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Mr. Bailey: The proposals to combat hospital-acquired infections are very necessary, but when I consulted a local doctor in an acute trust, he told me that the most effective way to combat MRSA in future would be with more nurses, more doctors, and better and newer hospitals with single-bed rooms. Investment is crucial to reducing infections. Does my hon. Friend agree, therefore, that proposals to take £2 billion out of the NHS could have devastating consequences for MRSA?
Miss Johnson: Absolutely. That would be devastating for many of our achievements. We have put £570 million extra into cancer treatment, for example, and anyone who considers the £2 billion that would come out can see the scale of the damage that would be done. [Interruption.]
Mr. Simon Burns (West Chelmsford) (Con): The boss is leaving.
Mr. Blunt: Will the Minister give way?
Miss Johnson:
Although I am happy to go on taking interventions, I would like to make some progress first.
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As part of updating and improving the NHS, we are creating the extra capacity needed to ensure better patient care. Some £135 billion for the NHS was announced by my right hon. Friend the Secretary of State last month. Compared with 1997, there are 77,500 more nurses and more than 19,000 more doctors working in the NHS. The hard work of NHS staff will help us to reduce health care-associated infections. A major new initiative has been the introduction of a target to halve MRSA bloodstream infections.
Miss Johnson: I am delighted to have the opportunity to talk about targets. This problem is challenging, but we know that having a target ensures that an issue is given priority in the NHS. We believe that the new target will raise the profile of infection control and ensure that effective action is taken. Opposition Members have disagreed with national targets, repeatedly arguing against them in the Chamber and elsewhere. Their manifesto contains a commitment to oppose targets. They believe that the magic of the market will in some way make everything better. That is clearly nonsense. We have achieved a lot through having targets. In the case of infections, no one on the Opposition Benches would even know what was happening if we were not publishing the figures. Nor would they know what progress we were making if we were not measuring ourselves against a target.
Jim Dowd: Will my hon. Friend give way?
Miss Johnson: I want to make a little progress first, and I will then be happy to give way some more.
Mr. Burns: You are on your own now.
Miss Johnson: That has nothing to do with whether I give way.
Hand hygiene is an important part of inspection control. Last September we launched what we believe to be the first ever national hand hygiene campaign. The clean your hands campaign was based on a thorough, successful pilot study undertaken by the National Patient Safety Agency. That evidence-based campaign is tackling what has been an intractable problem for health care systems worldwide, and its impact on infection rates will be evaluated.
We are also taking a proactive approach to research in that area. We hosted a science summit in December and issued a call for proposals on health care-associated infections in February.
Rob Marris (Wolverhampton, South-West) (Lab): I am grateful for what the Government are doing on this serious issue. To be prosaic, I get complaints from constituents, whose concerns I share, that some hospital staff do not take off their uniforms when they leave the hospital; they can be seen in supermarkets and so on in their uniforms. Back in the 1950s, the rule that staff should not go off site or travel to work in their uniforms was strictly enforced. Is that part of the Government's strategy to address the issue?
Miss Johnson:
It is up to local trusts to decide on their policy. Some operate the policy of providing and cleaning uniforms on site, while others allow staff to take uniforms home and clean them there.
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I should like to make some more rapid progress, but I want to deal with a couple of important matters raised by the hon. Member for East Worthing and Shoreham. He raised the question of MRSA and neonatal units. The figures relating to the parliamentary question that he mentioned are about reported bacteraemias only. Some of the figures in the Patients Association survey, which I think he was quoting, are for colonised patients—carriers—and not those who are infectious. That is an important set of distinctions, and we stand by our numbers: in 2003, there were only 71 reported MRSA blood isolates in England in children aged under five years. We expect that the provisional figure for 2004 will be lower.
Mr. John Hayes (South Holland and The Deepings) (Con) rose—
Miss Johnson: I would like to make some progress. I am conscious of time, and this is a shortened debate.
We have been actively supporting NHS staff in achieving the changes that we want. Our programme is one in which local action is crucial. The requirement in "Winning Ways" for each trust to designate a director of infection prevention and control is helping to change the culture so that infection control is everyone's business. The directors report directly to the chief executive and the board. The hon. Member for East Worthing and Shoreham asked who was responsible for this matter; of course, at the end of the day it will be the chief executive and the board. That is only right and proper; I cannot see how the hon. Gentleman can possibly disagree. In coming months, the directors will be producing publicly available annual reports on their local situation.
Mr. Hayes: Now that the Minister is moving beyond the knockabout politics that seemed to preoccupy her in most of the opening of her speech, will she specifically address the issues identified in "Winning Ways" with regard to the experiences of other countries? The document makes it clear that several policies have been adopted by other countries. I am sure that she is aware of them. Which of those recommendations has she taken on board in her policy for reducing the incidence of MRSA?
Miss Johnson:
We have looked at a number of things. I am sure that the detail involved would require me to write to the hon. Gentleman, and I am very happy to do that. I can say that the suggestion that we should operate a destroy strategy, which has been canvassed today, would not be one of those options. We have looked at the policy and the rates of infection in the Netherlands. Indeed, a Dutch expert came recently to a national conference to talk with our experts. That expert said that such an approach would be inappropriate here. The search and destroy strategy is appropriate for the Netherlands because the country has a much lower rate
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of MRSA in the population as a whole. It has nothing to do with anything else; the approach is practically feasible in the Netherlands in a way that it is not here.
Jim Dowd: Will my hon. Friend give way?
Miss Johnson: I must make some progress, or I will have the Whips on my back. I hope that hon. Members will be patient.
Cleanliness is improving, as is demonstrated by the PEAT—patient environment action team—visits. Notification of such visits will in future be made no earlier than the afternoon before the visit, and PEATs will not nominate areas for inspection until the inspection day. The results from PEAT inspections are very encouraging, but it is important that the public know that the inspectors are genuinely looking at hospitals as they are, not doing so after a notice period in which the place can be cleaned up.
I mentioned the launch of the matron's charter last October by Chris Beasley, our chief nursing officer. It is a clear document that sets out clear high standards and a new management system that will be evaluated in several sites to provide a means whereby matrons can control directly the use of cleaning resources at their disposal.
Jim Dowd: Will my hon. Friend give way?
Jim Dowd: Hallelujah! I thank my hon. Friend for giving way. She will be aware that Lewisham hospital has been at the forefront of the initiatives on infection control, and that it has reduced its infection rates by almost 30 per cent since 2001. My hon. Friend the Member for Lewisham, Deptford (Joan Ruddock) and I visited the hospital a couple of months ago, not only to see what steps it was taking but to see a ward that had been closed specifically to deal with infection. In a 450-bed unit, the decision to close that ward would have been a very difficult one to take. In support of what my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey) said earlier on the nature of MRSA, I must point out that the hospital is also undertaking screening of people presenting at the accident and emergency department. Of the 5 per cent. or so who come from nursing homes—all of which are privately owned in Lewisham—more than 40 per cent. have MRSA on admission.
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