Clause 13 - Code of practice relating to health care associated infections
Health Bill
9:30 am
David Kidney (PPS (Mr Elliot Morley, Minister of State), Department for Environment, Food and Rural Affairs; Stafford, Labour)
The hon. Member for Westbury (Dr.d¤Murrison) was right to question the nature and the point of surveillance. Does my right hon. Friend the Minister intend, in due course, to use the clause to impose a more comprehensive system of surveillance in the national health service for health care-associated infections, and if so, is she satisfied that the clause is sufficiently widely drawn to enable her to do that?
I have been assisted in thinking this issue through by postnote 247 of July 2005 from the Parliamentary Office of Science and Technology, headed “Infection control in healthcare settings”. The current mandatory surveillance started in 2001 when the Department made mandatory the surveillance of methicillin-resistant Staphylococcus aureus blood infections. In 2003, we also made mandatory the surveillance of glycopeptide-resistant enterococci, and in 2004 we made mandatory the surveillance of clostridium difficile. I hope that I have pronounced those conditions correctly.
Many hospitals also continue to use the nosocomial infection national surveillance scheme—NINSS—which was established by the last Conservative Government in 1996. NINSS is a voluntary scheme, using standard surveillance methods in hospitals in England to provide information on all health care-associated infections. However, there is still no national mandatory surveillance scheme for all infections. The different surveillance schemes that exist do not present comparable data. Also, a lack of information technology in some trusts means that surveillance sometimes cannot be carried out. Therefore, the overall extent of health care-associated infections remains difficult to gauge. The Public Accounts Committee has looked into the matter twice, and has recommended that there should be a national surveillance scheme, perhaps building on NINSS, and that it should be mandatory. In response to that, the Department has commissioned a national survey of all infections that is due to report in 2006.
Problems associated with the diagnosis of these infections can also compound issues associated with the surveillance of them:
“when a patient’s sample is sent for diagnosis, different laboratories use different methods for detecting HCAIs. This means that what might be reported as an HCAI by one laboratory might not be reported as such by another. Experts are calling for regulation to be introduced, recommending the use of certain tests over others.”
Does the clause allow the Minister, when the survey is completed in 2006, to say that a more robust national mandatory system of surveillance can be brought in, and that, under the code, it can be enforced by the Department? According to my reading of the clause, that will be possible because it addresses itself to all English NHS bodies—to any body that carries out surveillance for the Department. Proposed new section 47A(5) states that the code may
“operate by reference to provisions of other documents”.
Therefore, if the Minister has introduced a new scheme for surveillance, that could be referred to in the code, and thus be taken into account. Is my right hon. Friend the Minister satisfied that if that is what she intends to do in the future, the clause will allow her to do that?