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Hospital Beds

Volume 475: debated on Tuesday 6 May 2008

I am very grateful for the Minister’s response. To reduce the rate of the superbug clostridium difficile, there must be a hospital bed occupancy rate of 85 per cent. or less. Kettering general hospital had the worst C. difficile rate in the whole country. It has a hospital bed occupancy rate of 92 per cent. Would not the Minister agree that the way to solve the problem is to build a new hospital in my constituency in order to reduce the bed occupancy ratio in Kettering?

I am afraid that I have to correct the hon. Gentleman’s figures. My information from the local trust is that the bed occupancy rate in Kettering general hospital in the latest year for which figures are available was 81 per cent., whereas at Northampton general hospital it was 85.6 per cent. It is interesting that, according to the figures, although the occupancy rate in Northampton was higher, it has been even more successful than Kettering in reducing C. diff rates. In Northampton’s case, they went down by 61.3 per cent. between 2006 and 2007; in Kettering, they went down by 64.1 per cent. in the same period—a great achievement by his local hospital.

Without getting drawn into the relative merits of various claims for new hospital building, will the Minister look carefully at the arguments in favour of reducing occupancy rates? As I understand it, in France there is a presumption that a 70 per cent. occupancy rate is the tipping point beyond which the gains begin to be overtaken by hospital infections, re-admissions and staff turnover. May we have a similar independent study in the UK that would identify the tipping point at which we move from efficiency to absurdity?

We had such a report a few years ago, which stated that the optimal bed occupancy rate was 82 to 85 per cent. The latest figures available suggest that the rate has come down to below 85 per cent. on average, which we welcome. It is coming down slightly all the time, although we do not think it is our job to dictate to local hospitals how to run their affairs. If one examines the latest bed occupancy rates and superbug rates, there is no correlation between them. Other issues are much more important in the way in which hospitals manage disease outbreaks.

The Minister will be aware that Professor Barry Cookson of the Health Protection Agency has advocated an occupancy rate of about 85 per cent., yet about 50 per cent. of hospitals are running at above that level. He also highlighted the potential risk to patient safety if that level is exceeded. Despite a promise in the NHS plan that there would be 7,000 extra beds, there has been a reduction in beds of about 13 per cent. since 1997. With so many hospitals often in a state of crisis because they are completely full, is it not time for an urgent review of the number of beds in the system and the way in which those beds are used, to ensure that we do not put patient safety at risk?

Again, I must correct the hon. Gentleman. In the past there was a stronger correlation between bed occupancy rates and infection rates, but as infection rates and bed occupancy rates have come down, we have looked into the matter in great detail in the past two or three years and we cannot find the correlation that the hon. Gentleman points to. There are hospitals with a higher bed occupancy rate than 85 per cent. that have very good records on infection and other matters. What is much more important is how well the hospital is managed and what its overall anti-disease measures are, rather than the bed occupancy rates. Although we have said and I repeat that we think the optimal level is between 82 and 85 per cent., we do not think it is sensible to dictate to well performing hospitals that may have bed occupancy rates over 85 per cent. that they should bring those rates down. That is for them to manage, and it is for them to be answerable to their local communities.

A bid has been made by Stockport primary care trust for a community hospital in Shaw Heath, in one of the most deprived wards in my area. It is an exciting and innovative project. Does my hon. Friend agree that a community hospital on the site would enable better use of NHS beds at Stepping Hill, and at the same time would tackle health inequalities in the area?

I certainly would, and I was going on to say in response to the hon. Member for North Norfolk (Norman Lamb), who speaks for the Liberal Democrats, that one of the reasons for the decline in beds in acute hospitals is that more and more people are staying in community hospitals and then being cared for in their own homes, which I think is welcomed by Members in all parts of the House. My hon. Friend will be pleased to know that I am informed that the board of the North West strategic health authority is meeting tomorrow to make a final decision on the community hospital for which she has been a long and doughty campaigner. We think the scheme is a visionary and innovative one that meets national and local health objectives and will enhance community health services. I congratulate my hon. Friend on her successful campaign.

The Minister may well argue that other measures are important, but there is no doubt that an internal policy review from the Department of Health showed that reducing bed occupancy to a maximum of 85 per cent. could save about 1,000 cases of methicillin-resistant Staphylococcus aureus—MRSA—a year. The aim should undoubtedly be nearer 82 per cent. Does the Minister agree that while bed occupancy rates remain unacceptably high, consequences on the scale that we saw at Maidstone and Tunbridge Wells remain a real threat?

What was wrong in Maidstone and Tunbridge Wells was a totally incompetent management. As I have pointed out, there has been no correlation in the past two or three years between bed occupancy rates and infection rates. I would have expected that, rather than making the same old points time and again, the hon. Lady might have welcomed the fact that the latest national figures show a 30 per cent. reduction in MRSA rates and a 23 per cent. reduction in C. difficile rates in the past year. She should congratulate the Government on our action, rather than constantly criticise us.