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Plenary, 26 Mar 2008

26 Mar 2008 · S3 · Plenary

Item of business

Health Care Associated Infection

Grant, Rhoda Lab Highlands and Islands Watch on SPTV

Many members have talked about consensus, but consensus does not make the debate any less important—we should debate such issues.

The cabinet secretary mentioned the Western Isles hospital and I am pleased to have heard her announcement that it will form part of the screening pilot. The ethos at the Western Isles hospital is about infection control. When a person walks into the hospital, they hear a recorded message telling them to wash their hands if they have not already done so. They find hand-cleaning lotion for their use at the entrance to the ward and to the patient's room, and inside it at the foot of the bed, beside the patient notes, and by the wash-hand basin. The hospital strongly emphasises hand washing and informs patients, visitors and staff that they, too, should emphasise it. As I said, I am pleased that the Western Isles hospital is involved in the pilot. That demonstrates the effectiveness of the course of action that the hospital has taken. The pilot will also show any improvement that results from patients being screened before coming into hospital.

In many cases, it is too late to wait until someone has walked into a hospital to educate them on infection control. Patients are worried about their condition and what lies in store for them. Relatives, too, worry about what is happening to family members. That said, notices advising people to wash their hands are important. The Western Isles hospital displays them prominently. Other hospitals could learn from its example.

Hospitals have notices telling people not to sit on a patient's bed, but they do not tell people why they should not do that. We need a system that informs people about infection control long before they walk into a hospital, when they are feeling stressed because of what lies ahead for them, or their loved one.

Hand washing used to be taught in all schools. It then became part of community education, with notices posted in public places telling people to wash their hands. We need to return to those first principles on hand hygiene. We should mount a public information campaign to tell people why the rules have been put in place. People need to know about the importance of not sitting on a patient's bed, but on a chair, and of washing their hands before they visit the ward. Indeed, if someone is visiting more than one patient, they should be told about the importance of washing their hands between visits.

Advertising campaigns should be used to do that, given that they have been successful in the past. We also need to use the popular media. I am thinking of television programmes that highlight the health services, such as "Casualty" and Holby City" that have been used to put across good and important messages. We need to be told that it is everybody's responsibility to cut down on infection—staff, patients and visitors.

More public information is needed on the use of antibiotics, as many members have said. General practitioners are often pushed for time; they can come under a huge amount of pressure to prescribe antibiotics. Before patients go to their GP, it is important for them to be well informed about the ill effects of antibiotics on their health and that of others. We need to stop the over-prescribing of antibiotics, and responsibility for that lies not only with GPs but patients. Work also needs to be done on use of antibiotics in treating animals and, more generally, in farming. The impact of such use is not fully known, and it is an important source of antibiotic resistance.

We need also to counteract some of the scare stories that appear in the press on hospital-acquired infection. As other members have said, people can be reluctant to go into hospital because of the fear of catching an infection. It is also important that people understand the nature of the infections and where they arise. Hospital-acquired infections are obviously acquired in hospitals, but they do not always arise there; they can be brought into hospital.

We need to work with staff. I was interested to read the BMA briefing for the debate, which raised the importance of work clothing being designed with short sleeves and no ties. Perhaps it is time for us to look at the provision of uniforms for all staff. It is important for us to do so, given that the BMA has highlighted the issue. In the hospital pecking order, some staff wear uniforms and others do not.

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Plenary, 26 Mar 2008

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