Infection Prevention and Control

Douglas Ross Excerpts

Tuesday 15th May 2018 Westminster Hall

[Douglas Ross (Moray) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I, too, congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate. Naturally I wanted to take part; this issue is important to my constituents in Moray, as it is to those of all other right hon. and hon. Members. Furthermore, the hon. Member for Strangford is an assiduous contributor in this place. Indeed, some of my debates have been supported by him, so I was keen to reciprocate the support that he gives to others by coming along today.

The role of healthcare is, in essence, to treat and heal patients. That is why healthcare-associated infections, where someone acquires an infection in a hospital or another healthcare facility, can be so cruel. They can also be especially dangerous. Healthcare-associated infections, or HCAIs, lead to comorbidity and can interfere with the treatment that people are in hospital for in the first place.

Naturally, in today’s debate, which is looking at UK-wide issues, I want to focus, as I am sure the hon. Member for Central Ayrshire (Dr Whitford) will, on what we are doing in Scotland, and I will pick up on some of the points that have been made about sharing best practice across the country. It is particularly concerning that in Scotland, according to a Health Protection Scotland report, the incidence of HCAIs in intensive care units is higher than other parts of hospitals, with an incidence rate of 2.7% in 2016. Likewise, surgical site infections are among the more common HCAIs, with, for example, an incidence rate of 1.37% in the first 10 days after a caesarean section. Surgical site infections can be especially painful for patients, and in some cases can even require further medical intervention afterwards.

Healthcare-associated infections are distressing, painful and often dangerous to patients, and are costly for the NHS. Such infections frustrate, complicate and even undo the hard work of our medical staff. They exacerbate the strain on hospital resources, and cost money in compensation payments. In 2016-17, for example, 89 wards and 97 other bays were closed across Scotland due to outbreaks of norovirus. Clearly, action is necessary to prevent and control infections in hospitals and other NHS facilities. By reducing the incidence of HCAIs, the NHS would no longer need to treat those infections, and would avoid the complications that are caused in the treatment of the disease or disorder for which the patient was originally admitted to the hospital or healthcare facility.

Moreover, reducing instances of healthcare-associated infections will help to reassure patients seeking treatment in the first place. Unfortunately, some people, especially elderly people, worry about the possibility of picking up an infection while in hospital. That can lead to reluctance to seek treatment in the first place, which can be very dangerous. It is vital that we work to reassure people that an NHS hospital is a safe place where the risk of infection is low.

In Scotland, the picture for progress on preventing HCAIs is mixed, and there is more to be done by the Scottish Government in that area. In positive news, there was a decreasing year-on-year trend in the incidence of clostridium difficile infections between 2013 and 2017. However, the incidence of HCAIs in intensive care has crept up slightly, from 2.5% in 2014 to 2.7% in 2016, while the incidence of ventilator-associated pneumonia increased by more than 26% in the same period. There has been some good work, but there is room for improvement.

The NHS faces a number of challenges with respect to preventing infection—from the density of people in one place to the threat of superbugs and resistance to antibiotics, as we heard earlier. It is thanks to the hard work of our NHS staff across the country that infection rates remain as low as they are. There has been a discussion about unannounced hospital inspections. The main hospital in Moray, Dr Gray’s, was subject last November to an unannounced inspection. The findings were reported earlier this year. Importantly, it was found that the standard of domestic cleaning and compliance with standard infection control precautions was good. However, the head of quality care at the healthcare environment inspectorate said:

“NHS Grampian must ensure the environment is maintained and, where possible, refurbished to allow effective cleaning and reduce the risk of infection.”

Despite all the great work by the staff in Dr Gray’s and other hospitals, their hands are slightly tied behind their back if we have older, crumbling buildings that need capital investment. There is much more that we can do to support our staff, who want to do the best for patients but are sometimes hamstrung by the conditions in which they work.

There is still room for improvement, and the Scottish Government must ensure that staff have the support they need to make further inroads in the fight against HCAIs. That should include the Scottish Government and NHS Scotland working with their counterparts elsewhere in the United Kingdom to share ideas and good practice, as the hon. Member for East Londonderry (Mr Campbell) highlighted in his intervention. This issue does not stop at the border; we can learn from one another. Will the Minister explain how health departments across the country share best practice and work together to ensure that we deal with this important UK-wide issue?

There must be zero tolerance for failings, such as poor hygiene that can put patients’ health and lives at risk, as we heard in the very emotive speech made by my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns). Remarkably, as recently as 2013, one in 10 senior medics in Scotland were not complying with hand hygiene standards. That is a worrying message, and the situation must improve.

We should be proud and thankful that we live in a society where we have high-quality universal healthcare, with a low risk of infection. However, in every part of the United Kingdom we must not stop striving to control, and hopefully prevent, such infections from occurring in future.