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Mr. Stewart Jackson (Peterborough) (Con):
My hon. Friend makes a powerful argument on behalf of his constituents. Does he agree that the Governments policy is marked by duplicity? On the one hand, they
praise NHS staff and set them arbitrary targets to tackle MRSA and C. difficile, but on the other they issue secret memos to high-ranking civil servants saying that it is impossible to meet those targets and that the NHS might as well give up now. Is not that a duplicitous way to approach governing the NHS?
Bill Wiggin: My hon. Friend makes an excellent point, as always. He is right to be worried about the issue. It is our job to draw attention to the facts and not to be swayed by exaggeration, or to be convinced by the Government that everything is all right when it is not
We must also investigate superbugs transparently and honestly at both local and national levels; and that is why it is essential that the Government come twice a year to the House to report on the action that they are taking. Because of the NHS financial crisis created by the Government and the growth in superbugs, public confidence in the NHS needs to be restored. We know that virulent strains of MRSA can resist even the strongest antibiotics, but we also know that scientific developments and technologies are continually moving forward. What our constituents want to know is how well the Government and NHS are adapting to those changes and how new scientific and technological advances and new cleaning techniques are being applied in practice.
Only last week, microbiology specialists Oxoid developed a new test to detect C. difficile-associated diseases. It can be carried out in about 20 minutes and could make a huge difference in combating C. difficile, because of its ability to detect the disease early. That should be given serious consideration, along with the search and destroy pilot strategy promoted in this motion, because it will save lives.
The Governments own adviser on health protection has conceded that in the current circumstances the Governments target to cut MRSA bloodstream infections by half by 2008 will not be met. It has also been admitted that C. difficile is widespread and much harder to deal with than MRSA. New approaches are needed, and a six-monthly report to the House would enable hon. Members to debate this important issue and hold Ministers to account for their actions.
Those terrible infections can strike down anyone, but they hit the most vulnerable the hardest. In Herefordshire a quarter of the population is over 60, and the number of people of 85 and over will increase by 43 per cent. between 2004 and 2011. Many of them are currently in need of regular in-patient hospital careor are likely to be so in the futureand the NHS and the Government have a duty of care to ensure that the chances of superbug infection are kept to an absolute minimum. My constituents should be able to go into hospital, receive treatment and leave feeling better; they should not leave after suffering the ordeal of such an infection. We have to wage war on those diseases, but we are unlikely to win with this Government in charge of the NHS.
Daniel Kawczynski (Shrewsbury and Atcham) (Con): It is a great pleasure to follow my hon. Friend the Member for Leominster (Bill Wiggin), and I congratulate my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) on securing this very important debate.
At the outset, I want to say that the staff of the Royal Shrewsbury hospital do a tremendous job in very challenging circumstances. The socialists always criticise Opposition Members when we raise these matters [ Interruption. ] Well, I think that they are socialists. They claim that we are trying to denigrate the NHS, or the people who work in it, but that is not true.
I am a great supporter of everyone who works at the RSH, about which the House will know that I feel very strongly. It is my No. 1 priority as the local MP, and I am running the London marathon in April on behalf of its league of friends, a charity that raises money to buy vital equipment that should be provided by this socialist Government. I am not particularly fit, but I hope to finish the 26 miles and raise as much money as possible. If anyone wants to sponsor me, I should be grateful.
Bill Wiggin: I have every confidence that my hon. Friend will do considerably better than I did in the London marathon, when I set the record for the slowest time ever achieved by any MP. I wish him very well, and I hope that he raises a lot of money. What a shame it is that he has to use the funds that he raises to fill spending gaps left by the Government.
This debate is about MRSA. A leading campaigner on this issue in Shrewsbury is a lady by the name of Pat Davies. The Minister should get in touch with her, as she has spent many decades in the nursing profession and has dedicated her life to caring for people. She lives in Copthorne, near the RSH, and regularly comes to see me to tell me about current problems in the NHS. I want to raise with the Minister some of the matters that she has brought to my attention. Sometimes politiciansespecially socialist onesthink that they know everything, and do not need to listen to people with great experience who have worked at the coal face for years.
Daniel Kawczynski: The other Minister of State who is present, the hon. Member for Don Valley (Caroline Flint), is barracking me from a sedentary position, as is her custom. Surely we should listen to our constituents, especially when they have long experience of working in the NHS.
Mrs. Davies has offered me a number of suggestions, which I want to pass on to the Minister who will wind up the debate. First, no indoor uniform should be worn outside the hospital. Changing facilities should be provided, and that strict rule must be adhered to. Secondly, nurses should be made to wear a disposable
apron when in contact with patients. That is the practice in Europe, so why not here? It is obvious that disposable aprons should be used when a nurse comes into contact with a patient, and then disposed of immediately afterwards.
Thirdly, Mrs. Davies says that spot checks on thick uniforms should be carried out, to find out what types of bacteria are growing there. In addition, doctors should wear white coats over their suits. Fourthly, visitors should be supervised, and they should not be allowed to sit on beds. There should be no more than two visitors to a bed, and patients should not sit on other patients beds.
When I was recently in the Royal Shrewsbury hospitals maternity unit awaiting the birth of my first child, Alexis, I saw an awful lot of people sitting on beds, and there were far more than two visitors per patient. I mean no criticism of the hospital: the nurses are so overstretched that they do not want to keep going on about people sitting on beds. It is something that the Government should communicate to the general public. The Government spend millions of pounds on putting socialist propaganda on television, which they say is public informationbut why do they not talk about MRSA, or other important matters? They should tell people that they have a responsibility to act correctly when they visit relatives in hospital.
Mrs. Davies fifth point is that paper carries infections, so patients should not share newspapers or magazines. She is right about that, but the maternity ward was full of magazines that people passed around. There should be much stricter guidance about newspapers and magazines in hospitals, as Mrs. Davies assures me that MRSA can be carried by paper.
Mrs. Davies final point has to do with cleaning, and the need for wards to have domestic supervisors. When wards are cleaned, the clutter that gathers around beds is not moved, but that problem could be overcome if a ward sister were on hand. My right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) has often spoken about the need to have matrons or ward sisters in hospitals, and the Minister should take heed.
The RSH is more than £30 million in debt, as the Minister will know. People are very worried about the focus on debt reduction, and the problem is now so bad that charges for car parking are not confined to members of the public who use the hospital. Under this socialist Administration, nurses are being told that they will have to pay to park their cars when they come into work [ Interruption. ] The Minister may laugh, but that is the reality.
The hospital has set up all sorts of schemes to raise money to deal with the debt. Charging nurses to park their cars is one such scheme, but another is to charge the hospitals league of friends for operating its charity shops in the hospital. I and other Shropshire MPs have regular meetings with the hospitals chief executive, Tom Taylor, and the focus is always on finance and how the huge debt can be reduced. That approach worries me, because it lessens the attention given to problems such as MRSA.
When my daughter Alexis was bornon Trafalgar dayI was extremely impressed with the cleanliness of the RSHs maternity ward. However, the staff are very overstretched, and although I shall not go into the details now, I would be happy to write to the Minister about what I saw in the three days that I spent waiting for my child to be born.
As I noted in an intervention on the hon. Member for North Norfolk (Norman Lamb), 16 beds are to be cut at the RSH maternity ward between now and February. On top of that, the hospital in nearby Oswestry is to lose its maternity services completely. As a result, there will be even greater pressure on the RSHs maternity services. I fear that the cuts mean that people will take their eye off the ball, and the high standards of our maternity services will not be maintained.
All those things are part and parcel of the Governments attempts to take a one-size-fits-all approach to maternity services. In Shrewsbury a woman stays in hospital after giving birth for 2.6 days, on average. The hospital has won so many national awards that staff are repeatedly asked to come to the House of Commons to give evidence to the Health Committee about their great achievements, yet outside consultants have now told them that a stay of 2.6 days is far too long, and that they should aim for the national average of one day. That is a scandal. I am concerned about that situation, and about the impact of the cuts on dealing with MRSA.
Mrs. Nadine Dorries (Mid-Bedfordshire) (Con): It is especially fascinating to listen to the Secretary of State talking about MRSA. She talks about headline figures, targets, strategies and meetings, yet never once does she answer a question that relates directly to the problem or discuss it in practical terms.
We know that some hospitals do not have MRSA. There is little incidence in the private sector. Hospitals in Scotland have a low incidence. Field hospitals in Iraq and military hospitals have no MRSA. There are hospitals where MRSA does not occur, yet we seem unable to transfer their example to the national picture to deal with what is happening in hospitals with bad records.
It is not difficult to keep a hospital ward clean. I shall go through a few measures that I know make a huge difference to cleanliness on wards. We have already talked about ward sisters; the line of command is important. When I was training, we did not merely go on to a wardwe went on to Sister Joness ward or Sister Smiths ward. Their ward was their fiefdom, where they were in charge. There was competition between sisters; Sister Jones would never in a million years want her ward considered less clean than Sister Smiths ward.
Huge emphasis was put on the internal cleaning of wards. A large part of the job of nursing auxiliaries was cleaningwashing down beds, cleaning out cupboards, cleaning window sills, wiping down chairs and making sure the ward looked immaculate. That no longer happens to anything like the same extent.
I became aware of how far standards had slipped when I visited my grandfather in hospital recently. I found him sitting on a chair next to his bed. He was
cold, because he was not wearing pyjama bottomsI will not go into details, but it was a sorry sight. The ward floor was dirty. The bedside table was dirty; food had been left on it for days. Nobody took enough care. Nobody was worried about the cleanliness of the ward, yet the hospital has a high incidence of MRSA. It was obvious that the incidence could have been reduced by making the wards cleaner.
Mr. Charles Walker (Broxbourne) (Con): Does my hon. Friend think that hospital chief executives spend enough time on the wards? Any chief executive worth his salt would be appalled at the conditions that she found and would not allow them. Perhaps the wrong type of people are at the top of our hospitals. Such things would not happen in the private sector.
Mrs. Dorries: My hon. Friend is right. Many chief executives rarely go on to the wards, although the chief executive of my local hospital does. However, when I visited the hospital recently nurses told me that it was an unusual occurrence in other hospitals where they had worked, if it even happened at all.
Visiting used to be limited in hospitals. There would be a couple of hours in the afternoon and again in the evening, which restricted the amount of outside traffic into the wards, allowing them to be cleaned properly. Now we have open visiting, all day and all night. Families come into the wards, sitting on beds and by bedsides. The ward doors are never closed, so there is no proper cleaning.
People constantly have to deal with visitors. On a recent visit to a ward, as the MP, I was standing behind the nurses station and visitors thought I would know where various people were. People constantly came to the nurses station asking questions. That used not to happen because visitors were allowed only for a few hours in the afternoons and evenings so that wards could be cleaned properly.
Mr. Stewart Jackson: Does my hon. Friend agree that another associated problem, which was raised by our hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski), is the over-prescription of antibiotics because hospital staff are so overstretched? They cannot consider individual cases properly because they do not have enough time or resources to do so.
The solution is not just keeping hospital wards clean. It involves the end of hot bedding. Several Members have described how immediately after one patient has been discharged another one comes straight in before the bed is cold. The bed and the whole area around it should be cleaned and sterilised, but the targets mean that people are in and out before the cleaning can be done. The ward is not wet-mopped; it is merely dry-mopped with a big electric cleaner that cannot remove sticky substances or spillages.
Mr. Robert Goodwill (Scarborough and Whitby) (Con): Is my hon. Friend aware that in many German hospitals once beds are vacated they are sent to a cleaning station in the basement, where they are cleaned and shrink-wrapped before being sent back to the ward? Would not such a practice address some of our hot-bedding problems in British hospitals?
Mrs. Dorries: My hon. Friend makes an important point. Some UK hospitals have such facilities, although they may or may not be in use. However, we would not need to use such methods if nurses did not wear their uniforms to workan issue I have previously raised in Committee.
In supermarkets, we see nurses in uniform leaning over the fruit and vegetable counter with a toddler sitting on their hip. Are those nurses on their way to work or on their way home? If they are on the way to work, what bacteria are they carrying from the toddler on their hip or the supermarket vegetable counter to the hospital environment? Nurses should change into uniform when they get to work. When I was a nurse, I used to go to the hospital basement, give my name and then be handed my uniform, which was on a big rotating rack. I would go to the locker room, get changed and go on to the ward. When I finished work, I would change and put my uniform into a dirty uniform holder. I would never have dreamed of wearing my uniform home or back to work. I did not want to take bacteria from the hospital home to my children. It was a two-way process.
If there were laundries in hospitals we would not need to spend so much on dealing with MRSA in hospital. Measures such as shrink-wrapped beds might not even be needed if we implemented basic procedures. Laundering of uniforms is one of the most important measures, and the lack of it is one of the biggest contributors to the rise of MRSA.
Specialist equipment is available. Recently, I received information about an air-change instrument that removes bacteria from the air. When I visited a hospital ward not long ago, there were no alcohol wipes with which visitors or patients could wipe their hands. There was a dispenser on the wall, but the person I was with told me it had been empty for two days. There should be a procedure to ensure that alcohol hand-rubs are replaced every day, and a ward sister to ensure that the procedure is followed.
My hon. Friend the Member for Hemel Hempstead (Mike Penning) rightly spoke of the value of ward sisters in military hospitals in Iraq. Rank plays a part. If the wards are not clean, the ward sister calls the cleaner back. That is exactly what used to happen in our hospitals. The ward sisters word was law. If a doctor was not wearing his white coat, he would be sent to get one before he was allowed on to the ward. We need authority on the wardsand it can come only from ward sisters, which is why we need to take hospital cleaning back in house, back under the control of the wards and the ward sisters.
To conclude, as well as ward sisters, we need auxiliary nurses backnurses who take pride in cleaning and take responsibility for it on the wards. If the wards were basically kept fundamentally clean, we would not have MRSA.
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