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Question agreed to.


Queen’s recommendation having been signified—

Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with Bills),

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Question agreed to.


Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),


Question agreed to.

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

Question agreed to.

Motion made, and Question put forthwith, pursuant to Order [9 January] and Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

Electoral Commission

Question agreed to.


Merchant Shipping


Police (Peterborough)

10 pm

Mr. Stewart Jackson (Peterborough) (Con): The petition has 1,000 signatures. It reads as follows:

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To lie upon the Table.

Hospital Services

10.1 pm

Richard Younger-Ross (Teignbridge) (LD): I wish to present a petition from constituents who are concerned about cuts in service at our local hospitals, and particularly the cuts in the opening hours of the minor injuries units at Ashburton and Bovey Tracey hospitals.

To lie upon the Table.

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Clostridium Difficile

Motion made, and Question proposed, That this House do now adjourn. —[Huw Irranca-Davies.]

10.2 pm

Mr. David Burrowes (Enfield, Southgate) (Con): It is a pleasure to have secured, for the first time, a debate on clostridium difficile. The subject is important, and merits not merely a short Adjournment debate but a longer debate, perhaps in Government time. Clostridium difficile infection is recognised by the Health Protection Agency as the most important cause of hospital-acquired diarrhoea. The purpose of this debate is to challenge the Government on whether C. difficile—as I shall refer to it from now on—is given the importance that it deserves in action as well as words.

The debate is timely, given that last week a Department of Health memorandum warned that C. difficile was now

The official statistics paint only a partial picture. In 2005 there were 51,690 reports of C. difficile among people aged 65 and over; in 2004 an estimated 1,300 deaths were attributed to it. There are clearly at least seven times more cases of C. difficile than of MRSA—methicillin-resistant Staphylococcus aureus—and at least four times more deaths from C. difficile than from MRSA. But is C. difficile receiving the attention that it deserves? Many would describe it as the Cinderella of hospital-acquired infections, but it deserves to be at the centre of everyone’s attention, given its prevalence and the risks of fatality.

The purpose of the debate is also to highlight the tireless efforts of my constituent Graziella Kontkowski, who, with her brother Mark—both are here in the House tonight—set up a website and forum, There are literally thousands of hits per day from the many people who wish to receive support and advice, and to give their stories. That highlights the profound concern about C. difficile throughout the country.

My constituent was motivated by her and her family’s experience with her grandmother, who sadly and tragically died on 26 September 2005 as a result of contracting C. difficile at North Middlesex hospital. Graziella tells me that half the ward became infected with the deadly bacteria, all due to lack of hygiene. Measures were not taken to prevent the spread of the bug, and patients and their relatives were not given information about the severity of C. difficile. Graziella’s efforts to get to the truth and to secure improvements at North Middlesex university hospital and the other local hospital, Chase Farm, spurred her to set up the website and to help others in a similar situation to that of her family.

C. difficile is an appalling infection, attacking particularly the elderly on prescribed antibiotics. The symptoms of severe diarrhoea, stomach cramps and fever, often followed by dehydration, take their toll on the vulnerable. Loss of pride and self-esteem is great, and extremely sad for relatives as they watch the deterioration happen before their eyes. That is particularly aggravated by the lack of information
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about what is happening. That is why the C. difficile support group was set up, and that is also why the Government must take urgent action.

Many sad cases could be recounted, such as those of elderly patients who have fought successfully for years against cancer only suddenly to be struck down by C. difficile, and to die in a matter of weeks. Such tragic circumstances were highlighted in the outbreaks of C. difficile at Stoke Mandeville hospital that ended in 2005 and that led to at least 33 deaths. A Healthcare Commission report challenged the Government approach, not just to isolated incidents of infection control, but to the whole policy on health care.

The report stated:

Have the lessons from that report been learned? Let me give another quote that highlights the lessons that need to be learned nationwide by all trusts:

The juggling of those targets and reconfigurations is a reality across the country. In the Enfield area, Chase Farm hospital is facing the prospect of cuts to its accident and emergency services and doctor-led maternity services, and North Middlesex university hospital is debt-ridden. The risk is that as they juggle their priorities, they will drop the ball of infection control, particularly in respect of the care of the most vulnerable—the elderly. That is the Government’s responsibility. As Graziella has said:

The key question is: have lessons been learned? However, perhaps that could be prefaced by another question: do the Government know the extent of the problem, so that they can tackle properly the C. difficile problem? There is evidence of under-reporting; there is mandatory surveillance only of over-65s, so there is no obligation to report on under-65s.

Let me refer the Minister to three examples on the C. difficile support website this week. There is an example of poor hygiene not from someone older than 65, but from a 23-year-old young man. He said that he suffered from ill health; he had suffered from Crohn’s disease. He entered hospital and thought he

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That is just one example among many of poor hygiene.

I turn to an example of a lack of infection control, given by a 20-year old:

not an isolated unit, a general ward—

Here is an example of a lack of accurate information, which was posted on the website as recently as 10 January:

There are reports of patients being discharged from hospital before they are fit and ready to go home. This debate was also prompted by my experience over Christmas when visiting various residential homes. Sadly, I saw time and again residents who had recently been discharged from hospital who were malnourished and dehydrated; indeed, some were infected by the bug. Does the Minister therefore agree that all health care professionals, including those working in long-term care facilities, need to be made aware of the emergence of a stronger strain of C. difficile? Why are basic hygiene and the soap and water scrubbing that are so essential in tackling C. difficile not commonplace in hospitals?

Dr. Stephen Fowlie, medical director of Nottingham University Hospitals NHS Trust, said the following of the recent outbreak at Nottingham City hospital:

Why is this basic element of hygiene such a difficult message to get through?

Have the Government taken heed of the recent outbreak at Nottingham’s Queen’s Medical Centre and joined in the good practice of setting up isolation wards away from short-stay surgical wards? Why, contrary to advice from the chief medical officer, is there inadequate control over the prescribing of high-risk broad-spectrum antibiotics to over-65s? Why do we not in this instance—perhaps uniquely—learn a lesson from Europe and industrially launder nurses’ uniforms, instead of continuing with our unique British practice of laundering uniforms at home?

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Will the Government, who are so intent on a target culture—national targets, combined targets and now local targets—agree with the memo from their own Department, which said that this is basically a cop-out? Will the Minister condemn trusts that, according to the memo, simply see C. difficile as an unavoidable fact of hospital life? What will be done to tackle the lack of information for patients and relatives once patients are infected? What precautions are communicated to discharged patients when they go home, in order to stop C. difficile spreading in the community, as it can do? It is not just a hospital problem—it is out there in the community. Will the Minister therefore agree that C. difficile is indeed endemic and needs to be tackled as an urgent priority, rather than by simply trying to handle targets better?

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