Hospital-Acquired Infections

- Tuesday, 13th January 2004

 

Mr. Peter Lilley (Hitchin and Harpenden) (Con): I will do my best to observe your very wise recommendation, Mr. McWilliam. I pay tribute to the hon. Member for Norwich, North (Dr. Gibson) for securing a debate on this very important subject, and I make no apology for returning to it, having spoken on the matter last Wednesday on the Floor of the House. Indeed, I have raised the issue on several occasions in recent weeks and months because it is immensely important.

Sadly, despite the undoubted dedication of the men and women who work for the national health service, we suffer from a poor record of hospital infections in this country. Nearly one in 10 people who go into hospital acquire an infection that they did not have when they entered. In most cases, those infections are not due to the superbug but, according to the National Audit Office, between 5,000 and 20,000 people die wholly or partly because of infections acquired in hospital. Not only is that level of infection worse than in most of the European Union, but it is getting worse faster. The last report of the European Antimicrobial Resistance Surveillance System stated:

"We found strong indications for a rapid increase in the prevalence of methicillin/oxacillin resistance in the United Kingdom (about 6 per cent. increase per year)".

It went on to single out the UK again:

"Especially in the United Kingdom, MRSA is a serious resistance problem, as its prevalence has risen by up to 45 per cent. by 2001."

We have a very serious problem. If anything, it is remarkable how little attention is paid to it. Consider the number of column inches devoted to the tragedy of the Hatfield crash, which occurred near my constituency. It involved the death of six people: for every one and every family a terrible tragedy, but not remotely on the same scale as the number of people who have lost their lives through infections acquired from hospital. When I think of the number of people who have come to my surgery over the years who have lost relatives, lost limbs or been permanently maimed as a result of such infection, I am astonished at how little attention is paid to it.

There was a burst of publicity when the Government announced what we were initially told were new policies?although we later learned they were not. Shortly afterwards, I was speaking to a French friend, who asked what issues I was taking up in Parliament. Before I could answer, he said, "What you should be doing is pursuing this superbug issue. It is a scandal that you calmly take the fact that around 5,000 a year may die from it." Although there is such a problem in French hospitals, it is treated very seriously and, in his view, much better controlled. There was a recent scandal in northern France, where 14 people had acquired infections in hospital. The President of the Republic had been brought in, and the story was on the front page of all the newspapers. We should be taking the matter seriously, and I am glad that we are doing so today.

The main reason to be worried about the problem is the impact that it has on the mortality of those in hospital, but there are also cost implications. As the hon. Member for Norwich, North said, estimates of the costs incurred of more than ?1 billion are credible and,

13 Jan 2004 : Column 224WH

if anything, likely to be understatements. The solutions, by contrast, do not appear likely to be costly. If anything, they will save very substantial sums of money. It is extraordinary that at a time when resources are being pumped into the NHS with remarkably little effect, we have an opportunity to save lives, reduce the harm done to people and save large sums of money, and we are not taking it.

What do we need to do? As a result of expressing an interest in the matter, I have done a lot of interviews in the newspapers, on radio and in other media. I have often shared time on discussion programmes with medical people far more knowledgeable than myself, and subsequently received e-mails from them. They say that there are medical things that need consideration, which we should examine because they might help us tackle the problem.

I did a series of radio interviews with a representative of the Academy for Infection Management, a worldwide body of experts in the sphere. It says that there must be a change in the use of antibiotics in tackling infections in hospital. We must do the reverse of what we have done until now. When a case has been discovered and samples are being sent for tests and identification, which can take several days, we begin treating with the mildest of antibiotics and slowly build up through the range of increasingly intensive treatments. As a result of its work, the academy believes that it would be better to zap the infection initially with something strong, rather than waste several days on checks?allowing the bugs to take root and transmit in a hospital?before finally applying broad-spectrum antibiotics. That approach would save lives and money and release beds in intensive care, so it would be fully justified. I am not a medical expert; all I can do is put forward the suggestion and hope that the Government give it the consideration that proposals from such a source deserve.

I received another e-mail from a doctor who said:

"Hospitals used routinely to test doctors for ‘commensal carriage‘ of MRSA:"?

that means carrying it but not suffering any adverse effects, which is quite common?

"if the test proved positive, the doctor was immediately sent on compulsory leave while receiving treatment to eradicate the organism.

The practice has been quietly dropped by NHS trusts, with no explanation."

He suggests that it is down to the

"over-riding passion of hospital managers for saving money".

In my view it undoubtedly has the long-term consequence of costing money, and it would be ill advised. We should consider whether that practice needs changing to the original one.

I received correspondence from others about the potential in the long term for the use of bacteriophages?bacteria-eating viruses that have been developed in other countries. There is some literature in this country about their potential. They can be highly specific and geared to particular resistant microbes, and once they have eaten them they themselves die and have far fewer side-effects compared with microbiotics. It is another area in which we should consider whether research is appropriate. As a politician, I make it quite clear that I am not saying, "This is right; this is the

13 Jan 2004 : Column 225WH

medical procedure that we should adopt." I am merely saying that we should consider it and take it very seriously.

Another doctor wrote to me and criticised the impact of targets, which were impinging on his success in largely eliminating infections from the unit of which he was controller. Due to a target to move people from one unit to another at a certain speed within a certain time, people were being moved before they had been properly cleared of infection. It was then likely to spread in the hospital.

The over-rigid application of targets is an issue that came up time and again as one factor that contributes to the prevalence of bugs and various infections in our hospitals. I will not repeat the other case histories that I cited on the Floor of the House last Wednesday.

Above all, we must restore a consistent, rigorous and meticulous regime of personal cleanliness among staff. We must restore the Florence Nightingale culture that is the ultimate barrier to the transmission of infections within hospitals. That will be achieved only if we restore authority to clinical staff and medical personnel and take it away from management, bureaucracy and rigidly imposed targets. Unless and until we make the patient supreme, and medical staff have the authority in hospitals, we will not secure any change or improvement. I will not be satisfied until we have, not the worst record of any major country in Europe for the treatment and prevention of hospital-acquired infections, but the best.

 

 

Current Location:

 

Home / Parliament / Parliamentary Speeches / 2004

Hospital-Acquired Infections

 

Search this Site

 

 

Contact Peter Lilley MP:

 

E-mail

feedback@peterlilley.co.uk