Chamber
Plenary, 26 Mar 2008
26 Mar 2008 · S3 · Plenary
Item of business
Health Care Associated Infection
The cabinet secretary is to be congratulated on this initiative. As the Labour amendment states, the previous Government is to be commended for the establishment of the HAI task force. The additional money that the cabinet secretary announced today and previously will be greatly significant in targeting not only MRSA but other virulent infections.
The incidence of MRSA has risen steadily over the years, as my colleague Michael Matheson and other members said. There are numerous reasons for that increase, but I will concentrate on just a few of them. A number of members spoke about the increase in drug-resistant infections, which has been brought about by the overprescribing of antibiotics. Nanette Milne targeted that point very well in her contribution. I welcome the cabinet secretary's announcement on how we will monitor and tackle that problem. People have been used to going to the doctor and receiving antibiotics because of a perceived need. That has led to antibiotics no longer working and our being left with virulent infections.
Another area that gives cause for concern is the movement of patients between hospitals and wards. Not so long ago, it was much less common for patients to be moved from hospital to hospital or even between beds. Unfortunately, it is much more common now, which has something to do with the spread of infectious diseases.
Helen Eadie and Irene Oldfather mentioned the contracting out of hospital cleaning services, which has had a direct effect on the spread of infectious diseases. Staff are now paid less and less time is allocated to cleaning wards. It is certain that those circumstances have contributed to HAI. I hope that the cabinet secretary, or perhaps the task force, will look at that area. The one-year screening programme pilot will have positive results, but only as part of a coherent and integrated approach to overall hygiene in hospitals. That point was mentioned in the motion and recognised by the cabinet secretary.
I know that the cabinet secretary is aware of the different views about screening. I offer two examples. In Geneva, 3,000 patients were screened for MRSA and the conclusion was that there was no benefit in such a programme. However, three hospitals in America used screening for MRSA and the conclusion was that screening did work. That is why it is beneficial for us to run the screening pilot, which must be monitored and audited after a year, as was mentioned. The pilot scheme is most welcome.
The cabinet secretary spoke in her opening remarks about the appointment of nurse consultants. Could that role be enhanced to include targeted cleaning pilots? Ross Finnie raised that point, as did the HAI task force, which I think referred to the housekeeping monitoring group. Combined targeted cleaning, which would entail the cleaning of clinical equipment and the patient environment, including lockers and bedframes, would be extremely beneficial. If it is not possible to extend the role of the nurse consultant in that way, will the cabinet secretary consider a pilot of targeted hospital cleaning?
Nanette Milne and others spoke about the role of former matrons. We know that we cannot go back to those days, but it is important that hospitals are clean not only for patients and visitors, who are encouraged to wash their hands; the hospital environment must be considered too. Michael Matheson mentioned that services vary in hospitals. In a letter to The Herald yesterday, I think, a lady said that she went to visit her mother in hospital and was appalled to see blood on the handrails of her mother's bed. That is totally unacceptable. Although it is up to the hospital management to deal with the problem, a targeted cleaning pilot would tackle such situations and they would not be allowed to happen. Over time, it would become the norm for hospitals to reach that high standard of cleanliness.
Everyone here agrees that patients must come first. They must have faith in the health service. The MRSA screening programme and additional money that the cabinet secretary announced today will bring benefits not just to this generation but to many generations to come.
The incidence of MRSA has risen steadily over the years, as my colleague Michael Matheson and other members said. There are numerous reasons for that increase, but I will concentrate on just a few of them. A number of members spoke about the increase in drug-resistant infections, which has been brought about by the overprescribing of antibiotics. Nanette Milne targeted that point very well in her contribution. I welcome the cabinet secretary's announcement on how we will monitor and tackle that problem. People have been used to going to the doctor and receiving antibiotics because of a perceived need. That has led to antibiotics no longer working and our being left with virulent infections.
Another area that gives cause for concern is the movement of patients between hospitals and wards. Not so long ago, it was much less common for patients to be moved from hospital to hospital or even between beds. Unfortunately, it is much more common now, which has something to do with the spread of infectious diseases.
Helen Eadie and Irene Oldfather mentioned the contracting out of hospital cleaning services, which has had a direct effect on the spread of infectious diseases. Staff are now paid less and less time is allocated to cleaning wards. It is certain that those circumstances have contributed to HAI. I hope that the cabinet secretary, or perhaps the task force, will look at that area. The one-year screening programme pilot will have positive results, but only as part of a coherent and integrated approach to overall hygiene in hospitals. That point was mentioned in the motion and recognised by the cabinet secretary.
I know that the cabinet secretary is aware of the different views about screening. I offer two examples. In Geneva, 3,000 patients were screened for MRSA and the conclusion was that there was no benefit in such a programme. However, three hospitals in America used screening for MRSA and the conclusion was that screening did work. That is why it is beneficial for us to run the screening pilot, which must be monitored and audited after a year, as was mentioned. The pilot scheme is most welcome.
The cabinet secretary spoke in her opening remarks about the appointment of nurse consultants. Could that role be enhanced to include targeted cleaning pilots? Ross Finnie raised that point, as did the HAI task force, which I think referred to the housekeeping monitoring group. Combined targeted cleaning, which would entail the cleaning of clinical equipment and the patient environment, including lockers and bedframes, would be extremely beneficial. If it is not possible to extend the role of the nurse consultant in that way, will the cabinet secretary consider a pilot of targeted hospital cleaning?
Nanette Milne and others spoke about the role of former matrons. We know that we cannot go back to those days, but it is important that hospitals are clean not only for patients and visitors, who are encouraged to wash their hands; the hospital environment must be considered too. Michael Matheson mentioned that services vary in hospitals. In a letter to The Herald yesterday, I think, a lady said that she went to visit her mother in hospital and was appalled to see blood on the handrails of her mother's bed. That is totally unacceptable. Although it is up to the hospital management to deal with the problem, a targeted cleaning pilot would tackle such situations and they would not be allowed to happen. Over time, it would become the norm for hospitals to reach that high standard of cleanliness.
Everyone here agrees that patients must come first. They must have faith in the health service. The MRSA screening programme and additional money that the cabinet secretary announced today will bring benefits not just to this generation but to many generations to come.
In the same item of business
The Presiding Officer (Alex Fergusson):
NPA
The next item of business is a debate on motion S3M-1621, in the name of Nicola Sturgeon, on the health care associated infection task force.
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I am pleased to open the debate and to present our ambitious new plans for tackling health care associated infection in Scotland during the next three years ...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I emphasise how much we in the Labour Party welcome the debate. We acknowledge that our amendment will be accepted. I associate myself with many of the point...
Nicola Sturgeon:
SNP
I hope that I can reassure Margaret Curran that the investment that we have set aside for the next three years is 260 per cent higher than the investment ove...
Margaret Curran:
Lab
I will take that—graciously, I hope—as an indication of the cabinet secretary's commitment. However, as I understand it, England has prioritised the issue, a...
Mary Scanlon (Highlands and Islands) (Con):
Con
It is always good to follow the gracious Margaret Curran. The Conservatives welcome the debate on health care associated infection. We also welcome the inves...
Ross Finnie (West of Scotland) (LD):
LD
I do not discern—and I suspect that, by the end of the debate, I will not discern—any disagreement with the proposition that, because health care associated ...
Nicola Sturgeon:
SNP
I am pleased to intervene on that very serious point. I hope that the member will take some reassurance from my pronunciation of "coherence" during my speech...
Ross Finnie:
LD
I am greatly comforted. We must maintain standards in the chamber.Health care associated infection is a serious issue, and I welcome the debate. Margaret Cur...
Ian McKee (Lothians) (SNP):
SNP
We have heard a lot—and I am confident that we will hear a lot more as the debate progresses—about the virtues of cleanliness in preventing health care assoc...
Helen Eadie (Dunfermline East) (Lab):
Lab
I agree with Ross Finnie's suggestion that there is likely to be near unanimity on this vital issue. I welcome the cabinet secretary's announcements about th...
Nicola Sturgeon:
SNP
I am always happy to consider lessons from elsewhere, and I appreciate Helen Eadie's point, but I remind her that I mentioned our policy, which I launched ea...
Helen Eadie:
Lab
I am sorry that the cabinet secretary feels aggrieved, but if she had been listening she would know that I congratulated the Government on its screening init...
Michael Matheson (Falkirk West) (SNP):
SNP
I welcome the Cabinet Secretary for Health and Wellbeing's statement. In the spirit of consensus, I acknowledge the work that the previous Labour and Liberal...
Irene Oldfather (Cunninghame South) (Lab):
Lab
I welcome the commitment that the cabinet secretary has made and the opportunity that the debate gives us to consider how we can reduce the risk of contracti...
Nanette Milne (North East Scotland) (Con):
Con
This debate on dealing with health care associated infections is extremely important. However, I cannot help feeling sad that the reputation of a health serv...
James Kelly (Glasgow Rutherglen) (Lab):
Lab
I welcome the opportunity to take part in this afternoon's debate on health care associated infections. I endorse the cabinet secretary's announcement and, o...
Sandra White (Glasgow) (SNP):
SNP
The cabinet secretary is to be congratulated on this initiative. As the Labour amendment states, the previous Government is to be commended for the establish...
Rhoda Grant (Highlands and Islands) (Lab):
Lab
Many members have talked about consensus, but consensus does not make the debate any less important—we should debate such issues.The cabinet secretary mentio...
Nicola Sturgeon:
SNP
Rhoda Grant makes an important point. It may be of interest to her and other members to know that we are working with the trade unions on a national uniform ...
Rhoda Grant:
Lab
Yes. I am grateful to the cabinet secretary for that information. The BMA position shows that doctors have the will and wish to see the proposal progressed.W...
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD):
LD
I agree with nearly everything that has been said in this worthwhile debate. The unanimity of the message will be encouraging to patients and health professi...
Jackson Carlaw (West of Scotland) (Con):
Con
We welcome all that Nicola Sturgeon has said today in her speech and her interventions, including the MRSA pilot that she announced, in what has been a usefu...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
As all other members who have spoken have said, the debate has been consensual, informed and of a high standard. As Jamie Stone said, that should give comfor...
Nanette Milne:
Con
My point was that it does not matter who actually does the cleaning. What is important is the supervision of a high standard of cleaning.
Dr Simpson:
Lab
I hate to say this, but I could tell Nanette Milne numerous stories of when contract cleaners have come in, done their bit and gone away, leaving the questio...
The Minister for Public Health (Shona Robison):
SNP
I have listened with interest to this constructive, stimulating and wide-ranging debate, which has served as a stark reminder that the Scottish Government an...