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Linda Gilroy (Plymouth, Sutton) (Lab/Co-op): Hospital-acquired infection and MRSA are serious issues, and I am glad that we have had an opportunity to debate them. They are certainly important to my constituents in Plymouth.

The problem is not new, as hon. Members have said. As well as being resistant to certain types of antibiotic, MRSA in particular has an intrinsic propensity to spread. Hospital-acquired infection, like many serious problems, has various causes, and there are many strands to its solution. It deserves our serious consideration, and is far too important an issue to become a political football. I pay tribute to the Government for their work in taking it seriously and some of their initiatives are listed at the beginning of "Winning Ways".

It is an impressive list, even at that time, before our right hon. Friend the current Secretary of State took over, and includes circulars on management and control of infection and a controls assurance standard. In 2003 the National Institute for Clinical Excellence issued guidelines for the primary care and community care sector.

"Winning Ways" reflects the deep-seated nature of the challenges. It analyses and sets out how to tackle infection at all levels, from establishing a culture of surveillance and investigation to achieving a sharper focus on high quality research, which is needed to underpin best practice in information sharing, monitoring and action. The hon. Member for Sutton and Cheam (Mr. Burstow), one of the Opposition spokespeople, said that we did not want rocket science—we wanted common sense. However, we need both. We need common sense, as I shall discuss in a moment, but we need rocket science to establish which common-sense solutions are working.
 
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"Winning Ways" also sets out some aspects of hospital management and organisation for action, including the need to appoint a director of infection control. Peter Jenks has recently been appointed to that position in Plymouth Derriford Hospital Trust and is bringing a fresh impetus to the programme that our local hospital established. He described to me the open approach that the trust takes and some of the issues associated with achieving an open culture of reporting. That has considerable challenges attached to it.

The outcome of an infection is a balance between the intrinsic virulence of the organism, the susceptibility of the host, and the skills and resources available to treat the infection. A benign infecting organism may kill a seriously ill 80-year-old and not so much as raise a fever in a fit adolescent. Likewise, a virulent pathogen is likely to be much more harmful to more vulnerable patients.

I hope that the Minister of State, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), will agree that it is important for effective, active surveillance and investigation that the recording of these issues is of a high standard and that we are able to compare like with like. He will be aware of the concerns that Plymouth Derriford Hospital Trust has expressed about the recent publication of non-standardised data by the Office for National Statistics and the way in which that sparked some pretty ill-informed coverage in the national press.

As part of the surveillance systems that have been put in place, all hospitals in England and Wales must report every time an MRSA is grown from the blood of a patient. This is the most accurate national MRSA data and provides a standardised basis on which to make fair comparisons. I hope that my right hon. Friends the Secretary of State and the Minister will do all they can to ensure good practice in the use of statistics to inform not only our debates in the House, but the action that needs to be taken in all our local hospitals.

I turn now to what I know many of my constituents, whether they are patients, their relatives or people who work in the health service, as well as hon. Members consider to be a crucial aspect of bringing hospital infections under control. Although eight out of 10 Derriford patients rated care in the past year as excellent, patient perceptions of cleanliness remain much lower than I, they and the hospital would like. Through the Derriford cleanliness task force, matrons, members of the infection control team, the cleaning contractor, the unions and patient representatives are all engaged in tackling this key issue.

As others have described, matrons and ward sisters will take more control over the cleanliness of their wards. They are encouraging domestic and housekeeping staff to be valued as key contributors to patient treatment and welfare. Matrons will have direct accountability for cleanliness standards. I understand, and my right hon. Friend may be able to confirm, that if all else fails, that includes the ability to withhold payment for cleaning services.

People have rightly said that it is not appropriate for staff who clean toilets to serve meals. The tasks will now be separated in Plymouth Derriford and staff uniforms will identify staff who only serve food. Patients and visitors, as my hon. Friend the Member for Crawley
 
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(Laura Moffatt) mentioned, will be encouraged to ask staff questions about cleanliness and report things that they are unhappy with.

That is all good common sense, and it should never have been anything other than common practice. As the Secretary of State suggested, however, some in my constituency say that the fact that that was not the case stems from privatisation and fragmentation. That has been a particular issue at Derriford, as it has been at hospitals up and down the country.

I hope that my right hon. Friend the Minister has seriously considered ending the two-tier work force in our hospitals sooner rather than later. I also hope that he is examining how contracts can specify outputs that guarantee a minimum quality. That would certainly solve many of the problems that we have experienced in Plymouth. Strong scientific evidence proving a link between cleanliness and health care-associated infections does not exist, but common sense suggests that every care should be taken to achieve the highest possible standards of cleanliness, and patient and public confidence demands that too.

The debate has generated more light than heat, which is good and not something that the motion might have encouraged. The motion does not do justice to the depth and breadth of the problem and what is and what can be done. Much mention has been made of "Winning Ways". Playing on people's fears in the run-up to an election should have no place in anyone's strategy. If it occurs, we can expect the great British public to rumble it.

6.26 pm

Sir George Young (North-West Hampshire) (Con): It is a pleasure to follow the hon. Member for Plymouth, Sutton (Linda Gilroy). I agree that the debate has been good, and my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), who introduced it in his normal measured and rational way, set the right tone for a constructive exchange.

Along with other hon. Members who have spoken, I am, of course, anxious that my constituents should not acquire an infection when they go into hospital. Some signs are already apparent that fear of MRSA is beginning to affect people's willingness to have operations. I want to approach the subject not from the point of view of a patient with the infection, but from the point of view of a firm in my constituency that may have a solution, and I shall develop an argument that my hon. Friend the Member for South Cambridgeshire touched on in his opening remarks.

I welcome what the Government have been doing and the progress that we have heard about in this debate. I want briefly to share the frustrations that both the company in my constituency and I have had in communicating with the Government and their agencies, and gently contrast the rhetoric of urgency and of rapid reviews with the leisurely progress that has been made since last December.

Bioquell is a firm based in my constituency. It is a quoted company with a market capitalisation of some £60 million, and it has invested heavily in research and development over the past five years. I have been round it, and I was impressed by the professionalism of the operation and the commitment of the staff. It has a long
 
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record of developing bio-decontamination technology, and last year the US Government selected it for priority research into anthrax decontamination. In the health care sector, it secured contracts to bio-decontaminate three hospitals in Singapore during last year's severe acute respiratory syndrome outbreak. In July this year, it was awarded a contract by a French hospital to sterilise two intensive care units that were contaminated with a super-bug.

Progress at home has been tougher. On 3 December last year, the chief medical officer published "Winning Ways" in which he indicated as part of action area seven that the Department would set up a rapid review process to

"assess new procedures and products for which claims of effectiveness are made of their ability to prevent or control HAI".

On 15 December, I wrote to both the CMO and Lord Warner asking for a meeting to follow up the results obtained by a research team led by Professor Gary French, who is one of the UK's foremost authorities in the area—he is professor of microbiology at King's college London and head of the department of infection at St. Thomas' hospital just over the river. In a nutshell, his research shows that the hospital environment is heavily contaminated with MRSA.

In areas of the hospital where MRSA patients had been treated, 74 per cent. of swabs tested positive for MRSA.

More surprisingly, in a so-called non-MRSA ward, 43 per cent. of the bed frames were positive for MRSA. St Thomas' is probably a good proxy for all the tertiary hospitals in the UK.

Secondly, his research demonstrated that conventional cleaning does not work. In one experiment, 90 per cent. of 124 swabs were positive for MRSA before cleaning, but after cleaning the MRSA level reduced only to 66 per cent. The fact that conventional cleaning does not eradicate the superbug is highlighted elsewhere in scientific literature.

Thirdly, in another experiment the use of new technology reduced the level of MRSA dramatically. Prior to the deployment of the technology, the research team found that 74 per cent. of swabs were positive for MRSA. Use of the technology reduced that to just 1 per cent. That technology, which basically uses hydrogen peroxide vapour with high kinetic energy to decontaminate a room, equipment or furniture has been developed by the firm in my constituency.

The research that I have described was published in the "Journal of Hospital Infection" earlier this year, and it was referred to in the National Audit Office report. Lord Warner, to whom I wrote in December, neither agreed to my request for a meeting nor, indeed, answered my letter. Two months after I wrote, I got a reply from the chief medical officer that simply referred me to the rapid review process. However, that rapid review process was certainly not rapid. On May 24th, the CMO wrote to Bioquell to say that

"unfortunately, it is taking longer than anticipated to establish the rapid review process to assess new procedures and products which make claims of effectiveness against HAI. We will let you know when this has been agreed but we hope to start the evaluation before the end of the year"—

that is, one year after "Winning Ways" was announced.
 
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That frustration is also reflected in the NAO report. One of its recommendations is that the Department should

"As a matter of urgency, define how the rapid review process of new procedures and products is to be implemented, and how the findings will be promulgated so that they can be translated into practice at trust level with minimum delay."

The rapid review process is now set up. It had its first meeting at the end of August, some nine months after "Winning Ways" was published. I hope that the Minister will agree on reflection that that is a disappointing response to a matter that we are told is urgent and right at the forefront of the Government's priorities.

We have heard a lot about cleaning in this debate. Of course, common sense dictates that cleaning is important, and I welcome the emphasis that the Government are placing on that aspect. Cleaning is a necessary but not a sufficient condition, and the Government are in danger of misleading themselves if they believe that improved cleaning alone will combat MRSA and the superbug—it will not. I am sure that if any of us were about to be operated on we would like to be treated in a room, ward or operating theatre that had been sterilised as well as cleaned.

There has been ground-breaking research in this country into superbug eradication, but the first hospital to put it into practice is in Paris. I hope that the Minister will understand that from the point of view of a company that genuinely believes that it has a contribution to make, the response is one that can lead only to frustration.

I want to conclude on a broader but related point. The Government constantly promote the benefits of the knowledge-based economy and urge us all to adapt accordingly. As the hon. Member for Milton Keynes, South-West (Dr. Starkey) said, MRSA is a global problem that requires a knowledge-based solution. However, the Government should understand that in practice a British technology company has found it almost impossible to get any meaningful action from the Department of Health on testing and adopting its technology, although it clearly needs a domestic base to win export orders. The Department's document, "Towards Cleaner Hospitals and Lower Rates of Infection", which was published in July, says that it will

"bring the best expertise from abroad to tackle the worst problems at home".

But the best practice may already be in this country.

If the Government are really determined to drive forward their agenda on MRSA, I urge them to deal with the rapid review process with more rapidity than they have so far been able to apply to it and to get on with introducing this technology, when it has been tested, into hospitals with the biggest MRSA problem, then, subject to satisfactory tests, rolling it out. I hope that the Minister will make some commitment to faster progress on that particular aspect than we have had so far.

6.34 pm

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