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Dr. Andrew Murrison (Westbury) (Con): The first maxim in medicine is that one should do no harm. That is important to bear in mind in the context of today's
 
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debate. Our constituents go to hospital expecting to get better and many do not understand why they or their relatives get worse. Although we fully accept much of the data that have been exchanged across the Floor of the House, we must also accept that there is a problem of hospital-acquired infections, especially MRSA. We must therefore decide how we will improve matters for our constituents.

I welcome the Secretary of State's comments that the issue is not party political. It is not our intention to make it so, and we accept at face value his welcome for today's debate as a non-political issue.

There have been seven contributions from Back-Bench Members. They were all of high quality and constituted a genuine contribution to the general debate on such an important matter. The hon. Member for Sutton and Cheam (Mr. Burstow) did us all a great service by reminding us that much of the data on which we depend is somewhat dated. He made a good point about lack of surveillance of organisms and bugs other than MRSA. The headlines are full of MRSA, but we must remember that the majority of hospital infections have nothing to do with staphylococcus aureus or any related organism and are nevertheless important.

The hon. Member for Milton Keynes, South-West (Dr. Starkey) encouraged us not to make the debate party political. Indeed, up to that point, it had not been. My hon. Friend the Member for West Chelmsford (Mr. Burns) made a series of good points, drawing on his experience at Broomfield hospital. He discussed sharing best practice, which must lie at the heart of our battle with infections.

The hon. Member for Crawley (Laura Moffatt) made some useful remarks about nurse empowerment and developed them to include cleaner empowerment. I hope that I can agree with her in some of the comments that I intend to make shortly. My hon. Friend the Member for Tunbridge Wells (Mr. Norman) spoke about differentials and the reason for different results in different areas of the country and different sectors of health care when tackling hospital-acquired infections. We need to determine the reason for that and, again, spread best practice and learn where we can.

The hon. Member for Plymouth, Sutton (Linda Gilroy) suggested that our approach should be an amalgam of common sense and rocket science, a term that was repeated several times in the debate. My right hon. Friend the Member for North-West Hampshire (Sir George Young) made an extremely important point about the rapid review process of innovative products. The Secretary of State did not adequately cover that, so I hope that the Minister will say a little about it in his remarks.

If we criticise the Government's outcomes, we cannot fault their capacity to launch and relaunch initiatives, guidelines and various circulars. At the last count, we had touched on 12 today. The latest that I can remember dealt with the provision of individual hand-washing facilities for hospital beds—a tub of cleanser for every bed. The target date for that is April next year. That shows poverty of ambition; we need such basic measures straight away—we cannot wait until April next year. Otherwise, the findings of the National Audit Office's recent report, which suggests that we lose 750 people through hospital-acquired infection, will continue to be
 
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borne out. We cannot afford to let hundreds more patients die in the interim. The latest announcement is perhaps simply a repetition of that lack of ambition by Ministers to get on top of such a pressing problem. I revert to my initial maxim: that we should do no harm in our health service. That must be our first priority.

On Friday, I had the great pleasure of touring a new primary care centre in my constituency, which happens to be an Army primary care facility. Above all, the one thing that struck me, other than its obvious newness and the enthusiasm of the staff, was the impressive number of hand-washing facilities. I am sure that that was due to the energy of the nursing sister in charge, and that she will do her level best to make sure that all her staff—cleaners, doctors, nurses, medics—use those facilities. Certainly, it is not rocket science, although there is rocket science in relation to innovations, some of which we heard about today from my right hon. Friend the Member for North-West Hampshire. Fundamentally, however, this issue is not rocket science.

My constituent, Mrs. Burton of Warminster, who trained as a nurse several decades ago—I am sure that she will not mind my saying that—wrote to me that, sadly, she has recently become a patient in the hospital in which she trained. She gave me a 20-point list of improvements that might be made to standards in hospitals, about which she learned when she was a student nurse, and which, as a patient, she unfortunately observed were not being carried out today. I would be happy to send the Minister Mrs. Burton's list if he would be interested, and I am sure that it would be useful to him.

Above all, Mrs. Burton was worried about leadership in the NHS. We have heard a lot about that, and we have rightly heard Florence Nightingale mentioned in that context. We have heard about nurse empowerment, and about the recruitment of matrons—3,000 since 1999—apparently with the power to withhold payments to contractors and departments in the NHS that are not cleaning to a satisfactory standard. When the Minister responds, I would be interested to know how many incidences there have been of payment being withheld by matrons as result of that empowerment.

We must avoid the idea that cleanliness is somebody else's business. That has come across clearly this afternoon. Cleanliness needs to be woven into the fabric of the NHS. The NAO is rightly worried about the balkanisation of the issue—making it someone else's problem, whether the infection control team or the cleaners. I trained in the NHS, and I know full well that I was never given any instruction on hygiene during my years as a medical student. I dread to think how much infection I caused during that time. I know for a fact that, in those years, white coats were never taken from medical students for laundry. Basic measures, such as free laundry for white coats and uniforms, need to be considered. That may cost a bit of money, but as the National Audit Office points out, such infections cost us £1 billion a year, so there are savings to be made. We must not be afraid of investing money, perhaps to save some, if we want to reduce it to crude pounds, shillings and pence.

Training is exceptionally important. I am pleased to hear that training has now improved, and that medical students and nurses are being trained to apply proper hygiene. That must be fundamental to what they do, and
 
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it must go further than the ward. It is no good expecting nurses and doctors to put up with shoddy accommodation which is dirty and grimy. We need total quality management in hospitals—everything needs to be clean, including accommodation, which is often not the case. It is no good having "think clean" days, as Ministers seem to want, as in "Towards cleaner hospitals". That balkanises the problem, which the NAO is worried about. We need 365 clean days in a hospital year.

I part company from those who identify cleaning and ancillary staff as being part of the problem. It is easy for the tabloids to do that. Cleaners often appear to be marginalised—they seem to be shadowy figures in the national health service, and are often not seen as part of the mainstream NHS team. I suspect, from the remarks of the hon. Member for Crawley, that she would probably agree with me on that. Those staff need to be led, managed and made to feel that they are part of the general hospital effort.

It is no good expecting them to do their job effectively if people ignore them. It is no good saying to them, "You only shift dirt from one corner to another", if no one really takes an interest in what they are doing, and if they are not being managed properly. We hear a lot from the Government about empowering matrons, but we need to be assured that matrons and senior nursing staff have the capacity to lead and manage everyone and every activity on the ward if we are to control this problem. They must be able to lead and manage cleaners, doctors, everyone.

We have talked about differentials. It is important to compare and contrast what happens in different parts of the country. We know that hospital-acquired infection rates, particularly MRSA rates, vary dramatically. We need to learn lessons from that. Why is it happening? It is clearly not happening just by chance. Why do other countries have a far better record than ours? We need to learn from that as well, and apply best practice.

Different sectors of the health care system in this country produce different results. There may be many reasons for that. I suspect that Labour Members, in particular, will make the obvious suggestion that it has to do with resources. With respect, that would be the scoundrel's way out. Although it may have to do with resources, I am sure that it has a great deal more to do with management factors. We must be prepared to learn from that too, and decide why parts of our health care system outside the NHS appear to be doing better than the NHS in this respect. We need to establish, for example, why community hospitals seem to be doing very well. I suspect that some of that has to do with leadership. Perhaps leadership is rather better in community hospitals, owing to the sense of togetherness and teamwork, than it is in some of our larger establishments.

The Secretary of State said he felt that things had been achieved over the past few years, and none of us suggest that it is all bad news. There are people working very hard in this field. Nevertheless, we clearly have a problem. MRSA was first detected in 1960, and declined to almost zero in the 1970s. It has obviously been better managed in the past, and it is our task to ensure that it is better managed in the future.
 
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6.47 pm

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