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Mr. Barry Sheerman (Huddersfield): Has my hon. Friend made any international comparisons? One of the frightening things that I have learnt is that some other countries appear to have used antibiotics much more carelessly than we have, and are suffering from an epidemic of MRSA as a result. Cannot we learn from the mistakes that they have made?

Mr. Mackinlay: Certainly, but my charge this morning is that the Department of Health is doing very little in any direction and is indifferent to the size of the epidemic.

My replies from the Minister showed some confusion as well. He said that some new treatment was still at an early stage of development, but he also told me in a separate answer that two antibiotics are effective against all strains of MRSA--yet many hospitals, including Basildon, do not stock them. It appears to be the luck of the draw; someone may be taken to a hospital that has the drug, whereas someone else may not. My constituent's daughter was told that the antibiotics were not available. I suspect that the truth is that there were cost implications. That is the most worrying aspect of all.

From the limited answers that I was able to obtain, it became increasingly clear that while the contagion remained static between 1989 and 1991, it had increased by 8.1 per cent. by 1994. However, by the first half of 1995, it had increased by 13.5 per cent.

I also asked what was recorded on death certificates. My constituent's death certificate did not mention MRSA, and I understand that Lady Fitt's death certificate did not state

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that MRSA had contributed to her death. Ironically--my question shows how these matters are treated in this country--the Chancellor of the Exchequer had to answer the question on death certificates. I cannot help feeling that that shows that the matter has budgetary implications.

It is clear that, in many of our hospitals, doctors are not fulfilling the conditions and instructions that they are given on completing death certificates. They are charged with giving the primary cause of death, but in the second part of the form they are supposed to say what else contributed to the death. Doctors are not mentioning MRSA, either through ignorance or because they are being leaned on to cover up and keep quiet the fact that the disease contributes to so many deaths. If doctors do not fulfil those requirements, they are not behaving professionally and are vulnerable to litigation. They must be much more frank with the loved ones of people to whose deaths MRSA has contributed.

What is the Minister doing to prevent and contain the spread of MRSA outside hospitals? His Department seems breathtakingly complacent. We know that the disease presents a problem in nursing homes; to pretend otherwise is irresponsible. I understand that the brief that the Minister will read to us in a few moments says that he has issued a leaflet to nursing homes. That is as effective as banging on a door with a wet sponge. It does not underline the seriousness of the problem.

The Department of Health is reluctant to do anything about the problem, because it has budgetary implications for the nursing home service. Moreover, hospitals do not want to recognise the problem because of its budgetary implications. In short, there is a conspiracy of silence. There is wilful ignorance, on the part both of the NHS establishment in Whitehall and of hospitals and other agencies, which do not want to recognise the scale of the problem. Consequently, good people are being put in jeopardy and deaths caused unnecessarily.

When I was ferreting around in the Library, I came across a document that I believe the Department of Health placed there inadvertently. It is a working party report that gives guidelines for the control of epidemic MRSA. It was prepared by Mr. G. Duckworth, secretary to the working party on hospital infection, and it was published in August 1990. I believe that the Department did not mean the document to be in the Library, but meant some other document to be there. Under the heading, "Cost implications of EMRSA", the document says:


No such effective control measures are being implemented by the NHS. It is an extremely patchy map, and the document goes on to give some of the costs involved.

The document also says that great care needs to be taken in ambulances. The information that I have from going round the ambulance service is that the recommended procedure is not being applied by the ambulance service. People will be infected in our ambulances because the Government refuse to recognise the cost implications and the scale of the scandal. It is sometimes hazardous to be in an ambulance where the proper control procedures have not been applied.

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The document also refers to the fact that agency staff in hospitals may be MRSA carriers. I return to the point that I made at the beginning: there is inadequate screening in hospitals of patients and staff. In hospitals with a high staff turnover--agency staff go from one hospital where they might be screened to another where they are not--the danger of increasing infection is enormous. I hope that people who read our deliberations will demand to see a copy of the document to which I referred. Has the Minister read it? I want to be charitable to him and say that the Department has probably not told him the naked truth about the scale of the problem, and he may not have seen the document until I pursued the matter with his private office.

The real problem is cost. The noble Baroness Cumberlege alluded to that in the debate in another place to which I referred earlier. I implore the Minister to be bold and to understand that failure to recognise the problem and deal with it immediately means that a bigger burden on the NHS is looming. It will be dealt with by another Minister, because the Government will lose the election. I do not wish to speak in a party political manner today; I am simply frustrated at the Government's failure to recognise the big additional burden on the NHS budget. You, Mr. Deputy Speaker, will hear about MRSA time and again, whether or not I am in the House after the election, because the problem will not go away. Whoever occupies the Treasury Bench will have to deal with it.

I cannot help but recall that this Government refused to recognise the problems of E. coli, Gulf war syndrome and, until late in the day and at enormous cost, mad cow disease. MRSA is a problem of similar proportions. It beggars belief that the Department of Health has not addressed it with greater skill, determination and resolve before now.

Hospitals have also tried to keep the problem under drapes and have displayed wilful ignorance. If the debate achieves nothing else, it will flag up to hospital trusts the fact that the possibility of litigation is enormous. The Department of Health, too, will be vulnerable to litigation, because the debate is making it clear on the Floor of the House that this is a large-scale problem. Even if the Department of Health and the hospital trusts do not listen, their insurers will. They must know that there is a significant possibility of substantial damage claims by the loved ones of people who have died as a consequence of the indifference to and lack of planning on combating MRSA. Doctors will be vulnerable to the charge of not behaving professionally if they do not complete death certificates in a full and comprehensive manner, as is their duty.

Local newspaper editors throughout the country must ask their hospitals whether they screen for MRSA and, if not, why not. They must ask whether they follow the isolation procedures set down in documents to be found in corners of the House of Commons Library, rather than being flagged up as instructions to hospital trusts, and, if not, why not. They must ask whether ambulances follow the procedures laid down and, if not, why not. They must ask whether the hospitals stock the appropriate antibiotics and, if not, why not. They must also ask whether the hospital knows in how many instances MRSA has contributed to death and, if not, why not.

What support is the Department of Health giving to Professor Brian Austen of Heriot-Watt university, in developing a new drug to combat MRSA? Has the

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Department considered new products that I understand are being developed--basically paints and cleaners--that kill all known microbes and, if used within hygiene management programmes, minimise some of the super-bugs such as MRSA?

I am sorry if I have spoken in rather trenchant terms, but in the five years that I have been in the House, I have rarely felt so strongly about what I consider to be an NHS establishment cover-up. I do not charge any one individual, but believe that, nationally and locally, the national health service has recognised the problem, but has been afraid that it will throw its budgets out of proportion and that Ministers and incoming Ministers will be embarrassed. The problem has therefore been swept under the carpet, which is why I called this wilful ignorance.

I appeal to the Minister in his remaining period in office to give forthright instructions to everyone concerned to address the problem. I hope that he will ensure that his successor picks that up after the general election.


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