Clostridium Difficile

Lord Harrington of Watford Excerpts

Tuesday 9th November 2010 Commons Chamber

[Mr David Burrowes (Enfield, Southgate) (Con)]

It was in January 2007 that I last secured a debate on clostridium difficile, or C. diff as it is commonly known. It was the first time that the House had debated the subject, and I recall how at the time Mr Speaker’s office questioned what C. diff was. Indeed, many hon. Members had never heard of it. Since that time, however, sadly the impact of this cruel and often unremitting infection has demanded the public’s and, indeed, the Government’s attention. All hon. Members will probably know of someone in their constituency or family who has suffered from C. diff. Indeed, in that regard I welcome the attendance of Mr Deputy Speaker, who has a deep and personal interest in the issue, following the loss of his mother as a result of C. diff.

I gladly acknowledge that there has been much progress in the three or so years since I last raised this subject. However, C. diff still leaves thousands of people each year suffering great discomfort, loss of dignity and, sadly, loss of life. The media spotlight comes on to the subject when there is an inquiry into a hospital trust and then moves on but, away from its glare, the terrible and often tragic effects of this infection have not gone away.

I know that the Minister will provide me with an answer, which is the primary purpose of this debate—namely, an assurance that the Government take C. diff very seriously and are working hard not only to reduce it but to eradicate it. Much has changed since 2007, not least with the Government’s plans to revolutionise the national health service and empower patients and general practitioners. I hope that this debate will help to identify the challenges and opportunities to tackle C. diff, not only in the hospital setting but in the community.

Some things, or rather someone, have not changed since the previous Adjournment debate in 2007. I refer to the active involvement and national leadership on the issue of C. diff of my constituent Graziella Kontkowski, who has attended the debate this evening, as she did back in January 2007. Tragically, Graziella’s grandmother died as a result of the C. diff infection. Graziella describes being

“helpless, watching my grandmother die a slow and painful death without being able to do anything to help her—it was the worst thing I've ever experienced.”

Since then, she has used her experience and remarkable passion and energy to ensure that other families are able to face and fight C. diff and its terrible effects. Alongside her brother Mark, Graziella set up the online C. diff support group, which can be found at www.cdiff-support.co.uk, to make it possible for people who have been infected by C. diff, or whose loved ones have suffered from its effects, to share their experiences and advice with one another. The C. diff support group has about 1,500 members and continues to make a valuable contribution to the public debate on C. diff and to the lives of many who are struggling in similar circumstances to those that Graziella and her family went through.

Graziella also helps to support the work of the Centre for Healthcare Associated Infections, which is based at the university of Nottingham. With the danger of bacteria mutating to become more resistant to antibiotics, its efforts towards the development of new vaccines and rapid diagnostic tests for the detection of the infection are to be commended. Its research can truly be described as life saving, and I encourage members of this House, and members of the public, to consider supporting its work.

[Richard Harrington (Watford) (Con)]

I congratulate my hon. Friend on the work that he has done on this very difficult subject. I would like him and his constituent to know that there is a device in America called Zimek, which I have observed. It is the most fantastic system that disperses disinfectant and has eradicated C. difficile in hospital wards. It is undergoing clinical tests in Northwick Park hospital, which is just next to my constituency and where many of my constituents are being treated. I urge the Minister to take note of this. I would be delighted to send him details showing the fantastic effects that the device has had in America, very cheaply and in a way that I believe could save millions of lives in this country.

[Mr Burrowes]

I am grateful to my hon. Friend. He makes the case for that proposal very well. Indeed, there are several innovative developments, not only in the hospital setting but in trying to look at prevention. Prebiotics is another area that is worth considering. I ask the Minister to look at supporting the centre I mentioned and at how we can support research in this field.

A C. diff infection exacts a great cost from the patient who suffers from it and the family who witness it. It is also financially expensive. In 2008, the Department of Health released a report called “Clean, safe care: reducing infections and saving lives”, which noted that treating one patient with a C. diff infection cost the NHS more than £4,000 per patient. By this estimation, and considering the number of infections reported last year, C. diff cost taxpayers close to £1 billion in the past 12 months.

It is true that C. diff has received a far more coherent and concerted response from the NHS in the past three years than it had previously. It is equally clear that this focus has had a positive effect on the quality of care and on survival rates in our hospitals. Last year the infection was noted on fewer than 4,000 death certificates and was considered to be responsible for deaths in 1,712 cases. That is less than half the rate in 2007, when more people died as a result of C. diff than as a result of road accidents. However, as the Secretary of State for Health has said:

“There is no tolerable level of preventable infections.”

I am grateful to his Department for making it clear that a zero-tolerance approach to health care-associated infections is a priority for the Government. During the week beginning 26 September, 190 new cases of infection were reported by hospitals in England and Wales—an average of 27 cases a day, or more than one every hour. There is no room at all for complacency.

One problem of which we need to be aware is the number of incidents of recurring C. diff symptoms in patients. I am greatly concerned that hospitals are releasing those who have suffered with the symptoms of the infection too early, which leads to many having to return to hospital with the same problem. I am glad that the Department has recently made it clear that hospitals are responsible for the care of a patient for up to 30 days after they have been discharged.