Previous SectionIndexHome Page

Orders of the Day

Health Bill

[Relevant document: The uncorrected Minutes of Evidence taken before the Health Committee on 20th October, 17th November and 24th November 2005, HC (2005–06) 485 i-iii.]

Order for Second Reading read.

4.7 pm

The Secretary of State for Health (Ms Patricia Hewitt): I beg to move, That the Bill be now read a Second time.

I am proud to introduce a Bill that is a landmark in the protection of public health and the improvement of our health services. It does three key things. It gives us power to ban smoking in enclosed public places and workplaces, it strengthens our hand in the battle against methicillin-resistant Staphylococcus aureus and other hospital infections, and it contains a series of measures that will strengthen control of dangerous drugs, improve pharmaceutical and ophthalmic services and help to deal with fraud in the national health service.

I realise that the House may be particularly interested in the provisions on smoking, but I want to make a few brief points about other aspects of the Bill first to ensure that they are given due attention. The first commandment of the medical profession is "Do no harm". Unfortunately, as we all know, there are occasions when patients are harmed, not healed, by their hospitals. It is not surprising that MRSA and other health care-associated infections are of great concern to members of the public, particularly if someone in the family or neighbourhood has suffered from them. Part 2 of the Bill—clauses 13 to 15—gives us stronger powers to reduce MRSA and other infections to the absolute minimum.

We were the first Government to require surveillance for MRSA, and we are already using the information to help drive down infection rates. We set a target of no later than 2008 for the halving of MRSA infections. Indeed, some of our specialist hospitals such as Guy's and St. Thomas's, which treat some of the most complex cases in the country, and in early 2004 had among the highest MRSA rates, had already nearly halved their infection rates a year later.

The Bill builds on the work that we are already doing; it provides for a legally binding code of practice on health care-associated infections, which will apply to any relevant NHS body. The code will be based on existing best practice, and a draft on which we consulted earlier this year was well received. It will be backed up by new duties for the Healthcare Commission to ensure that it is observed, including the power to serve an improvement notice.

Mr. Paul Burstow (Sutton and Cheam) (LD): The Secretary of State referred to the statutory code and the consultation held on it. Last year's National Audit Office report on hospital-acquired infections found that half of all NHS managers are struggling to reconcile meeting Government waiting time targets with managing hospital infections. That issue came through again in the response to the consultation on the code.
29 Nov 2005 : Column 145
The NHS wants to know what priority the Government will attach to the code, compared with other health priorities—so can the Secretary of State make that clear today?

Ms Hewitt: The hon. Gentleman raises an important point. It is not acceptable to try to achieve infection targets at the expense of waiting list and other targets, nor is it acceptable to try to achieve waiting list targets by compromising on patient safety and infection rates. Throughout the country there are hospitals that are both improving the number of patients whom they treat, thus getting waiting lists and waiting times down, and getting a grip on infection control, thus bringing MRSA and other infection rates down. The answer is that hospitals need to do both.

Mr. Andrew Lansley (South Cambridgeshire) (Con): I fear that the Secretary of State has not answered the perfectly reasonable question asked by the hon. Member for Sutton and Cheam (Mr. Burstow). The essence of the question, which we have asked Ministers time and again, is this: will the Secretary of State give a simple guarantee that when, after a suitable risk assessment, infection control teams in a hospital recommend that beds or wards should be closed for infection control purposes, they will not be overruled in pursuit of waiting time targets?

Ms Hewitt: That would be a matter for the Healthcare Commission to consider, under the new code and under the Bill.

As we increase even further the capacity and the number of hospital beds available to the NHS, as we are doing, it will be possible to reduce occupancy rates in acute wards, which will help. It is not essential, but it will certainly help, as hospitals get their MRSA rates under control.

Mr. Lansley rose—

Ms Hewitt: I shall give way one more time to the hon. Gentleman on this point.

Mr. Lansley: The Secretary of State does not have to give way to me, so I am grateful to her for doing so again—but does she not recall that two weeks ago I presented to the House data that showed that although in 2000 the NHS started with 186,000 beds, with a target of 7,000 additional beds, the number went down by 4,000? On present indications, we estimate that this year, as a result of NHS deficits, the number is likely to reduce by another 2,500, so there will be fewer than 180,000 beds. The number of beds is going down, and bed occupancy rates are persistently far higher than the Government said they would be when they responded to the National Audit Office five years ago.

Ms Hewitt: The hon. Gentleman is doing exactly what he did in that debate two weeks ago, and ignoring the fact that with modern medical techniques and technology, far more operations can be done on a day-
29 Nov 2005 : Column 146
case basis. He is also confusing acute beds with beds available for mental health patients, for whom far more treatment is being carried out within the community.

Mr. Lansley indicated dissent.

Ms Hewitt: I make again the point that I have made before: thanks to our investment and unprecedented funding for the NHS, which the Conservative party failed to make available, and thanks to our reforms, we are bringing waiting lists down, and as more capacity becomes available to the NHS both in NHS hospitals and in independent sector treatment centres, as is happening now, it will be possible to get the waiting lists down even further, with lower bed occupancy rates, which in turn will help to build on the good results already being achieved with infections. The other point to consider on this particular issue is that, if a hospital is still failing to abide by the new code and to reduce its infections, even after an intervention by the Healthcare Commission, I—or in the case of the foundation trusts, the regulator—have the power to intervene.

Mark Pritchard (The Wrekin) (Con): Does the Secretary of State agree that the Government can have all the codes that they want to try and tackle ESBL—extended-spectrum-lactamases; VRSA—vancomycin-resistant Staphylococcus aureus; MRSA and all the superbugs, but if primary care workers are unable to obtain flu jabs this winter, patients will be put at direct risk? In my constituency, primary care workers are unable to have flu jabs, putting my constituents at risk.

Ms Hewitt: As I have already told the House, more people are being vaccinated against winter flu than ever before in our country—even more than last year, when we achieved a level twice that achieved under the Conservatives.

Mr. Stephen Dorrell (Charnwood) (Con): The Secretary of State has been talking about the code of practice that will be introduced to enforce better standards in NHS hospitals. When we come to consider the enforcement of those standards within hospitals, will the Secretary of State explain why she is not planning to extend the sanctions regime that applies to private sector hospitals to their NHS counterparts?

Ms Hewitt: The right hon. Gentleman raises an important point. As for private hospitals and the independent sector generally, the same standards will apply, using the same code provisions but under the existing legal powers of the Care Standards Act 2000. The obvious reason why we have a somewhat different enforcement regime is that we have direct management controls—or through a monitor, direct regulatory controls—on NHS and foundation trust hospitals that do not exist in respect of the private sector.

The new code that we are introducing, backed up by the new powers of the Healthcare Commission, will help to ensure that our NHS, which is treating more patients faster than ever before, will also provide the highest possible standards and quality of care.

I want to refer briefly to parts 3, 4, and 5 of the Bill, which deal with drugs, pharmaceutical and ophthalmic services and various other matters. We are
29 Nov 2005 : Column 147
strengthening the management of controlled drugs in response to some of the shortcomings identified in the Shipman inquiry's fourth report. Those provisions, which are UK-wide, will require every health care body to appoint an accountable officer who will have to take personal responsibility for the use of controlled drugs within that organisation.

We are also taking steps to continue improving pharmaceutical and other services. Community pharmacists are already playing a much wider role than they used to within the NHS—for instance, providing screening services and reviewing medicine use for people with long-term conditions. We know from our recent consultation on community health and social care services that the public welcome the work of community pharmacists and would like to see it increased. The Bill, by freeing pharmacists from the requirement personally to dispense every item, will allow them to expand the other services that they offer without in anyway compromising patient safety.

Next Section IndexHome Page