidents panel consultation paper 'Management of Hospital Exposure to CJD through Medical Procedures'. [15291]
§ Jacqui Smith[holding answer 15 November 2001]In 1999, the Department inaugurated a programme of research to develop and evaluate novel decontamination reagents and processes. Ten research contracts have been issued so far and a further four will be initiated in the near future. Progress on these contracts is overseen by a co-ordinating group which meets every six months, includes advisers from the Public Health Laboratory Service, the Medical Devices Agency and the National Health Service Estates Agency.
Over £565,000 was spent on this subject in the year April 2000/March 2001 and expenditure is expected to rise to nearly a £1 million in the current year. Details of the current research programmes can be found on the Medical Research Centre website at http: //www.mrc.ac.uk/tse_tb2c.htm.
§ Dr. Evan HarrisTo ask the Secretary of State for Health if he will give details of the(a) composition, (b) work and (c) number of meetings held by the project team set up by Department and to oversee the implementation of the programme of action set out in HSC 200–032. [15292]
§ Jacqui Smith[holding answer 15 November 2001]The decontamination project is managed by a steering group that varies in composition depending on the aspect of the project it is considering. In its original form, it met four times. It is now led by Roger Evans, a former national health service trust chief executive, and its "core" membership contains representatives from the NHS Estates Agency, the Medical Devices Agency, the NHS Purchasing and Supply Agency, the Department's Operations Directorate and the Department's Public Health Division. It is responsible for overseeing the day-to-day running of the project, including recommending the allocation of 439W resources and co-ordinating communications with the NHS and with the providers of sterile supply equipment and services. It has met three times and meets monthly.
§ Dr. Evan HarrisTo ask the Secretary of State for Health what guidance he issued to press offices and Department of Health appointees on dealing with BBC inquiries on surgical instrument decontamination. [15419]
§ Jacqui Smith[holding answer 16 November 2001]The Department's communications directorate has standing instructions on how to deal with requests from the media. The media centre worked with Panorama over several months, answering a number of inquiries, arranging a briefing meeting with the Department's policy leads on CJD, blood and decontamination and ensuring Panorama was invited to a key media briefing. The press officer dealing with Panorama was provided with answers to their questions and gave Panorama a statement on behalf of Ministers, which they chose not to use.
§ Dr. Evan HarrisTo ask the Secretary of State for Health when he received the(a) interim report and (b) final report by Dr. Hurrell into the adequacy of hospital decontamination of surgical instruments. [15421]
§ Mr. Andrew TurnerTo ask the Secretary of State for Health (1) when a Minister saw a draft report from Dr. David Hurrell on Creutzfeldt-Jakob disease in hospitals; and if he will make a statement; [15381]
(2) what action he is taking on Creutzfeldt-Jakob disease in hospitals following reports by Dr. David Hurrell; [15380]
(3) when Dr. David Hurrell was commissioned to investigate the risk of hospital patients developing Creutzfeld-Jakob disease; what his terms of reference were; when a draft of his report was communicated to his Department; and what was his Department's response. [15378]
§ Jacqui Smith[holding answer 16 December 2001]The survey, which began in September 1999, was a snapshot of decontamination practice at the time in a small number of hospitals and other health premises in England. It was commissioned by the Chief Medical Officer
To investigate the provision and use of equipment, facilities, trained personnel, management arrangements and technical support for decontamination of re-usable medical devices within NHS hospitals, private and voluntary organisations and primary medical and dental facilities;To establish the extent to which these complied with current legal requirements, published standards (both European and UK) and Department of Health best practice guidance;To obtain information on the usefulness of existing advice and guidance.A presentation on the progress to date was given to regional directors of public health (RDsPH) in March 2000 and the completed report was sent to the Department in September 2000. Mr. Hurrell was employed as technical co-ordinator for the survey, acted as lead assessor for some of the visits, helped to analyse the information collected, contributed to the production of the reports and helped to give the presentation to the RDsPH. He was not responsible for writing either report. The survey was carried out for specific purposes, one of which was to set in train further work—including deciding whether a more comprehensive survey was needed.
440WThe results of this preliminary survey showed that there were variations in decontamination practice, including instances that fell below acceptable standards. A comprehensive survey of national health service trust decontamination facilities began when Health Service Circular 2000/032 was issued on 18 October 2000. This circular clearly stated that
a snapshot survey of current decontamination practices in a small number of healthcare premises in England has now been carried out. A more comprehensive review of decontamination provision across the health service now needs to take place so that plans for the future can be based on national findings.In tandem with the surveys of decontamination, the Department developed a risk assessment on surgical instruments, which was first considered by the Spongiform Encephalopathy Advisory Committee in May 2000 and endorsed at its meeting in September 2000. It was published in March 2001. The Department presented its risk reduction strategy to the Committee's November 2000 meeting. The key components of this strategy were announced by my right hon. Friend the Member for Southampton, Itchen (Mr. Denham), the then Minister of State, Department of Health on 4 January 2001 with £200 million to be invested in the modernisation of NHS decontamination facilities and with the introduction of single-use instruments for tonsillectomies. Since then, we have:
Devised a self-assessment tool and collected data from every NHS trust;Run a series of development workshops to raise awareness of the importance of decontamination among NHS managers and technical staff;Visited and assessed all NHS acute hospital sites carrying out decontamination;Implemented a programme of work to improve standards where necessary.As a result of this, all NHS acute hospitals have access to a satisfactory standard of decontamination.
The modernisation of NHS decontamination services is a long-term process, not a one-off event and we will continue to ensure that appropriate precautions, based on evidence and scientific advice, are taken to ensure patient safety.
§ Dr. Evan HarrisTo ask the Secretary of State for Health what assessment he has made of the views of the Chairman of the CJD Incidents Committee relating to the report of Dr. Hurrell. [15422]
§ Jacqui SmithWe gave careful consideration to the views of the chairman of the CJD incidents panel but decided there was nothing to be gained from letting the panel have sight of an out-of-date and partial survey that had been overtaken by more recent work.
The preliminary survey was a "snapshot" of decontamination practices at some national health service hospitals and other health premises. It was prepared for specific purposes, one of which was to set in train further work—including deciding whether a full survey was needed. The Department has since announced:
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- i. in October 2000, that a full survey would be undertaken; and
- ii. in January 2001, that a £200 million investment programme over the next two years to address decontamination standards would be set in train.
The Department has published the results of the full survey, including the snapshot. A copy will be placed in the Library.