In a speech which the Labour Minister acknowledged was a “very important contribution about Hospital Acquired Infections”, Peter Lilley again raised the issue of superbugs in Parliament yesterday.
He accused the government of failing to come up with any new policies despite the fact that this problem is worse in Britain – and getting worse faster – than anywhere else in Europe. Peter Lilley praised West Herts NHS Trust which used to have one of the highest infection rates in the country for dramatically reducing MRSA infections last year.
Peter Lilley said: “Patients are not interested in the drive for targets that has dominated the NHS; they want to know that when they go to hospital for treatment , they will come out healthier than when they went in. Sadly, nearly one in 10 patients who go to hospital acquire an infection there that they did not have previously. According to the National Audit Office between 5,000 and 20,000 people die of superbug infections that they get in hospital.
“Following my recent question to the Prime Minister on this issue, he accused me of being negative, but I shall continue to raise this issue until our record on hospital infections is not the worst but the best in Europe. Since then I have had many emails from consultants and doctors throughout the country pointing out what is happening and saying that solving the problem does not require large expenditure. It requires a transfer of responsibility back from management and bureaucracy to local clinical people.
“West Herts NHS Hospitals Trust used to have one of the highest levels of MRSA, but I am very glad to say that the Trust – and I pay tribute to it – has halved that level during this last year which just shows that dramatic improvements are possible and can be made.”
Note to Editors: Peter Lilley‘s speech during yesterday‘s debate is attached:
Mr. Peter Lilley (Hitchin and Harpenden) (Con): It is a great privilege to follow the very constructive contribution from the hon. Member for Dartford (Dr. Stoate), which had more in common with the contributions from my hon. Friends the Members for Tiverton and Honiton (Mrs. Browning) and for Tunbridge Wells (Mr. Norman) and my right hon. Friend the Member for Charnwood (Mr. Dorrell) than with that made from his own Front Bench.
The key question underlying the debate on the health service today is why, despite the superb dedication of NHS staff, the huge increase in taxpayers‘ money going into the health service has not resulted in a commensurate improvement in clinical services.
In a nutshell, the reason is that those resources are allocated by a system that is highly centralised; micro-managed from the centre; and where the management is driven by the desire for media manipulation and good headlines in the press tomorrow.
Perhaps I can give some concrete examples of how that obsession with media manipulation and micro-management at the centre results in, at best, waste and, at worst, the undermining of clinical standards and staff morale.
The Government announced a waiting list initiative. They got a good headline. They announced a waiting list budget for each hospital-another good headline. They announced that each hospital should have a waiting list manager-a third good headline. What does that mean in practice? Well, in hospital A-I am not at liberty to reveal which hospital that is, but it is not in my constituency-the waiting list manager used his waiting list budget to meet his waiting list target by employing locum surgeons on Sundays, at much extra expense, but from his extra budget, to operate on people on the waiting list. That seems a good idea-expensive, but on first sight, it would reduce the waiting lists. Unfortunately, sterilisation teams are not employed on those Sundays, so all the equipment needs sterilising by the end of Sunday. Come Monday, no operation can be performed until late in the day, when all the equipment has been sterilised. But that is part of a different budget, so it does not matter. So a huge amount of money has been wasted for no extra improvement or no reduction in the waiting list.
That is waste, but the result can be much worse than waste. In the same hospital, one of the senior consultants had made major advances in reducing infection-I shall refer to that problem again in a minute-by having a dedicated ward where people went for open-wound surgery. No one with an infection was allowed on the ward. But the waiting list manager, up against his waiting list target, had some people on the list who would go over the target by just a few extra days. So the senior consultant found that they were plonked on his ward. Some of them had bowel infections-one even had MRSA. So he said that he was not prepared to operate with those infections in the feeder ward for his operating theatre. He was told that he had to, because he had to meet his targets. He said, “Well, I will if you insist.” He told his patients that they could be operated on if they would first sign a disclaimer, which they would be wise to do only if they were feeling suicidal. So no operations were carried out that day. More waste, and possibly a risk to people‘s lives as a result of a target-driven culture in the health service. That is what the Government‘s policies mean in concrete terms, and those are not isolated examples.
Patients are not interested in targets; they want to know that, when they go for treatment in hospital, they will come out healthier than when they came in. Sadly, we have a system where nearly one in 10 patients who go into hospital acquire an infection in hospital that they did not have before they went in. According to the National Audit Office, between 5,000 and 20,000 people a year die of superbug infections that they get in hospitals. The European Union says that the situation is worse in our hospitals than in any other country in Europe and getting worse faster in this country than elsewhere in Europe.
When that first became a matter for public concern, the Government‘s response was to set up a system of traffic light indicators for hospital cleanliness: red for not so clean, amber for okay and green for fine. Unfortunately, they then discovered that, of the 20 hospitals with the highest level of MRSA superbug infection in the country, they had rated 15 green, five amber and none red. So they have naturally kept quiet about that expensive, time-consuming, costly and bureaucratic initiative for some while.
I managed to raise the issue with the Prime Minister recently, asking him why we were fighting and losing that biological war in our hospitals. He said that I should not discuss negative aspects of NHS hospitals. But all hon. Members have to raise those matters and should continue to do so until our record is not the worst but the best in Europe. I will do so particularly because I had a hospital with one of the highest levels of MRSA infection serving my constituents. I am glad to say-I pay tribute to it-that it has halved that level during the past year, which shows that it can be done and that improvements can be made.
A few days after I raised the issue with the Prime Minister, the Secretary of State-I regret that he is not here-announced with great fanfare a new initiative to deal with superbugs. There were headlines in all the newspapers. I asked whether he would make a statement about that new initiative and those new policies in Parliament. He wrote back to me, saying:
For the record, the press notice last Friday did not announce any new policy.”
The press statement actually says:
Mr. Reid gave his backing to wide-ranging proposals . . . which seek to revolutionise the way potential infections are handled in hospitals”
new rules . . . a new system . . . a new drive . . . new plans”.
Apparently not new policies, however. It may well be that the Minister is happy to deceive the newspapers. I am certainly not accusing him of deceiving the House-I am accusing him of telling the truth to the House by saying that he does not have new policies to deal with an issue on which he should have new policies.
In following this situation, I have done more than 20 radio and media interviews with consultants and people from the Academy for Infection Management. They have proposals to deal better with the problem, so why are the Government not giving them serious consideration? I have received many e-mails from consultants and doctors throughout the country pointing out what is happening and saying that solving the problem does not require large expenditure. The solution requires, above all, a transfer of responsibility back from management and bureaucracy to local clinical people. If that were successfully adhered to, it would save massive amounts, but it is not allowed because of the target-driven culture.
One e-mail I received said:
We have managed to keep MRSA out of our rehabilitation unit by a combination of pre-screening, rigorous hygiene and vigorous treatment . . . However, we have been put under pressure to relax our criteria because they delay transfers”.
It says that there is a target
to move people out of casualty departments within a set time”,
so targets are putting pressure on the person who wrote the e-mail to undermine the clinical standards that were saving lives. The issue is important and I am sorry that the Secretary of State is not in the Chamber to tell us why he has no policies to deal with something that is killing thousands of our constituents. I hope that the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), who will wind up the debate, will tackle the problem more seriously than his colleagues have so far.
Hansard – 7 Jan 2004 : Columns 309-312