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Hospital-acquired Infections

4. Richard Ottaway (Croydon, South): If he will make a statement on the incidence of hospital-acquired infections in the last 12 months. [82619]

The Minister of State, Department of Health (Mr. John Hutton): Since April 2001, all acute NHS trusts have had to report methicillin resistant staphylococcus aureus blood stream infections. The first year's data show that rates tend to be higher in specialist trusts and in the south and east of the country. Early next year, surveillance will be extended to other micro-organisms and adverse incidents associated with infection.

Richard Ottaway : Up to 5,000 lives are lost each year through hospital-acquired infections. Are not the Government being extraordinarily complacent about

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the matter? The figure is almost double the number of lives lost on the roads each year. Does not that show that all the spending announcements in the world do not add up to a row of beans if lives continue to be lost through inefficient procurement programmes of sterilisation and contamination equipment? They have been getting progressively slower. The Government should get a grip and act to improve matters.

Mr. Hutton: I certainly agree with the hon. Gentleman that that is a serious problem. We should tackle it on three different levels. First, it is important that we start to monitor the rates of MRSA and other hospital-acquired infections; we are doing that for the first time this year. No previous Health Minister—Tory or Labour—has been able to tell the House what the rates of such infections are. That is our first port of call. Secondly, we need to get in additional resources to improve standards of cleanliness and hygiene in our hospitals. We are doing that: there will be £62 million for the clean hospital programme and a £200 million additional investment to improve sterilisation.

I agree with the hon. Gentleman, however, that this is not just about money. That is why the third strand of our work involves the chief medical officer and others working with the service to improve levels of performance and to spread best practice in regard to hygiene and cleanliness. That is the right way to do this. There is a problem, but we are trying to address it.

Helen Jones (Warrington, North): My right hon. Friend has rightly said that one of the keys to reducing MRSA infection is good hygiene on the wards. Does he not agree, therefore, that the disastrous privatisation of cleaning services under the previous Conservative Government seriously impeded efforts to tackle this problem? Will he tell the House how the agenda for change programme will facilitate involving cleaners and others in the ward team in raising the level of skills to remedy the problem?

Mr. Hutton: I agree with my hon. Friend that the record of previous Conservative Administrations has not been anything to crow about. It ill behoves the hon. Member for Croydon, South (Richard Ottaway)—for whom I have a great deal of respect—to blame the Labour Government for problems relating to levels of cleanliness and hygiene. We have done more than previous Governments to tackle them, including—as my hon. Friend the Member for Warrington, North (Helen Jones) said—ending the disastrous experiment with compulsory competitive tendering, which had not improved levels of cleanliness in our hospitals. Agenda for change is a new pay modernisation framework for the NHS, which represents a significant step forward, particularly for low-paid workers, including cleaners. I hope that that will improve morale and retention among some of the most important workers in the national health service.

Chris Grayling (Epsom and Ewell): Those are complacent words from the Minister, nearly six years into a Labour Government. According to a new report from University college London, nearly 12 per cent. of patients suffer from what it calls Xadverse events" within

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the NHS. That seems a long way from the Government's clean hospitals initiative. What actions is the Minister actually taking?

Mr. Hutton: I welcome the hon. Gentleman to his new responsibilities. We look forward to further exchanges with him, although I hope that they will be of a better quality than the one that we have just heard. To be fair to him, however, I think that he is mixing up two issues. He is confusing adverse incidents—which include a much wider variety of potential harm that patients could experience in hospital, including operations that go wrong, and so on—with hospital-acquired infections. They are different issues. I tried to outline to the hon. Member for Croydon, South the three areas in which we are taking action to improve the problem of hospital-acquired infections. Because of the steps that we have taken, a Health Minister will, for the first time ever, be able to report to the House on whether we are making progress in tackling the problem. I agree with the hon. Gentleman that that is a first step forward, but it is not the only step that we are taking. I have outlined fully all the steps that we are taking to deal with this problem. It is a serious one, and we are determined to get on top of it.

Tony Wright (Cannock Chase): Will my right hon. Friend give us a little more information about how he is collecting this data? Two years ago, when my father died from a hospital-acquired infection, I was surprised to discover that there was no mention of that fact on the death certificate. Why do we not record on death certificates the fact that a hospital-acquired infection has been involved? Are the other kinds of data that my right hon. Friend is collecting sufficient to enable us to get to grips with this issue?

Mr. Hutton: I am truly sorry to hear of my hon. Friend's loss, as I am sure that all hon. Members will be. The details that are recorded on a death certificate are, as I am sure he is aware, a matter for the coroner to decide. I understand that a review of those procedures is currently under way, however, and perhaps that is the right place in which to consider that problem. In relation to the data that we are currently record, it is true that, this year, we have been collecting data only about MRSA. Next year, however, we will extend the data collection to include salmonella, for example, and glyco-peptide-resistant enterococci. That is part and parcel of our attempt to extend the data collection so that we can be in a position to deal with the important issues that my hon. Friend and others have raised.

Dr. Evan Harris (Oxford, West and Abingdon): I commend the Minister on the data collection; that is clearly the first step, and he is right to say that it has not been done before. He described the hospital cleanliness programme as a means of driving down hospital-acquired infection. Is he aware, however, that, of the 19 measures that went into that programme, part of only one of them deals with issues that might reduce hospital-acquired infection—that is, cross-infection as opposed to issues of cleanliness? A survey carried out by my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) and other colleagues showed that 60 per cent. of those who responded found that they had insufficient

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resources for infection control. Is not the Minister worried that some of the other targets that the Government are setting are taking resources away from infection control?

Mr. Hutton: I do not think that that is a fair criticism. The hon. Gentleman, as I understand his position, is against pretty well any target of any kind for the NHS. He certainly knows how to spend more money, but he would be unable to account for any beneficial result of such expenditure. I agree, however, that it is clearly important to keep that whole area of work under review. I am not going to stand here for a second claiming that we have solved every problem—quite clearly, we have not. Removing such infections, particularly the avoidable ones, will be a long hard job. Remember, MRSA is resident in the community as a whole, and it is inevitable that it will come into hospitals as well. We have to focus on avoidable infection rates, which may be between 15 and 30 per cent. of the total, and working with the profession. The Chief Medical Officer is leading that work to find the right way forward, but concentrating on reducing waiting times in no way contradicts or gets in the way of reducing hospital-acquired infection rates.


5. Andrew Mackinlay (Thurrock): If he will make a statement on further measures he proposes to combat smoking and tobacco use. [82620]

The Secretary of State for Health (Mr. Alan Milburn): The measures that we have so far taken have helped over 200,000 smokers to quit. We will now make available extra resources to advertise the dangers of smoking and to extend help for people who want to give up.

Andrew Mackinlay : Does the Secretary of State agree that the practise of smoking tobacco should be confined to consenting adults in private? Is it not time that he put pressure on his ministerial colleagues who are in charge of employment rights to protect, in particular, those people in the food and drink and entertainment industries, as well as others, who are obliged to endure and suffer the smoke of others? Will he ensure also that the Secretary of State for Trade and Industry and the Department for International Development are empowered to prevent British companies from trying to peddle that terrible drug among the poorest and most disadvantaged people in the world?

Mr. Milburn: My hon. Friend makes an extremely important point. Clearly, smoking is the principal avoidable cause of death in our country—it kills about 120,000 people a year and is responsible for one death in five, so action across the piece is necessary to reduce it. He raises in particular the issue of workplace smoking, which is a genuine problem, although he will be aware that the Health and Safety Executive has been considering it, as have we. In the meantime, we have been trying to persuade employers, through our local tobacco control alliances, to take action locally. We want to encourage more of them, especially in the restaurant and pub business, either to make their environment smoke free or to at least make it clear to

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consumers and workers where smoking is allowed. Many employers want to take such action. I agree that there is a lot more to do, but we are beginning to make real inroads into a real problem.

Mr. John Baron (Billericay): Given that the Government's own figures show that more and more young people are smoking, will the Secretary of State explain why the Government yesterday tried to block new European Union measures that will ban cigarette company sponsorship of Formula 1 a year earlier than planned? It appears to many that they were trying to help their friends in Formula 1 at the expense of the public's health.

Mr. Milburn: I begin by welcoming the hon. Gentleman to his new post.

Mr. Stephen Pound (Ealing, North): He will be gone in two weeks.

Mr. Milburn: I am getting some advice. Sometimes it is worth taking, the hon. Gentleman will find, although not from his own side. He started with a slight factual error, if I may say so, on the proportion of young people who are smoking. He may know that figures published today from the general household survey show that in 1996 about 13 per cent. of 11 to 15-year-olds were regular smokers. That had fallen to 10 per cent. by last year. Clearly, however, a lot more needs to be done to combat smoking, particularly among girls.

Yesterday, as the hon. Gentleman knows, there was a European Council of Ministers in Brussels to discuss the draft tobacco directive. The case argued by the hon. Gentleman is not the case that I put. There were two problems with the Commission's tobacco directive. It was not strong enough, and it was not clear enough. As the hon. Gentleman knows, we have tobacco-advertising legislation in our country—opposed, incidentally, by his party—which is all about banning not just tobacco advertising but tobacco promotion. As for the question of clarity, one thing I have learnt over the last five or six years is that the tobacco industry will be relentless in delaying and preventing any measures that are necessary to protect the public.

Dr. Howard Stoate (Dartford): I welcome my right hon. Friend's commitment to a reduction in smoking, and his work in making nicotine replacement therapy available to all NHS patients. That was a wonderful move. May I remind him, however, that 400 pupils are still dying every day in this country from tobacco-related diseases? The industry therefore needs to recruit 400 more young people a day, particularly teenagers, to this dreadful habit. What can my right hon. Friend do, in addition to what he is already doing, to discourage people from taking it up in the first place?

Mr. Milburn: My hon. Friend is right, and he speaks with some clinical experience and expertise. Four steps are necessary. First, we are now enacting the Tobacco Advertising and Promotion Bill. From next spring, all tobacco advertising on hoardings and in the media will be banned, because we know that it is the recruiting sergeant for young people in particular. Secondly, from next year there will be stronger health warnings on

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cigarette packets, and misleading doublespeak from the industry about certain products being Xlight" or Xmild" will go. The strengthened health warnings will include warnings about the link between tobacco consumption and impotence. Thirdly, for the first time the Government will publish a list of the additives that go into every brand of cigarette, including everything from solvents to sweeteners. Fourthly and perhaps most important, in conjunction with the British Heart Foundation and the Cancer Research UK campaign, we will launch a £15 million advertising campaign pointing out the dangers of smoking.

I think that those measures, together with the help we are already giving to the seven out of 10 smokers who say they want to quit, will make a real difference and, most important, will save lives.

Rev. Martin Smyth (Belfast, South): I welcome that news, but the Secretary of State expressed concern about the European directive. What action have he and the Government taken to put pressure on the European Community to stop subsidising the growth in tobacco exports from Greece—and in our own exports, which are adding to the plight of the developing world?

Mr. Milburn: The hon. Gentleman makes an extremely important point, which I should have made in response to my hon. Friend the Member for Dartford (Dr. Stoate).

The British Government at all levels continue to raise, in our discussions in Europe, the issue of subsidies for the tobacco industry, which must stop. As my hon. Friend said, they produce a product which, although legal, kills 120,000 of its consumers every year. It is therefore no surprise that the industry must recruit extra smokers. Eighty-three per cent. of smokers began smoking before they were 20. The industry claims that its advertising is not aimed at children and teenagers, but that is simply wrong. We know from evidence that the vast majority of brands most smoked by children are the most advertised. That is why we were right to introduce tough new anti-tobacco-advertising legislation.

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