Chamber
Plenary, 26 Mar 2008
26 Mar 2008 · S3 · Plenary
Item of business
Health Care Associated Infection
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 Curran is right to point out the previous Government's important role in recognising the problem and in establishing the HAI task force—although, without wishing to be picky again this afternoon, I notice the amendment's reference to "the previous Labour-led government". I comfort myself, however, with the knowledge that the radical thrust, and indeed the majority for everything that was passed, was provided by the Liberal Democrats.
The amendment refers to
"tackling all healthcare associated infections, not just MRSA",
with which I am sure we all agree. It was my understanding that the health targets for 2007-08 included reducing by 30 per cent the incidence of all Staphylococcus aureus—including MRSA—bacteraemia by 2010. Like Mary Scanlon, I have difficulty with the pronunciation. I would be grateful if the minister clarified that, as it is quite important in relation to the amendment. We obviously will support the amendment: it adds to the motion.
We welcome the Government's positive approach and its building on the work of the previous Government. Although the problem has not proved intractable, the figures remain extremely worrying. As the cabinet secretary suggested, we now have more evidence on the nature of HAI, and it is clear from the epidemiology that resources must be targeted at those people who are identified as being most susceptible to the infections that we are trying to address.
I mention targeting because it will be useful as we examine the issue in greater depth. The Dutch have developed much tighter controls on the use of antibiotics and have much higher standards of general hygiene in their hospitals, but they put their ability to control infection down to targeting, thus they restrict testing to all patients from high-risk groups. That is an extremely important point, to which I think the cabinet secretary alluded in her opening remarks. We welcome the establishment of further means to address those high-risk groups and we welcome the establishment of the screening pilot and the whole thrust of trying to tackle MRSA in particular.
We have an assurance that the situation will be monitored. Margaret Curran was right that an assessment will be brought to the Parliament. Although, on the face of it, the proposals appear to be a better way of ensuring that we get to the high-risk groups, we need evidence for that. The establishment of the MRSA screening pilot and of the C difficile reference library will go a long way to ensuring not just that we identify the disease but that we get results from testing to our hospitals much quicker than before.
I trust that the commendable resources that the Government is allocating will involve not just provision but capacity in hospitals, because there could be problems if we start to identify other difficulties.
I share some of Mary Scanlon's concerns. I hope that, in the next few weeks and months, the minister will help us to understand where we have got to with the action plan that was developed. The plan contained five clear headings under which we needed to develop where we were going—I accept that the previous Government did not complete the work. We need to get from the minister, at a fairly early stage, a statement that does not just reiterate the five broad areas—patient safety, education, surveillance, guidance and standards, and physical environment—but sets out the targets and where we are in meeting them. That is extremely important.
Finally, there is the issue of the public themselves. I welcome the emphasis on hand hygiene, but we must also deploy the work that the Food Standards Agency did in getting the general public to be much more aware of hand hygiene and engaging them in understanding and tackling the very difficult problem of HAI.
Health care associated infection is a serious issue, and I welcome the debate. Margaret Curran is right to point out the previous Government's important role in recognising the problem and in establishing the HAI task force—although, without wishing to be picky again this afternoon, I notice the amendment's reference to "the previous Labour-led government". I comfort myself, however, with the knowledge that the radical thrust, and indeed the majority for everything that was passed, was provided by the Liberal Democrats.
The amendment refers to
"tackling all healthcare associated infections, not just MRSA",
with which I am sure we all agree. It was my understanding that the health targets for 2007-08 included reducing by 30 per cent the incidence of all Staphylococcus aureus—including MRSA—bacteraemia by 2010. Like Mary Scanlon, I have difficulty with the pronunciation. I would be grateful if the minister clarified that, as it is quite important in relation to the amendment. We obviously will support the amendment: it adds to the motion.
We welcome the Government's positive approach and its building on the work of the previous Government. Although the problem has not proved intractable, the figures remain extremely worrying. As the cabinet secretary suggested, we now have more evidence on the nature of HAI, and it is clear from the epidemiology that resources must be targeted at those people who are identified as being most susceptible to the infections that we are trying to address.
I mention targeting because it will be useful as we examine the issue in greater depth. The Dutch have developed much tighter controls on the use of antibiotics and have much higher standards of general hygiene in their hospitals, but they put their ability to control infection down to targeting, thus they restrict testing to all patients from high-risk groups. That is an extremely important point, to which I think the cabinet secretary alluded in her opening remarks. We welcome the establishment of further means to address those high-risk groups and we welcome the establishment of the screening pilot and the whole thrust of trying to tackle MRSA in particular.
We have an assurance that the situation will be monitored. Margaret Curran was right that an assessment will be brought to the Parliament. Although, on the face of it, the proposals appear to be a better way of ensuring that we get to the high-risk groups, we need evidence for that. The establishment of the MRSA screening pilot and of the C difficile reference library will go a long way to ensuring not just that we identify the disease but that we get results from testing to our hospitals much quicker than before.
I trust that the commendable resources that the Government is allocating will involve not just provision but capacity in hospitals, because there could be problems if we start to identify other difficulties.
I share some of Mary Scanlon's concerns. I hope that, in the next few weeks and months, the minister will help us to understand where we have got to with the action plan that was developed. The plan contained five clear headings under which we needed to develop where we were going—I accept that the previous Government did not complete the work. We need to get from the minister, at a fairly early stage, a statement that does not just reiterate the five broad areas—patient safety, education, surveillance, guidance and standards, and physical environment—but sets out the targets and where we are in meeting them. That is extremely important.
Finally, there is the issue of the public themselves. I welcome the emphasis on hand hygiene, but we must also deploy the work that the Food Standards Agency did in getting the general public to be much more aware of hand hygiene and engaging them in understanding and tackling the very difficult problem of HAI.
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...