Hansard

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 points that the Cabinet Secretary for Health and Wellbeing made about tackling the issue, which is a challenging policy area.

It is important to begin by giving some context and by appreciating the scale of concern that exists more broadly in Scotland about the human impact of the lack of control of infections and its consequences. I will begin with a story that is from south of the border but which illustrates the human dimension to the issues that we are discussing. In October 2003, Emma Lynch gave birth to her daughter, Daisy, at Derriford hospital in Plymouth. Within two weeks, Daisy began developing a cyst on her chest. That one cyst spread and soon cysts covered her entire body. Daisy and her mother fought the infection for the next three years. It turned out that the child was sick because of an antibiotic-resistant form of the MRSA infection. She developed the infection at a hospital, a place where, one would assume, children are supposed to be taken care of, especially in the early years. In all likelihood, the little girl developed that horrific and life-threatening infection because someone did not wash their hands.

That story exemplifies how crucial the issue of health care associated infections is. As has been said, the number of such infections is on the rise. In the United Kingdom, the number of cases of infections that cause meningitis, pneumonia and toxic shock has increased by up to 100 per cent since 2002. The rate of MRSA infection has increased by 6 per cent and that for E coli infection has risen by 48 per cent. I acknowledge the cabinet secretary's focus on MRSA, but our amendment mentions the significance of tackling other infections.

As has been said, Scotland seems to have limited the spread of MRSA infection. According to a Scottish surveillance quarterly report, incidents of MRSA infections as well as the number of deaths resulting from them have remained largely stable since 2003. On the other hand, Clostridium difficile has been on the rise in certain areas in Scotland. In NHS Highland, the number of documented cases of C difficile rose to 120 in 2006, whereas there were only 50 in 2005. We have a problem with the spread of such infections in Scotland. We need to stay ahead of the rest of the UK on combating the spread of health care associated infections.

The fact that we have controlled infections such as MRSA is in large part a result of work by the previous Labour-led Executive. In England, emphasis has been put on investing in tackling such infections. I hope that Scotland will maintain the progress that we made in the past. We produced the first health care associated infections action plan, in 2002, and established a ministerial task force in 2003 that had the explicit goal of tackling issues such as the decontamination of medical instruments and antibiotic prescribing. The task force has established numerous initiatives, such as the promotion of alcohol-based hand rubs, the national cleaning services specification for hand hygiene and the cleanliness champions programme, which is an education initiative.

The task force has recognised risk management methodologies and model infection-control policies, and it has promoted the innovative "NHSScotland Code of Practice for the Local Management of Hygiene and Healthcare Associated Infection (HAI)". As I said earlier, it is important that Scotland continues to lead the way in fighting all health care associated infections. We will no doubt debate that again and again in the Parliament.

The Government's commitment to more funding to address the potential spread of infections is welcome—it is representative of our approach when we were in government. We welcome the investment as a necessary step in ensuring that Scotland remains at the forefront of medical advances in the field, and in ensuring that health care associated infections are addressed. As I have said, there are more cases of C difficile in the UK than cases of MRSA. I hope that the cabinet secretary will address that issue in the near future.

As the cabinet secretary said, it is important that we focus on—and provide funds for—tackling the issue of antibiotic resistance. That, too, will be a continuation of work that has gone on in the past. The 2005 prescribing policy established recommendations for proper practice in acute hospitals; increased NHS boards' accountability; promoted training and education in prescribing; and defined the minimum requirements for collecting information, auditing, and developing performance indicators. It is proper that the priority given to tackling the unnecessary prescribing of antibiotics is continued. It will undoubtedly be a crucial part of fighting the spread of health care associated infections.

One of the most important points that the cabinet secretary made was that we have to focus on the importance of promoting hand hygiene—a significant and effective way of stopping the spread of health care associated infections. I am persuaded that full hand hygiene compliance is essential in health care facilities if we are ever to control such infections. Health care workers must be trained in proper hand hygiene. It can be difficult to grasp that doctors, nurses and other members of staff need to be trained in hand hygiene. Knowledge of hand hygiene should be common to all, but the prevalence of health care associated infections shows that it is not. That must remain a priority.

Patients need to feel confident about speaking up if they think that a health care worker has not used proper hand hygiene measures when treating them or other patients. We need to let people know that they have the right to speak up. That will be imperative in addressing the problem of high rates of infection.

I note that the Government has set what seems to be an aggressive target of achieving 90 per cent hand hygiene compliance by November 2008. The quarterly statistics will help us to measure that. The Health Protection Scotland report shows us how and where the problem of a lack of hand hygiene compliance is most severe. I understand that some NHS boards, such as NHS Forth Valley and NHS Orkney, as well as the national waiting times centre, already have compliance rates of over 90 per cent. They should be congratulated on that. However, in some areas, compliance is below 70 per cent and, in others, it is below 60 per cent. It is vital that we continue to address the problem.

It is imperative that the Government focus on care homes, as we suggest in our amendment. The previous Executive made important strides in that area and we need to ensure that that work is continued.

In 2005, the care commission published "A Review of Cleanliness, Hygiene and Infection Control in Care Homes for Older People". I note what the minister has said today, but it is vital that older people in care homes can be promised a clean and secure environment. They have to be protected from infection.

It is vital that funding levels are maintained in order to match those in England. I hope that the minister will reassure us on that.