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Hospital Cleanliness

Volume 467: debated on Tuesday 13 November 2007

8. If he will make a statement on the training given to staff conducting the deep clean of hospitals. (162937)

Deep cleaning will occur in all hospitals starting this winter, and it will be completed as soon as possible thereafter. Resources will be allocated through the strategic health authorities. Trusts’ deep clean plans will vary according to local need, and trusts will be able to identify what additional training is needed to ensure that their local programme is delivered to the appropriate standards. All trusts will submit costed deep clean plans to their lead primary care trust, which will monitor performance against the plan, according to normal performance management arrangements. Strategic health authorities will take an overview of progress across their area and will report to the Department. We will assess the progress and impact of the programme.

Given the importance of tackling hospital-acquired infections, perhaps the Secretary of State will explain why it has taken the Government 10 years to come up with a rigorous cleaning programme, say how many fewer cases of MRSA we can expect in our hospitals as a result of the initiative, so that we can test whether it has been successful, and say how deep cleaning compares with using environmental cleansing equipment, such as Steris’s vaporised hydrogen peroxide equipment, to tackle the disease.

The deep clean is one of a series of initiatives. The issue is the subject of huge public concern. We are the only country in the world that has mandatory comprehensive surveillance, and the only country in the world that knows exactly what the situation is with our health care-acquired infections. As a result, we are able to tackle the issue through a series of measures—not just through the deep clean, but through the “bare below the elbows” policy, which has been used at the Royal Marsden hospital for many years, just as deep cleans have been used in many hospitals for many years. It is a case of ensuring that every hospital follows best practice.

There are other initiatives, of course, such as the new powers that we are giving the care quality commission—an issue that we will discuss in the debate on the Gracious Speech. There is pre-screening for MRSA for all people coming into hospital, whether for elective or emergency surgery. There is a whole series of other measures, which means that we have a comprehensive programme to address the problem, which affects all countries around the world.

Does the Secretary of State accept that what is needed for clean hospitals is not just deep cleaning but an assurance that we will continue to clean them, and thus a motivated, well-funded work force? Will he learn the lessons of the 1980s, when the Conservatives reduced the number of ancillary workers in England from 177,000 to 60,000?

I agree with my hon. Friend about the need to ensure that there are proper cleaning facilities. He may wish to know that spending on hospital cleaning has increased from £403 million in 2000 to £662 million in 2006-07, which is an increase of almost 65 per cent., so it is essential to ensure that there is investment in cleaning services as part of a range of measures to tackle those problems.

My constituent and friend, Doug Gregory—a wartime Mosquito pilot who was awarded the distinguished flying cross—has just survived his latest brush with death in Southampton general hospital, where he contracted C. difficile after a routine operation. Is it not a disgrace that people go into our hospitals and find themselves fighting for their lives under such circumstances in the 21st century?

I express my commiserations to the hon. Gentleman’s constituent, but let us get this into context: there have always been health care-acquired and associated infections.

We do not know what the scale was, as the simple fact is that it was never measured and no figures were produced. Indeed, people who have worked in the health service for many years suspect that it was far greater in the past than it is now. Turning to the serious point made by the hon. Member for New Forest, East (Dr. Lewis) about clostridium difficile, there is a question about hand cleanliness, and it is soap and water that work rather than an alcohol rub. The big problem, however, is a certain complacency about prescribing antibiotics. We can engage in political cut and thrust, but the message that we must all give our constituencies is that this issue is about washing hands and ensuring that they are clean; it is about ensuring that there is responsible prescription of antibiotics; and it is about ensuring that patients who unfortunately acquire those infections are isolated as soon as possible and given cohort nursing. Those are the three major rules, and it would be good if we all ensured that that is the message that we give the public.

While questions remain about the scientific evidence and the Government’s analysis and monitoring of the Prime Minister’s deep-cleaning policy, Ministers cannot escape the fact that the Government are responsible for infection control. Centrally controlled process-driven targets, high bed occupancy, lack of focus management and financial deficits all exacerbate the prevalence of hospital-acquired infections. Given that 111 trusts have not complied with hygiene standards, it is clear that Government policies have not worked. When will the Government implement a search and destroy policy, and ensure that the Healthcare Commission specifically analyses, measures and reports on C. difficile rates?

I disagree completely with the hon. Gentleman about the reasons for the problem, particularly, as once again, the lame excuse that targets have something to do with the failures at Maidstone and Tunbridge Wells has been trotted out. [Interruption.] The hon. Member for Guildford (Anne Milton) says, “Read the report”, but the exact words of the chairman of the Healthcare Commission were:

“Targets or their equivalent are an inevitable feature of a modern 21st-century healthcare system, in the sense that some standard or measure to be achieved must be part of the management of any organisation providing healthcare. The obligation to meet targets cannot be used as an excuse for failing to meet other management objectives.”

Indeed, he made exactly that point in the text of the report on Stoke Mandeville a year ago, so to suggest that patients have a choice—they must wait on long waiting lists, or take eight hours to get to accident and emergency, and if they are not prepared to do so, they must put up with hospital-acquired infections—is nonsense. The second point I would make—

Order. That would not be fair to those who took part in the ballot and whose names appear on the Order Paper.