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Health Care-Associated Infections

I am grateful to the hon. Lady. I recall her Adjournment debate on that subject earlier this year, which clearly caught the interest of the House. Where C. difficile is concerned, staff in the NHS need to be extraordinarily well aware of the risks that they run with broad spectrum antibiotics, particularly when they are combined with proton pump inhibitors, because the combination of those two things can leave patients very vulnerable to the consequences of C. difficile infection and its proliferation. The hon. Lady refers to one way of combating that, but another would be the use of probiotics, which has been pioneered in Nottingham. The hon. Member for Bolton, South-East (Dr. Iddon) talked about things being obvious. Some of the things on which we should focus have been obvious for a long time—the point is that those things have not been done. Let us take the screening of patients for admission. Ministers have repeatedly told the House that they are in favour of screening at-risk patients, but it was not until September this year that they came to the House to say that they supported the universal screening of admissions. I welcome the fact that they have now done that, albeit that it is nearly three and a half years since we called for it to happen. This is not the first time that the Department of Health has advised that. Last November a best practice code was published, which said:"““The logical conclusion of risk factor assessments and the results of modelling studies is that the most appropriate approach to the reduction in MRSA carriage in the population, and resultant MRSA infection, is the universal screening of all admissions to hospital””." Now, a year later, Ministers tell us that they are going to put in place the resources to support screening; we said during the general election that that should be done and that the necessary technology should be supported. The hon. Member for Bolton, South-East mentioned research; we said that there should be research and support for new technologies to deliver rapid screening, so that when one is in a ward and asks staff about the process of managing patients, one does not find that it will be two days before they are in a position to be able to access results and know whether patients are infected. In the past few weeks, I have had responses to freedom of information requests that I made of hospital trusts, and the results are deeply disappointing. Only 2 per cent. of trusts said that they screen all patients for MRSA, only 32 per cent. of trusts can provide any data on the number of patients screened, and not one trust collects data on whether patients are isolated following a positive MRSA screening result. None offered data on whether, if a patient was screened and found to be positive, they would as a matter of course be put in a single room or isolated. I am afraid that that rather accords with the findings of the Health Protection Agency, which were published by the Department just a couple of weeks ago, although not with a press release. The HPA said that nearly one third of trusts did not screen all patients, only 60 per cent. screened all previously MRSA-positive patients, and only 55 per cent. screened all patients from nursing homes, despite that being a high-risk factor. It is all very well to say that there should be screening of admissions, including emergency admissions, but that has been said before and it has not been done. We want to see results. On the isolation of patients, Pat Troop, chief executive of the Health Protection Agency, said:"““The most effective way of controlling the spread of both Staph. Aureas and MRSA is through early detection and appropriate isolation and treatment.””" In 2004, the National Audit Office noted that many trusts had undertaken a risk assessment but only a quarter had obtained the required isolation facilities. The study published by the Department last month said:"““Three quarters of Trusts indicated that they had problems implementing isolation policies due to inadequacies in the number and fitness for purpose of isolation rooms.””" What about bed occupancy? In April 2001, the Government said, in response to the Public Accounts Committee:"““Health Authorities should plan bed numbers in order to achieve a bed occupancy rate of no more than 82 per cent. in 2003-04.””" What happened after that? The bed occupancy rate went up. It is still at 84.5 per cent., and in many parts of hospitals, it is way above that.