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House of Lords

Wednesday, 3rd June 1998.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers--Read by the Lord Bishop of Wakefield.

In-hospital Infections

Baroness Young asked Her Majesty's Government:

    How many patients in the last year have picked up infections in hospital which cause them either to remain longer in hospital or to return to hospital, and what is the cost.

The Minister of State, Department of Health (Baroness Jay of Paddington): My Lords, data in the form referred to in the Question posed by the noble Baroness are not available. It is inherently difficult to collect data in this form because of the many factors that can affect the outcome of a person's stay in hospital. However, I can reassure the noble Baroness and the House that the Government take very seriously the subject of infections picked up in hospitals. The Department of Health has issued guidance to the NHS about in-hospital infections, monitors hospital practice and is developing systems to improve the quality of data in this field. The Government particularly welcome the contribution of the recent report of the Select Committee of your Lordships' House on resistance to antibiotics and other microbial agents. We are studying the recommendations carefully and expect to make a response to Parliament during this Session.

Baroness Young: My Lords, I thank the noble Baroness for her reply, but does she accept it is disappointing that the Government do not have any detailed information on this very important issue? Further, is the noble Baroness aware that there is considerable anecdotal evidence about people going into hospital, picking up infections and having to return to hospital or receive treatment subsequently at home? Does the Minister accept that that adds enormously to the cost? Will she ensure that much greater effort is made to collect this information and, following the report of your Lordships' House, consider the dangers of the overprescribing of antibiotics as a counter-measure against problems many of which arise from lack of proper training in elementary hygiene?

Baroness Jay of Paddington: My Lords, I very much reinforce the final point made by the noble Baroness. It is estimated that about one patient in 10 in hospital acquires an infection subsequent to his or her admission. I entirely accept her point that this is a serious problem. However, the Question put by the noble Baroness is concerned with the extent of readmissions caused primarily by that factor.

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That is more difficult to ascertain. However, we are working with the Public Health Laboratory Service to establish a new system for surveillance of hospital-acquired infection which we hope will produce results quickly. The Department of Health has recently commissioned new clinical guidelines from the Standing Medical Advisory Committee to report on standards of infection control in hospitals. We expect that to be available in July.

Lord Taylor of Blackburn: My Lords, does my noble friend agree that it is better to spend money on patients than on the collection of too much information and administration?

Baroness Jay of Paddington: My Lords, I always emphasise the importance of spending NHS resources primarily on patient care but, as I hope was clear from my original Answer, the Government take this issue of patient care very seriously. Therefore, we believe that money spent on collecting the appropriate data helps us to look after people better.

Lord Renton: My Lords, can the Minister inform the House what proportion of the one in 10 cases referred to earlier arises from surgeons and anaesthetists passing on infections from which they suffer?

Baroness Jay of Paddington: My Lords, I am afraid that I cannot provide that statistic. I suspect that, like the previous question put by the noble Baroness, Lady Young, that breakdown of the figures is not available at national level, although such information is probably held by individual hospital trusts. The noble Lord is right to suggest that sometimes new forms of surgical intervention cause infections in respect of which people might not otherwise have been at risk. On the other hand, that must be balanced against the very good results which on the whole come from new forms of surgical intervention.

Lord Rea: My Lords, I am delighted that my noble friend is taking note of the report of your Lordships' Select Committee on Science and Technology on the development of resistance to antibiotics chaired by the noble Lord, Lord Soulsby. I was privileged to serve on that committee. Is my noble friend aware that the committee made a number of recommendations with regard to the control of hospital infections? It is true that a reduction in the total level of infections will reduce the rate of development of resistant infections. In particular, is my noble friend aware of the statement in paragraph 11.26 that investment in good infection control

    "will pay for itself quite quickly"?

Baroness Jay of Paddington: My Lords, I acknowledge my noble friend's very important contribution to the work of that committee and repeat the comments of the Secretary of State for Health, in welcoming the report, that the Government see it as a valuable, constructive and timely contribution to the current national and international debate. As to the specific

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question of infection control, I repeat what I said in response to the supplementary question of the noble Baroness, Lady Young. Of course, primary infection control is very much dependent upon primary methods of hygiene which probably have not changed over many years.

Baroness Masham of Ilton: My Lords, does the Minister agree that over the years there has been complacency among hospital managers about infection control, which is not always very expensive? Given the pressure on hospital beds and the number of agency nurses, there is growing concern about such matters as the failure of staff to wash their hands and infections passed by doctors' ties, pencils, stethoscopes and basic things like that, in going from patient to patient?

Baroness Jay of Paddington: My Lords, as I hope I made clear in answer to previous questions, basic rules of everyday hygiene must be considered and applied even more carefully in a hospital setting. There can be very disastrous effects if these problems arise in places where people are already vulnerable, perhaps because of their own originating illness. All hospitals have specialist infection control teams whose specific function is to advise on the precautions necessary to prevent the spread of infection both in the more complicated ways that may arise from invasive surgery and in the everyday ways that the noble Baroness mentioned.

Baroness Thomas of Walliswood: My Lords, does the Minister accept that there must be some concern about a situation which affects 10 per cent. of patients? I think she implied that the statistics are collected at hospital level but not at national level. If I have that wrong, I apologise. But if that is the case, would not the collection of those statistics be valuable to assist in analysing why it is worse in some places than others?

Baroness Jay of Paddington: My Lords, my original response was obviously not clear. The Public Health Laboratory Service is trying to develop a national surveillance approach along the lines suggested by the noble Baroness. I am sure that that would be helpful. In my original response, I was trying to say that the detailed point rightly raised by the noble Baroness, Lady Young, that the figures relating to the relationship between in-hospital infection and delayed discharge were much more difficult to collect.

Lord Tebbit: My Lords--

Lord Soulsby of Swaffham Prior: My Lords--

The Lord Privy Seal (Lord Richard): My Lords, we have four Questions to answer in 30 minutes. We have had eight minutes on the first. I think that we should move on.

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Heathrow: Minimum Fuel Requirements

2.45 p.m.

Lord Berkeley asked Her Majesty's Government:

    What action they are taking to ensure that planes landing at Heathrow comply with the Civil Aviation Authority's minimum fuel requirements.

Baroness Farrington of Ribbleton: My Lords, the CAA recently reissued its aeronautical information circular giving advice on fuel levels to aircraft which are inbound to UK airports. Such advice is updated regularly as a matter of routine. There is no evidence to suggest that there is a problem with planes arriving at Heathrow Airport with inadequate fuel levels.

Lord Berkeley: My Lords, I am grateful to my noble friend for that Answer. Is she aware that over the past six months five aircraft about to land at Heathrow sent out mayday or distress calls, saying that they had run out of fuel and asking to have priority landing? That is a major safety issue. What action can the Government or the CAA take about aircraft which continue to flout the basic rule of having enough fuel to go on to another airport?

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