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The Minister of State, Department of Health (Mr. John Hutton): I congratulate all who have spoken in this short debate. They spoke with considerable passion and conviction. I am glad to say that we have all recognised the clear need to reduce the incidence of health care-acquired infections, especially MRSA: that, at least, is common ground.

This is one of the most extraordinary debates in which I have had the pleasure of taking part. The background was intensely party-political. Last week the Leader of the Opposition made his attack on the Government's stewardship of the NHS, entirely focused on our record on hospital-acquired infections. We were blamed for the incidence of such infections because we had introduced a range of national targets for the NHS.

One of the extraordinary aspects of the debate is that it rapidly lost most of that party-political dimension. The longer it continued, the more that happened. On one level this is very encouraging: it shows that we can have a mature, grown-up debate across the Chamber, which is very important. I shall pay tribute to a number of speakers shortly, but let me say first that on another level that aspect is disappointing, because I shall have to junk most of the speech that I had prepared. There we are; that is part and parcel of the life of a Minister, and I will receive no sympathy.

Actually, I may have to inject just a little bit of party politics later—[Interruption]—but, obviously, in a mature and sensible way. I agree with my hon. Friend the Member for Plymouth, Sutton (Linda Gilroy)—and with the hon. Member for Westbury (Dr. Murrison) and his hon. Friend the Member for Tunbridge Wells (Mr. Norman)—that we should not treat this subject as a party-political football, and we have seen plenty of evidence today that that is not happening.

The hon. Member for Sutton and Cheam (Mr. Burstow) spoke for 17 minutes in his customary style, without—I think—making a single positive suggestion about how we might deal with the problem.

[Interruption.] Perhaps I missed it. I am afraid that when he started to read out the e-mails, I may not have given his speech the attention that I normally give. I found it slightly odd that he constantly complained that the Government are not being prescriptive enough and should be collecting more data. Having heard many of his previous contributions, I am not sure how that fits with his standard critique that we are being too prescriptive and collecting too much data.

Tim Loughton (East Worthing and Shoreham) (Con): At least he was being consistent in that regard.

Mr. Hutton: Indeed. My hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) brought a very sensible balance to our debate, particularly on the question of cutting waiting times and whether abandoning targets would make sense. She is of course right, and that theme underpinned many of the Opposition's contributions. The hon. Member for South Cambridgeshire (Mr. Lansley) found himself on rather lonely ground when he suggested that we should abandon waiting times targets. The hon. Member for West Chelmsford (Mr. Burns) made a very helpful contribution, pointing out that it is possible to make
 
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progress in reducing incidents of MRSA infections in particular, while also making progress in reducing waiting times. In fact, that was very much the theme of the speech by the hon. Member for Tunbridge Wells.

The hon. Member for West Chelmsford successfully anticipated my own speech, as he always does; it is deeply irritating when he does that. Perhaps he and I need to go into a quiet corner and discuss where we are on these issues. I was going to refer to the success of Broomfield hospital, which is an outstanding example of people on the ground dealing with this difficult issue at local level. There are capacity constraints in Chelmsford—the hon. Gentleman knows about the problem, and so do we—but as examples such as Broomfield hospital show, it is perfectly possible to raise awareness and promote best practice across the NHS. Such efforts are a tribute to the local NHS, and I am delighted to hear that the hon. Gentleman endorses the work of his constituents, who are making such a success of that policy.

As the hon. Gentleman knows, on a much broader strategic level across the service, we have been trying to separate out more elective and emergency work. Our treatment centres will help to accelerate that trend, so, coupled with the approach adopted in Broomfield hospital, we are entitled to be optimistic about the future.

My hon. Friend the Member for Crawley (Laura Moffatt) spoke, as she always does, with a great deal of common sense, borne out of her extensive nursing experience. I agree strongly—this was a theme of her speech and no one else's—that nurses have a critical role to play in tackling MRSA and other health care-acquired infections. She was right to highlight that aspect of the problem.

I agreed with just about everything that the hon. Member for Tunbridge Wells said. That is a problem for me but probably not for him—a fact on which I need to reflect. He is right: performance is of course variable across the NHS, and there are indeed limits on what the centre can do. My right hon. Friend the Secretary of State and I, the chief medical officer and all my colleagues in the Department of Health do not actually treat patients. Our job, as always in these cases, is to establish the right direction and to invest in the quality of local leadership. Ultimately, that is where this problem needs properly to be located, as the hon. Gentleman rightly said.

Mr. Lansley: Far be it from me to add anything to what my hon. Friend the Member for Tunbridge Wells (Mr. Norman) said, but surely one inference that can be drawn from his comments is that it is not central directives, guidelines and targets that deliver performance in the NHS, but leadership and local clinical teams. Indeed, Broomfield hospital is an excellent example of that. The initiative was specialty specific and on the elective orthopaedic ward; it was not hospital-wide or done on the basis of Government guidance.

Mr. Hutton: The hon. Member for Tunbridge Wells will speak for himself; he is perfectly capable of saying what he intends to say in his contributions. I am simply saying that there is a sensible balance to be struck. In
 
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fact, the hon. Gentleman rightly said that there should not be an argument concerning targets versus no targets. There is a proper place in the NHS for strategic targets, and that is what we have established. The Conservatives referred today to having fewer targets, yet the Leader of the Opposition has been talking about scrapping all targets. Perhaps—

Mr. Lansley rose—

Mr. Hutton: I shall not give way to the hon. Gentleman, who made a long speech. The hon. Member for Westbury was not interrupted, and I have one or two other points that I want to make.

I also agreed with the description that was given of fragmented responsibilities for ward cleanliness. In terms of management and leadership, such fragmentation is not acceptable, yet as we know, it has happened. I do not want to inject an unnecessary element of party politics into the debate—I know that some of my hon. Friends want me to—but things started to go wrong when the Conservative Government introduced compulsory competitive tendering, thereby fracturing the responsibility of ward sisters and nurses for cleanliness on their wards.

I do not want to dwell on that historical point, which we are now moving away from, but we are entitled to point out some of the inconsistencies.

The hon. Gentleman rightly referred to another important issue: open wards. Open access to NHS wards is a problem, but none of us wants to lock down our hospitals and make them a prison where no one can see a patient until they come out. There has to be a balance. We have been saying to the service—the issue needs to be taken up locally—that we should be concerned not only about the cleanliness and hygiene standards that we operate but about how we share information with patients, their families and the public about the contribution that they, too, can make. I agree, however—this is probably the most important thing—that to get on top of this we will need a total change of culture, leadership and management in the service. Ministers have a responsibility to the House and the service, as well as to taxpayers, to set the tone for that change, which is very much what my right hon. Friend the Secretary of State has been trying to do.

My hon. Friend the Member for Plymouth, Sutton expressed support for the work that we are doing, for which I am grateful, and rightly stressed the need for accurate information and the importance of data on bloodstream infections.

The right hon. Member for North-West Hampshire (Sir George Young) broadly welcomed the progress that we are making, for which I am grateful, but he raised some concerns about companies in his constituency. He did not ask me to meet him to discuss those concerns, but I will be happy to do so if he will find it helpful. He referred, as did others, to the rapid review process, which is now under way, and I am advised that the team of officials steering that work is now considering six products. His criticisms are not entirely unreasonable, but the most important thing is that the work has now started.

We have covered a lot of ground in the debate, but here I am afraid I must part company with some Opposition Members—I cannot avoid it. In these
 
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debates, we are entitled to compare and contrast what they say now with what they did in office. They had the opportunity to do something about this problem in the 18 years of their stewardship of the NHS, and what did they do? First, they refused to take any action to establish the scale of the problem, so none of us, in the House or outside, had any way of knowing how many cases of MRSA occurred in our hospitals. Collecting the right information is an essential precondition for developing the appropriate responses, but they never did it.

Then, the Conservatives forced hospitals to contract out their cleaning services to the private sector. Quality did not come into it: it was the lowest bidder who always won. CCT did not lead to an improvement in overall standards of hospital cleanliness—quite the opposite. They issued two pieces of policy guidance to the service and, interestingly, if hon. Members get the chance to read it, they will see that their advice is entirely consistent with the direction of travel that we have set. That is not an impression that anyone listening to the contribution of the hon. Member for South Cambridgeshire today could reasonably have formed. There were, however, some important differences: there was no follow-up—they introduced no means of monitoring progress; and neither was there any effective accountability or any requirement to implement the guidance.

The Conservatives' approach can best be summed up in this way: first, they turned a blind eye and denied that there was a problem; for ideological reasons, they then pursued actions that made it harder to get on top of the problem; and then they took no action at all to enforce their own guidance. They gave the matter no real priority, so very little changed.

When it comes to dealing with the problems of MRSA and hospital-acquired infections, consistency and a credible track record are not the Opposition's strongest cards. In direct contrast, my right hon. Friend has made tackling MRSA a priority for the NHS, as has been acknowledged by the National Audit Office. We have introduced mandatory reporting, which the Opposition always declined to do. We have set out a clear programme of action that we expect every NHS organisation to take in order to—

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