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Health Care-Associated Infections

May I first apologise for not having been here during most of the opening speeches? I had already told Mr. Speaker that I was coming from Market Harborough—splendid place—and was at the mercy of both trains and a passage across London in the rush hour. I am grateful for the opportunity to speak in this debate, particularly as my trust forms such a central part of the motion. I digress for just a couple of seconds to answer the gibe made by the hon. Member for Livingston (Mr. Devine). He said that because I had private health insurance, I was some sort of terrible public liability. I point out to him that every time that I pay full whack for my prescriptions I take a burden from the NHS. Although I am an OAP, I still pay full whack—a bit more than the hon. Gentleman pays, and people benefit from it. However, I digress; I shall pull myself back into order before you do, Madam Deputy Speaker. I turn to the main part of the motion. I make no apology for repeating what I said when I raised a question with the Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen), after the publication of the report into Maidstone and Tunbridge Wells NHS Trust. I have since had a meeting with her and I reiterated the point then. The crux of the matter relates to authority and accountability in the wards themselves. No matter how good the chief executive or matron, they are not on the ward all the time. They cannot be. Ward sister, however, is on one ward for an entire shift and therefore authority and accountability need to be vested in her. It is clear that that system has broken down in large parts of the NHS and in particular in my own trust. I do not wish to go over again the problems that my trust has faced, because the crucial thing now is that we look forward and try to put right what has gone wrong. We should address ourselves to the future, rather than always harp on about the past. Nevertheless, I have to say that, despite all the publicity around that report and all the local press and media coverage, I still got a letter from a constituent saying that she had recently visited a relative in hospital where a nurse had dropped a syringe on the floor, picked it up and gone to use it. The nurse was stopped—this is the crucial point—not by a ward sister but by an observant relative, who said, ““Hey, you can't use that.”” The role of a ward sister should be almost wholly supervisory. She should be going round the ward saying, ““Nurse, that drip is empty””, ““Nurse, that patient has been ringing the bell””, or ““No, nurse, you don't use that syringe—you've just dropped it on the floor.”” That is the ward sister's job, together with issuing appropriate instruction of the nurses as to why not to use the syringe that has just fallen on the floor—if such instruction should really be necessary. However, the ward sister does not do such things anymore, and there are three reasons for that. First, her role has become confused and she spends far too much time commissioning blankets and bandages instead of supervising the nurses. Secondly, she spends rather too much time filling in forms. If this Government do not get to grips with form-filling, targets and box-ticking, a lot of time will be diverted from the sharp end of patient care. The ward sister also nurses, because when there are nursing shortages she has no choice but to do so; and while she is nursing, however admirable that may be, she is not supervising others. Thirdly, there is an air of what I might describe as excessive egalitarianism whereby she no longer likes to boss. When I went to see the Minister, she told me rather endearingly how she used to be bossed tremendously, even to the extent that she was not allowed to plump up a pillow because it released germs into the air. Indeed, she told me that she never plumps up her pillows at home having learned that lesson so thoroughly. What a difference between that level of supervision and what we have today. We need the ward sister bossing, however nicely and politely, and taking control of the ward. Ward design has a major role to play, although I know that that cannot be put right by the middle of Tuesday afternoon. I have had one very positive experience of the NHS in recent years, when I took my mother into Royal London hospital under trauma procedures. The wards there were of the old Nightingale design, which meant that all the nurses could see all the patients all the time and all the patients could see all the nurses all the time. Nobody was ringing bells for people to appear round double corners, which is the layout of most modern wards. Given that the Government are boasting about how many hospitals they are building, perhaps before they build any more they might revisit the whole issue of ward design and how easy it is for nurses to be supervised in a situation where they can hardly ever be seen.