Hansard

It is always good to follow the gracious Margaret Curran.

The Conservatives welcome the debate on health care associated infection. We also welcome the investment of £54 million in the targeted three-year programme of action on health care associated infection from April this year alongside the one-year MRSA screening pilot. However, we do not know whether £54 million is enough and I did not know until I came to the chamber exactly what outcomes we could expect from the programme and how they would be measured.

I also want to be gracious in welcoming the quarterly audits. It will be helpful to see not only what the outcomes are and where the money is invested, but how effective the investment is.

I acknowledge the target of 90 per cent hand hygiene compliance by November. My colleague Nanette Milne will say more on that. We note the previous Government's work on the issue. Although the measures that it took had a negligible effect on the number of infections, we can only assume that the situation would have been much worse had that action not been taken. We can all safely assume that the detection and recording of infections are also much better thanks to the measures that have been put in place.

However, while I was preparing for the debate, I came upon some interesting statistics and information. I ask the Minister for Public Health to consider responding to one or two of the points in her closing speech.

First, I notice that, in response to a written question from Margaret Mitchell in July last year, the cabinet secretary confirmed:

"Recording of MRSA infection on death certificates is based on the clinical judgement of each doctor."—[Official Report, Written Answers, 13 July 2007; S3W-1495.]

Given the £54 million investment, should we not insist on a standardised method of recording MRSA and other health care associated infections when they are significant contributory factors to death? Unless the information is recorded consistently, we will never know the true extent of the problem. Moreover, in 2002, hospital-acquired infections were not notifiable causes of death. Has that changed in the past six years? I trust that the minister will respond to that in her closing speech.

We need guidelines on the provision of proper changing facilities for staff to combat the possibilities of cross-infection. All members have probably had letters from constituents asking whether it is all right that their doctor walks round Tesco with his uniform on or that nurses walk their dogs with their uniforms on. I do not know the answer, but Brian Adam posed that question in 2006, and the British Medical Association confirmed that research has shown that pathogenic micro-organisms, including—I hope that I pronounce this right—S aureus and C difficile are frequently carried on clothes, which represents a potential source of infection in the clinical setting. Are there clear guidelines on wearing the same clothes in hospital and outside? Unless the basic facts about how health care associated infections spread are made known to staff, we are unlikely to be able to prevent them and treat them early.

Many hospital patients now fear a hospital-acquired infection more than surgery. The cost to the health service is significant: £186 million a year. Hospital-acquired infections also mean that patients take longer to recover and have longer hospital stays, which reduces bed nights for other patients and delays admissions and discharges. There is also the cost of closing wards to prevent the spread of infection.

I welcome what the health secretary said about the care commission recruiting a nurse consultant to address standards in care homes—the point about care homes is well made in the Labour amendment. The delivery plan states that care home surveillance will be explored in March 2009. I would like more information about that. I welcome the recruitment of the nurse consultant, but we must wait another year before there is proper care home surveillance.

There is another interesting set of figures relating to MRSA rates for large, medium, small and very small hospitals. I noted that the very small hospitals fared the best, whereas the large hospitals fared the worst by far. There could be many and various reasons for that, which I hope will be investigated during the period of the delivery plan. However, it is concerning that the training package for infection control teams relating to ventilation and water systems has no stated target completion date in the delivery plan. Once again, I ask the minister to address that in her summing-up speech.