House of Commons Hansard Debates for 11 Dec 1996 (pt 50)

10.14 pm

Mr. Alan W. Williams (Carmarthen): I am grateful for the opportunity to make a few remarks in this debate. I congratulate my hon. Friend the Member for Newport, West (Mr. Flynn) on securing the parliamentary time. I should like to confine my remarks to MRSA--methicillin-resistant staphylococcus aureus--and underline the serious threat that that poses to anyone who goes to hospital for treatment.

I first heard of MRSA in 1993, when a friend telephoned me to say that there were a few cases of the antibiotic-resistant strain in my local Carmarthen hospital. I wrote to the hospital and met the chief executive and the public health laboratory consultant there. I was reassured that the number of cases was quite small.

At the hospital, in 1989, there were two MRSA cases; in 1990 there were two; in 1991 there were five; in 1992 there were 10; and in 1993, the year when I first heard of MRSA, there were 13. I spoke at the time to my brother who was a consultant in a London hospital. He said that MRSA was common in London hospitals, but that in Wales we did not have a particular problem.

I tabled some parliamentary questions at that time, and wrote to the Welsh Office. Generally, I received non-answers. The Welsh Office said that the information was not available, and not collated centrally. The reply that I received from the Under-Secretary of State for Wales was:

"The information . . . is not routinely collected"--

MRSA, in a sense, was too unimportant in 1993 for the figures to be collated centrally. I kept reading about MRSA incidents, however, in local and national newspapers. In July, I again tabled questions to the Welsh Office, and I was pleased that the information was now being made available and collated.

In my hospital, in 1994, there were 18 declared MRSA cases, in 1995, there were 36, and to July 1996, there have been 49 cases. That was a tenfold increase during that five-year period. Figures in parliamentary replies to my

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hon. Friend the Member for Newport, West show that, for Wales, in 1995 the total was 442, and that this year to date it is 2,100. That is a fivefold growth in the past year.

I am glad that the information is now being collated centrally and made available. A parliamentary reply from the Department of Health to a further question on 3 December showed that, in England and Wales, there were 2,286 MRSA cases in 1992 and 17,063 in 1995. During those three years, there had been a sevenfold growth in the incidence of MRSA in hospitals in England and Wales. That is disturbing. What was a small problem in the late 1980s and early 1990s has become a major problem. I know two people--members of the Labour party, as it happens--in my constituency who last year contracted MRSA while in hospital.

My hon. Friend the Member for Newport, West quoted the speech on 4 November by Lord Fitt, whose personal tragedy highlighted the problems that the bug is causing in hospitals.

The problem of antibiotic-resistant bugs is international and widespread. I only wish that the Government would take it more seriously. First, the Department of Health needs to liaise with the British Medical Association and the Medical Research Council to persuade general practitioners to prescribe antibiotics only when they are necessary.

Secondly, it is absurd for animal feeds to routinely contain antibiotics so that animals gain weight faster. It is done for economic, not health, reasons. Thirdly, there needs to be research into new antibiotics. We are in a race against new super-bugs that are adapting and modifying to become resistant to antibiotics. The Department of Health and the pharmaceutical companies must redouble their efforts to develop new antibiotics to address that increasing problem.

10.20 pm

The Minister for Health (Mr. Gerald Malone): I am pleased to have the opportunity to respond to the important debate initiated by the hon. Member for Newport, West (Mr. Flynn) and the points raised by the hon. Member for Carmarthen (Mr. Williams). They have raised a wide range of issues, and I am sure that they will understand that I cannot cover them all in great detail in the 10 minutes available to me.

First, I should like to reassure the hon. Gentlemen that Britain has one of the most effective control and licensing systems for drugs in any developed country, through the combination of the Medicines Control Agency and the Committee on Safety of Medicines. As the hon. Member for Newport West said, it is important that we do not have a closed mind on developments. The system for investigating the efficacy of drugs and the problems they may cause is a constant process of re-evaluation. Those who are charged by Government with the responsibility constantly to examine such matters on behalf of the public need to review their decisions in the light of any new evidence that emerges.

The hon. Member for Newport, West was quite right to point to the enormous benefits of modern medicine. The proper use of medicines relieves human suffering and cures or alters the course of many life-threatening diseases. However, modern medicine also involves a number of risks, and some concerns have been expressed about antibiotic-resistant organisms.

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It is not a new phenomenon. One might think from the lurid headlines on the issue that we are hurtling towards a post-antibiotic era, and that the problem has only just been spotted. That is not the case. It was identified at an early stage in the use of antibiotics, and was countered by conventional infection control techniques and other intervention strategies, such as limiting or rotating their use. Those methods were successful, but they were also overshadowed by what at the time seemed to be a plentiful supply of new antibiotics. Between 1939 and 1972, for example, more than 30 new antibiotics were discovered. In more recent years, however, the number has fallen.

Microbial antibiotic resistance has always been an issue, but the need to address it has now become more focused. It has to be managed better. In considering new strategies and policies to combat its spread, we need to ensure that we make the best use of those antibiotics currently available, and perhaps be prepared to re-learn a number of lessons from the past.

The hon. Member for Newport, West referred to the particular problems that are found in other countries. It might be useful for the purpose of this Adjournment debate to look at the difference between this and those other countries.

Mr. Jon Owen Jones (Cardiff, Central): Will the Minister give way?

Mr. Malone: I do not intend to give way. I have a limited period in which to answer a very complex debate.

In many countries, the spread of such types of micro-organisms has now been accepted as more or less inevitable. That is not so in the United Kingdom. One of our most effective weapons is the high quality of the infection control systems in our health service and hospitals. We also maintain--the hon. Member for Newport, West asked for reassurance on them--very strict controls over accessibility to antibiotics by ensuring that they are available only on prescription. That is very different from what happens in other countries--even other countries in Europe--where antibiotics are available over the counter, and very readily too. We are concerned about the matter.

MRSA was especially mentioned. It has attracted many headlines recently, and it is not helpful when phrases such as "killer bug" and "super-bug" are used. They have invoked anxiety among many patients and their families and friends, and conjured up images of a modern-day health care system that cannot cope with such problems.

It might be important to put on the record the fact that MRSA is an antibiotic-resistant form of a fairly common bacterium, staphylococcus aureus. It is one of the most common of all bacteria--it is present in about one third of the population--but a problem occurs when it gets out of control, which may have alarming effects. How do we deal with it in the NHS?

Specifically to tackle the problem, clinical guidelines on MRSA have been developed over recent years. Such guidance includes that jointly published, for example, in 1986 by the Hospital Infection Society and the British Society for Antimicrobial Chemotherapy. The guidance was updated, republished in 1990 and formally commended by the Department of Health to the NHS in 1994. We are working with professional groups on