The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, under the voluntary reporting system then in existence it is clear that the proportion of MRSA isolates in bloodstream infections increased from 4 per cent to 30 per cent from 1993 to 1997. The full national picture became known only after this Government introduced mandatory surveillance of MRSA with effect from April 2001. The data from mandatory reporting have been published from the outset to assist the NHS in tackling this difficult problem.
Lord Rosser: My Lords, if my noble friend is saying that there was a rapid increase in MRSA in the years immediately prior to 1997 and that the then government did not demand to know the full picture, does he share my view that their recent attempts to blame others is a clear-cut case of the Official Opposition seeking to sweep their full responsibility for the increase in MRSA under the hospital bed?
Lord Warner: My Lords, it is a normal convention that governments are not allowed to see papers relating to previous administrations. However, it is very difficult to escape the conclusion that the Official Opposition did not have their eye on the ball on this issue before 1997. I think that my noble friend's comments are a fair summary of the position.
Baroness Pitkeathley: My Lords, does my noble friend agree that not only has there been a huge increase in the awareness of hospital staff of problems associated with MRSA, but also a concentration on making visitors to wards aware of the necessity to take proper hygiene precautions? I have been very struck by that when visiting hospitals recently.
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Lord Warner: My Lords, my noble friend is absolutely right. We have introduced the "Clean Your Hands" campaign which is improving hand hygiene. We have raised awareness by publishing information rather than, as my noble friend said, sweeping the problem under the bed. There is a rising public consciousness, and a consciousness among staff, of the importance of cleanliness and good cross-infection control.
Lord Warner: My Lords, the Chief Medical Officer published his document Winning Ways in December 2003. That set out an action plan in this area, including better control of use of antibiotics so that we did not stimulate this very clever bacteria to modify itself further.
Lord Warner: My Lords, this Government are proud that they have had some targetswhich the Official Opposition wish to sweep away, I understandwhich have reduced waiting lists and enabled people in pain, who are suffering and possibly dying, to get into hospital faster. We do not think that there is any conflict between good cross-infection control and good bed management. We have made it clear to trusts and chief executives that they are expected to control both those agendas in the interests of patients.
Baroness Barker: My Lords, given the Secretary of State's stated expectation that MRSA rates will halve by 2008, what resources have been given to NHS trusts to implement the new model cleaning contract that he announced in December 2004?
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Lord Warner: My Lords, under this Government NHS allocations have increased over the past couple of years, and for another two to three years will continue to increase on average by about 7.1 per cent in real termsan unprecedented level of extra funding. After the 2000 NHS Plan we also introduced an extra £68 million for cleaning. We accept that the cost-cutting measures on contracting out carried out by the Official Opposition in the 1980s have not helped hospital cleaning.
Lord Ashley of Stoke: My Lords, while the hand-washing campaign is very important, I have seen one report which indicates that even hospitals with the highest hygiene standards have some of the highest rates of MRSA. What conclusion does the Minister draw from that and what lessons can be learned?
Lord Warner: My Lords, it is true that we have a particularly difficult strain of MRSA in this country. However, healthcare-acquired infection rates in this country are not very different from those across Europe. We are continuing to battle against MRSA. The NHS is now responding to the lead given by the Government in this particular area.
Baroness Gardner of Parkes: My Lords, does the Minister recall our recent debate when, on that very day, the Secretary of State demonstrated a brand-new machine that was going to vacuum up MRSA and solve the problem? How many of those machines have now been introduced and into how many hospitals?
Lord Warner: My Lords, I obviously have the sort of collective amnesia that sometimes afflicts the Opposition on the NHS. I do not remember that particular event. I can tell the noble Baroness that we introduced the Rapid Review Panel, which has considered 58 products that have come forward from industry. We have announced the results of that review and are making the best and most effective products available to the NHS through framework contracts via the Purchasing and Supply Agency.
Lord Phillips of Sudbury: My Lords, as one who contracted MRSA in an excellent hospital years ago, is it possibleI was certainly given the impression there that it was the casethat there are far too many impositions and interferences in hospital management centrallyI am talking not just about this government but all governmentsand that we might get further with fighting MRSA if the hospitals were left with more of the initiative?
Lord Warner: Well, my Lords, that is why the Government are shifting the balance of power. We have made guidance and money available and have given a clear lead in the area of cleanliness and MRSA.
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It is down to trust boards and chief executives, working with their staff, to ensure that those problems are addressed.
The Minister of State, Office of the Deputy Prime Minister (Lord Rooker): My Lords, the answer is no. We have no plans to withdraw from or renegotiate the 1951 refugee convention. It is part of the legal and ethical framework that enshrines basic principles of human decency through which all countries meet their obligations. A better and more realistic way of addressing today's protection issues is to adopt effective domestic asylum procedures and to work with other governments and the United Nations High Commissioner for Refugees.
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