---

Health: Hospital-acquired Infections

I also thank the noble Lord, Lord Patel, for giving me the opportunity to get involved in this subject, which I do not normally do. I come from a medical family; my father was a GP, my mother was a midwife and my brother is a GP. I was the black sheep of the family who went into commerce and then, even worse, into politics. At least I now have a chance to make a contribution to the area. We are all aware as citizens of the astounding statistics, of which the noble Lord, Lord Patel, has mentioned a number: the 300,000 cases of hospital-acquired infection per annum; an estimated 5,000 deaths; the UK’s performance being the fifth worst of 29 European nations; and a potential cost of £1 billion to the NHS. Even more important, as the noble Baroness, Lady Masham, said, is the movement of resources and skilled people into coping with those areas rather than those with which they would rather be dealing. Statistics that came out today include some 10,000 C. difficile cases over a quarter year and, over the past four years, 200,000 cases of C. difficile and 20,000 cases of MRSA. Although those statistics are staggering and abrupt in their own way, the issue is more important than that. These infections, in particular, bring real fear to those who must deal with the NHS and are not well. Over the past couple of years, people have, for the first time, hesitated about being admitted to hospital. We cite the statistics, but there are people who have decided not to have hospital treatment because of their concern about this area. As people in politics and Parliament, we must ask ourselves whether that is because of the tabloid press scares, like the scare over street crime, which is a real issue in certain areas but does not necessarily affect where we are and our lives. Is people’s fear greater than the risk? I do not think it is, because even I know a person who died and other people who have been affected by these diseases. It is far less remote than many other things that we get involved in. What are the issues here? One of the causes is the problem with cleanliness, but I have been aware for some time of the abuse and overuse of antibiotics. When I was a youngster, I was put on tetracycline—I can still remember its name and think it is an antibiotic, but perhaps it is not—for some three years, just in case I reacquired an infection that I had had earlier. I am sure that practice would not now be acceptable. We used antibiotics regularly in veterinary care. We fed animals antibiotics to make sure that they did not stand a chance of getting infections. Clearly, the mismanagement has meant, as the BMA put it in one of its documents, that life-saving technology has become life-threatening. Is the Minister confident that the management and use of antibiotics for humans and animals means that that is no longer a problem? We have that problem with malaria, in particular. I am sure that my mother would have been concerned by the way that cleanliness got decoupled from medical care in hospitals and similar establishments. I am sure that the focus on that is much better because we have seen the improving figures on these infections over the past year. However, I question whether cleanliness is at the heart of medical as well as administrative practice. Having been in hospitals a number of times over the past year because of a family member, I was struck by how little the washes, which we do not think are completely effective, were used by visitors and medical staff when moving around hospitals. Does the Minister believe that screening patients as they come in and isolating them if necessary is successful? Does it need to be applied more? Where are we on that? My other concern, which comes from my management career, is about judging people against targets. It is right in principle, but there are unintended consequences of keeping targets in place for too long and managing people’s performance too carefully. One aspect of that is the bed occupancy rate. What are the Minister’s views on the correlation between hospital-acquired infections and bed occupancy rates? The evidence seems to show that where the rate is above 85 per cent there is a positive correlation with cases of infection. I should like to know whether the Government accept that correlation. If so, surely that means that we have to manage the whole area of bed occupancy, which in every other way is clearly a measure of a hospital management’s efficiency. It can be fantastic but, if patients are killed on the way, that is not quite so good. It is a question of how we should look at those sorts of targets. A final area on which I should be interested in hearing from the Government is nursing homes and homes for the elderly. Those come outside the hospital arena and therefore may go slightly beyond the subject of the debate, but they carry the same importance in that they have many vulnerable people facing similar threats. What actions are the Government taking and what plans do they have to deal with the problem in that area, which is not highlighted much, or perhaps greatly understood, in the media? Does the Minister see that as a threat to the reputation of healthcare more generally in this country? Most of all, we all want to see hospitals where patients—you and I—can be confident that they are going to be healed and will not feel that they are risking their lives even more by engaging in their services.