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Health Care-Associated Infections

I congratulate the Opposition on choosing the subject of this debate, which represents good use of an Opposition day. I do not want to disappoint them too much, but I will not vote for their motion, although I welcome the opportunity to take part in this debate, which I have found extremely interesting up until now. It would be remiss of us to have a debate on what is seen by the general public as one of the biggest patient safety issues in the country and not put that debate in its proper context. We have had a chance today to raise some of the many issues associated with MRSA and C. difficile, but we should do so in a balanced way and look at the wider picture of problems with patient safety and of public concern about national health issues. That was touched on by the hon. Member for North Norfolk (Norman Lamb), who opened his speech by saying that we needed to see the issue in context. The hospital-acquired infections of MRSA and C. difficile are a matter of great concern, but they are as nothing compared with the problem of hospital-acquired venous thromboembolism. The hon. Member for Ilford, North (Mr. Scott) talked about the tragedy of his constituent going in for orthopaedic surgery and coming out with the dreadful infection of MRSA. However, believe it or not, his constituent was 25 times more likely to come out with a potentially fatal or debilitating venous thromboembolism, which could involve deep vein thrombosis, than he was to contract MRSA or C. difficile. According to the latest recorded figures, just over 2,000 NHS patients died after contracting MRSA. In the same period, as far as we know—I ask the House to listen carefully to this figure—25,000 patients a year died from hospital-acquired venous thromboembolism, yet we hear very little about it. The hon. Member for Beverley and Holderness (Mr. Stuart) made the valid point that the difference between the two kinds of hospital-acquired conditions is that the figures for the deaths caused by the superbugs are collated accurately by the NHS, yet the number of deaths caused by hospital-acquired venous thromboembolism are not collated properly. So when we say that 25,000 people a year are dying unnecessarily from hospital-acquired venous thromboembolism, that is a great underestimate. That figure comes from the Health Committee's report in 2005, which, I am pleased to say, was accepted in full by the Government and the chief medical officer, but it is almost certainly a great underestimate of the exact figure. I refer the House to the seminal work of Dr. Ander Cohen of King's College hospital, one of the leading epidemiologists in the country. He suggests that the figure is at least double the one that I have just cited. These are huge numbers, so when we have a debate on hospital-acquired diseases and patient safety issues, for goodness' sake let us look at them in context. The Government have rightly decided to spend £270 million a year on tackling hospital-acquired infections such as MRSA, C. difficile and some of the new conditions that have recently been identified, yet they are spending less than £30 million a year on the prevention of venous thromboembolism. It has been made clear from the start of this debate that tackling those superbugs is not a simple business. In fairness to the hon. Member for South Cambridgeshire (Mr. Lansley), he said that we needed to take a comprehensive approach. We need new research into medicines, a review of bed occupancy and more deep cleaning in our hospitals. Even if we had all those things, however, there would be no guarantee that they would have the desired effect. As far as deep vein thrombosis is concerned, however, all that we need to do is to introduce mandatory risk assessments in all patients in the NHS, which is relatively easy compared with treating the superbugs. We know that that could save at least 15,000 lives a year and avoid the tragedy associated with this unnecessary loss of life. The chief medical officer, having been asked to report on this matter by the Government, recommended that we should produce mandatory risk assessments for all NHS hospitals, certainly in England. He made that announcement last April. Shortly afterwards, National Institute for Health and Clinical Excellence guidelines were issued which contained the same recommendation for the risk assessment of patients using a relatively simple questionnaire, to enable doctors to work out what thromboprophylaxis—preventive treatment—could be applied. This devastating loss of life could be prevented at very low cost and, in some cases, at no cost at all. Those recommendations came out seven months ago, and we welcome the steps that the Government have taken. The all-party parliamentary group on thrombosis conducted a survey, starting in August, that was published this week. It surveyed 174 NHS hospitals and received a very good response. Eighty-one per cent. responded, and 99 per cent. of those hospitals said that they were aware of the chief medical officer's recommendations on dealing with this condition—I stress that this is hospital-acquired; this is not DVT in the community—and of the NICE guidelines, both of which recommended mandatory risk assessment. We do not want to decry—indeed, we want to encourage—such responses in future, but sadly, fewer than a third—only 32 per cent.—actually implemented risk assessments on all their patients, as recommended. We calculate that it is seven months since the recommendations and guidelines came out. Once again, I ask the House to listen carefully. We have heard figures on deaths from MRSA and C. difficile, but they are as nothing compared with the number of deaths from hospital-acquired deep vein thrombosis. We calculate that since April to today, approximately 11,000 patients have died. The all-party group on thrombosis and the excellent charity Lifeblood believe that those deaths were unnecessary and were relatively easily preventable. If we did something now, we could offset the cost of those who suffer this dreadful illness but survive—usually after orthopaedic surgery and general medical treatment—and re-present themselves to the NHS. No correlation is made with their presence in hospital, but the cost of those patients re-presenting themselves back to the NHS is £640 million a year. I welcome what the Government have done since the Health Committee report two years ago. They have moved quickly and comprehensively, but we cannot wait another 18 months for these mandatory risk assessments to come into our hospitals, which could mean thousands, if not tens of thousands, more patients—especially in England, but in the whole of the UK—dying from this condition.