Speaking in the debate on the Health Protection Agency Bill this week in Parliament, Peter Lilley, MP for Hitchin and Harpenden, said Ministers were still in denial over tackling superbugs and condemned their failure to spell out a role for the new Health Protection Agency ? which was set up to tackle infections ? in dealing with hospital acquired infections which affect nearly one in ten people treated in NHS Hospitals.
However, he welcomed the recent improvements in regard to both West Hertfordshire Hospitals and East & North Hertfordshire NHS Trusts in tackling this problem.
Peter Lilley said: “The control of hospital acquired infections ? an issue of growing importance to the public ? is hugely important, but the Public Health Minister did not mention it during the debate. It is extraordinary that the relationship between the new Health Protection Agency and that problem was not debated at all.
“We know that nearly one in 10 patients who enter hospital acquire an infection there that they did not have beforehand. And we know from the National Audit Office that an estimated 5,000 people at least die every year from superbug infections acquired in hospitals and that up to 20,000 may lose their lives through some involvement of superbugs in complicating other factors. We should have been told during this debate what role the Health Protection Agency will play in tackling this very important problem.
“It is extraordinary how little attention has been paid to this issue until recently. When one thinks of the disparity between the government?s pursuit of what turned out to be illusory threats of biological warfare in the middle east and the actual biological warfare being fought and, it would seem, lost in our hospital wards through dirty and unwashed hands, one cannot help feeling that there is a disproportionate failure to recognise the seriousness of the problem.
“I am glad to say, though, that recently I had a lengthy briefing from the clinical standards officer of the West Hertfordshire Hospitals NHS Trust and met the infection control directorate at the East and North Hertfordshire NHS Trust and I am very pleased that this issue is now being given priority locally. I would like to see it given an even higher priority at the national level and I hope that the HPA will play its role in that.?
Note to Editors: Transcript of Peter Lilley MP?s speech during the debate is attached.
Mr. Peter Lilley (Hitchin and Harpenden) (Con): I had intended to follow the excellent example of my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) and focus exclusively on the health policy aspects that the Bill raises, rather than on the bureaucratic reshuffle on which the Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson) focused and on which the hon. Member for Erewash (Liz Blackman), who has temporarily left the Chamber, made a thoughtful contribution. However, in view of the Minister‘s failure to answer my question on the powers that this body is being given, I feel it necessary to return to that issue.
The Bill gives as the main functions of the new body
“the protection of the community . . . against infectious disease”
“the prevention of the spread of infectious disease”.
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That is fine; we all support those objectives. However, the Bill goes on to give the agency apparently unlimited powers to achieve those objectives. It says:
“The Agency may do anything which it thinks is?
appropriate for facilitating, or
incidental or conducive to,
the exercise of its functions.”
I find that surprisingly open-ended. The Minister, who appeared to be rather unfamiliar with that provision, said that it was intended to enable the body to be independent of the Government, but as my hon. Friend the Member for Buckingham (Mr. Bercow) said, a body does not have to be omnipotent in order to be independent. Clearly, that provision has nothing to do with restraining interference from Ministers.
I would therefore like the Under-Secretary of State for Health, the hon. Member for South Thanet (Dr. Ladyman), when he winds up, to tell the House what powers the agency will actually have. Will it, in its attempts to fulfil its function of preventing the spread of disease, have the power to detain people suspected of being infected? Will it have the power to distrain property thought to be carrying infection? Will it have the power to levy charges or impose fines on those who interfere with its attempts to restrict the spread of infection? Those are important issues. There could be arguments for giving a body such powers, but it would be unusual for the House to give them away without any restraint at all, without specifying in the Bill the circumstances in which they could be used and without any recognition by Ministers that such draconian powers were being conferred on a Government agency, albeit one acting at arm‘s length from the Government.
Dr. Julian Lewis: My right hon. Friend has been in the House much longer than I have. In his long experience, has he ever come across a Bill that has given such an open-ended mandate to an agency in that fashion?
Mr. Lilley: My hon. Friend makes a good point. I have cast my mind back to see if I can remember such a case, but I cannot. That might be?I have some sympathy with the Minister on this?because when one is dealing with a long Bill, one often approaches the Dispatch Box with some trepidation that one might be asked the meaning of one of the obscure and complicated clauses. One therefore tries to focus on what those clauses mean and perhaps misses the more obvious clauses at the beginning, so I may have missed such clauses in other Bills. However, I am not aware of this Bill having any precedent. I hope that the Minister will tell the House why this provision is included in such an unrestrained and draconian fashion.
I really want to focus on the main issue raised by the Bill, which is the prevention of the spread of infections and in particular, the control of hospital-acquired infections?an issue of growing importance to the public, although the Under-Secretary did not mention it in her speech, nor does the publicity material on the Bill issued by the Government. That is a hugely important issue, so it is extraordinary that the relationship between this body and that problem was not discussed at the Dispatch Box.
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We know that nearly one in 10 patients who enter hospital acquire an infection there that they did not have beforehand. We know from the National Audit Office that an estimated 5,000 people at least die every year from superbug infections acquired in hospitals and that up to 20,000 may lose their lives through some involvement of superbugs in complicating other factors. We know from the European Union that the problem is more prevalent in British hospitals than in those of anywhere else in the European Union with the possible exception of Greece. We know, too, that the problem is getting worse more rapidly in this country than anywhere else in Europe. We should like to know what role the Health Protection Agency will play in tackling that important problem.
That is an important aspect of health to which the Government‘s main approach does not appear to be relevant. The Government‘s main approach is that all health problems can be solved by having billions of pounds rolled at them in the hope that they will eventually be tackled. However, if we succeeded in tackling the problem of hospital-acquired infections, far from needing extra resources, we would save many lives, and release vast resources for the treatment of other illnesses or to save the Exchequer money.
It is extraordinary how little attention has been paid to that issue until recently. When I compare the uproar at the five people killed in the railway accident at Hatfield near my constituency?every one of whose loss of life was a personal tragedy?to the reaction to the fact that an estimated 5,000 people a year die as I have described in our hospitals, I cannot help but think that the treatment given to the matter by Government, politicians and, until recently, the media, has been disproportionate.
When one thinks of the disparity between the Government‘s pursuit of what turned out to be illusory threats of biological warfare in the middle east and the actual biological warfare being fought and, it would seem, lost in our hospital wards through dirty and unwashed hands, one cannot help feeling that there is a disproportionate failure to recognise the seriousness of the problem.
Dr. Julian Lewis: My right hon. Friend is most generous in giving way. One is tempted to comment on the paradox that he just raised by recalling the statement once made about a small number of deaths being a tragedy and a large number of deaths being a statistic. My right hon. Friend rightly points to basic failures such as not washing hands as being responsible for some deadly infections. Why, then, should we need a Health Protection Agency to put something right, when we all know what is wrong?
Mr. Lilley: My hon. Friend makes another very good point. I hope that we do all know what is wrong, and I intend to investigate further the causes of this problem.
I became interested in the subject partly as a result of cases that I encountered in my own “surgery”, as we tend to call our advice bureaux in our constituencies. Over the years, I have met people who lost relatives as a result of infections acquired in the course of hospital operations or who themselves had acquired the infection and been maimed permanently by it. I was sub-consciously aware that there was an issue there.
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Some years ago, I wrote a paper about the health service entitled “Patient Power”. While I was working on it, I discovered the National Audit Office estimates of the scale of the problem. I campaigned for the publication of information authority-by-authority, hospital-by-hospital, on these sorts of problems, so that patients would have the power to take informed decisions on the basis of that information. It was as a result of the subsequent publication of such information that I learned that the trusts in my own constituency had very poor records at that time and were near the bottom of the national league table. Indeed, one was virtually at the bottom. I am happy to say that both those trusts now take this issue seriously and that both have improved their ranking markedly?they are now close to the national average.
A little while ago, I had a meeting with the infection control directorate at the East and North Hertfordshire NHS trust, and a lengthy briefing from the clinical standards officer at the West Hertfordshire trust. I am glad that this issue is now being given priority locally: I would like to see it given an even higher priority at the national level and I hope that the HPA will play its role in that.
We have to ask ourselves why, given the manifest dedication of most people who work in the NHS, to whom I pay tribute, does this problem exist, and why have we as a nation been so slow to face up to it? Part of the answer to the latter question lies in the fact that, as a former health Minister said, the NHS has become part of our national religion. As a result, we are reluctant to think that anything can go wrong within it. We do not want to accept or face up to the fact that it can be a place where illnesses are caused and acquired as well as cured and treated, but we must accept it. Moreover, the Government must face up to it. I am afraid that some people in government are still in denial about the problem and believe that it can simply be spun away or ignored, but it cannot and it must not.
I shall not develop at great length?at least, not at this stage?the disgraceful episode that occurred last autumn. The Government issued a statement to try to pretend that they were doing something about the problem, but when asked to bring the statement before the House, they admitted that they were doing nothing new at all. That was symptomatic of the their attempts to deny the problem. The Minister‘s failure even to mention it today in the context of the Bill suggests that some in government are still in denial about the seriousness of the problem.