Hansard

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 and beyond.

It is important that we acknowledge that Scotland is a world leader in tackling HAI. During the past five years, our HAI task force has taken forward a high-quality programme of action to address infection and I take this opportunity to commend its work. On the amendment to our motion, I have no difficulty in recognising the previous Administration's contribution in setting up the task force and the Scottish National Party intends to support the amendment.

Although action that has been taken in recent years has stabilised rates of some infections and reduced rates of others, the overall rate of infection in our acute hospitals remains stubbornly high at 9.5 per cent, which is unacceptable. HAI takes a heavy financial toll—it costs the national health service nearly £200 million per year—and the threat of HAI erodes public confidence in the NHS. Many patients believe that, as a matter of course, they will catch an infection during their stay in hospital. We must work to recapture a sense of ownership and pride in our hospitals. NHS staff must embrace a culture in which keeping patients free from infection is not just their responsibility but everyone's responsibility.

In tackling HAI we must understand two important points. First, we will not eradicate all infection from our hospitals; what we can do is reduce infection and control it better. Robust and stringent infection control measures that are regularly applied in our health care environment will go a long way towards effectively tackling HAI.

Secondly, the NHS is not always to blame. Many infections are brought into hospitals from the community. That means that the public have a vital role to play, for example by washing their hands thoroughly, not sitting on beds and not touching drips and intravenous stands. However, it is essential that the NHS redoubles its efforts to drive down infection. A fresh and more targeted approach to HAI is needed if we are to ensure that the NHS delivers to the high standards that patients rightly expect.

Last November, I announced the largest ever investment in the fight against HAI in Scotland—£54 million over the next three years—to drive infection rates down from the rates that were published in July in the final report of the NHS Scotland national HAI prevalence survey. I also made it clear that the key elements of our patient safety and patient experience programmes will link with the HAI agenda to bring about a coherence of approach in the way the NHS in Scotland delivers its service.

It is also essential that we set NHS boards tough targets and hold them more firmly to account. A key example is the health improvement efficiency access and treatment target for all NHS boards to achieve a 30 per cent reduction in Staphylococcus aureus blood infections by 2010. We are at an early stage of monitoring progress, but the signs are good: seven mainland NHS boards already show signs of a downward trend. I am encouraged by that and I have asked the HAI task force to put in place stronger supporting mechanisms to assist boards in achieving the HEAT target.

Another core target is good hand hygiene compliance among NHS staff. Good hand hygiene is the single most effective way of cutting infection rates in hospitals and simply must become more embedded in everyday culture. The first Scottish national hand hygiene NHS campaign audit report, "Compliance with Hand Hygiene—Audit Report", which was published in December, showed that compliance had risen from 68 per cent in the first audit period, in February 2007, to 79 per cent in the second audit period, in September.

The increase in compliance is welcome, but there remains enormous scope for improvement. Patients rightly expect the highest standard of hand hygiene from staff, and a compliance rate of 79 per cent is not nearly good enough. I have set all NHS boards a target to achieve at least 90 per cent hand hygiene compliance by November. To help NHS boards to attain that target, Health Protection Scotland will step up its monitoring regime and publish quarterly audits from April this year. HPS will also take charge of a new look campaign that will be aimed primarily at NHS staff, patients and visitors.

Health Facilities Scotland has also been invited to raise the bar on hospital cleaning. It will overhaul the monitoring framework to ensure that it continues to set demanding and challenging standards for boards.

All those actions—and many more—are part of the new three-year HAI delivery plan that starts on 1 April. It aligns key action areas with the findings in the Scottish point prevalence survey and complements and co-ordinates the work being carried out on patient safety. The plan will be backed by £5 million of annual resources over the next three years.

I am making available £90,000 a year from the budget to allow the Scottish Commission for the Regulation of Care to recruit a nurse consultant for infection prevention and control. The nurse consultant's main target area will be to promote and increase higher standards of prevention and control of infection across the range of services that are regulated by the care commission, particularly those for the elderly. I know that that point is covered in the amendment to the motion.

I understand and stress how vital it is that we tackle all hospital infections, but the next matter that I want to touch on is our ambitious plan to tackle MRSA in our hospitals through the implementation of a national screening programme.

I have on previous occasions made clear my intention, subject to successful piloting, to roll out a national MRSA screening programme from April next year. That is in line with recommendations in the NHS Quality Improvement Scotland publication "The clinical and cost effectiveness of screening for meticillin-resistant Staphylococcus aureus (MRSA)", which was published in September 2007. To pave the way, and to ensure that we move ahead on the basis of robust evidence, we will invest £7 million this year in a screening pilot. NHS Ayrshire and Arran, NHS Grampian and NHS Western Isles will host the pilot as pathfinder boards from April this year. Those three boards together cover a population of almost a million people—a fifth of the Scottish population. They represent a diverse mix of urban, rural and island areas and include a range of hospitals from the very smallest to large teaching hospitals. The pilots will be an exhaustive test of the screening model and, crucially, will enable us to make informed decisions about the shape of the national programme that we intend to roll out from next year.

We should be under no illusion that MRSA screening is an ambitious undertaking, but I am proud that Scotland will lead the way with a planned, structured and deliverable national screening programme, which will help us to combat MRSA in our hospitals. I hope that the Parliament will give it enthusiastic support.

Closely linked to our work to tackle MRSA is our national initiative on improving the use of antibiotics. Earlier this month, I launched our new Scottish management of antimicrobial resistance action plan—ScotMARAP for short, which is perhaps not one of the NHS's better acronyms.

We have already invested £1.25 million in automated equipment to allow rapid standardised testing of antibiotic resistance in our laboratories. A new national forum will oversee implantation of the plan and will collate and disseminate information to help us to up our game in a key plank of the fight against infection in our hospitals.

I hope that in the short time that I have had today I have managed to convey to Parliament and to the public the priority that I personally, and the Government as a whole, have accorded to the fight against infection in our hospitals and other care settings.

My announcements today mark a new era of HAI action in Scotland. A multimillion pound investment is being made in Scotland to reduce HAI and I am setting a raft of demanding targets for NHS boards.

Allied to that, we will deliver a linked agenda with that on patient safety and patient experience to ensure a coherent approach. We will drive up standards, deliver more effective measures to minimise the spread of infection, lessen the number of ward closures and bring down HAI rates. We intend to deliver an NHS that is safer, more reliable, more anticipatory and more integrated. The effect of that will be to ensure that all those who are involved in the provision of NHS care in Scotland have a renewed sense of purpose to improve the quality of care that they provide.

Our new approach to tackling HAI means that health boards will have to adopt more flexible practices, develop new roles and design new ways of working. I will expect better motivation and support from senior NHS staff, to help individual staff members to understand why it is essential that they adopt safer and better practices. I assure members that I will expect NHS boards to deliver in this important area. Progress will be monitored closely. I look forward to reporting back to the Scottish Parliament on the progress that is being made on reducing infections in our hospitals.

I move,

That the Parliament notes the Scottish Government's commitment to bring infection rates down by investing £54 million to support a far more intensive and targeted three-year programme of healthcare associated infection (HAI) work from 1 April 2008; believes that the Scottish Government is right to introduce a one-year pilot MRSA screening programme to shape a planned, structured and deliverable national screening programme from 2009-10; welcomes the links that will be established between the Patient Safety and Patient Experience programmes and the HAI agenda to bring about a coherency of approach in the way that NHSScotland delivers its service to patients; welcomes the Scottish Government's continuation of the multi-agency HAI Task Force, and agrees with the challenging target that the Scottish Government has set for all staff of NHS boards to achieve at least 90% hand hygiene compliance by November 2008.