Clause 16
Health and Social Care Bill
6:30 pm
Stephen O'Brien (Shadow Minister, Health; Eddisbury, Conservative)
I rise in support of the amendment that has just been moved. As the hon. Gentleman rightly said, amendment No. 165 moves beyond simply making provision; it also looks at nutritional standards and seeks to make
“provision for the prevention and management of malnutrition and may include such provision as the Secretary of State considers appropriate for the purpose of safeguarding individuals (whether receiving health or social care or otherwise) from the risk, or any increased risk, of malnutrition”.
In our combined amendments, we seek to impose action on malnutrition on the CQC. Our amendment is drafted in the same terms as subsection (5) on health care acquired infections. I hope the amendment will commend itself strongly to the Minister on that basis, as there is no greater flattery than to be copied, which is precisely what I have done.
In 2006-07, 139,127 patients were discharged from hospital in a state of malnourishment—an 84 per cent. increase from the 1997-98 total of just 75,431 patients. Those are Government figures. In 2006-07, 130,594 patients were admitted to hospital in a state of malnourishment, an 85 per cent. increase on the 1997-98 total of 70,658. The Government had previously admitted to slightly more than a mere 2,000 patients being discharged from hospital in a state of malnourishment. Last year, the nutritional state of at least 8,500 patients worsened while they were in hospital. In the Minister’s own trust, the Royal Devon and Exeter NHS Foundation Trust, 782 patients were admitted with malnutrition, nutritional anaemia or other nutritional deficiency, and 850 were discharged in such a state. That is where deep concern about malnutrition and nutritional standards arises, because some patients are going home or back to their care setting worse off than when they entered hospital, in terms of malnutrition or associated deficiencies.
It is estimated that MRSA affected about 6,000 people in 2006-07. C. difficile has affected about 56,000 people, according to the Government’s figures in “Clean, safe care: Reducing infections and saving lives”, which was published on 8 January this year. I have given figures on malnutrition in an effort to impress on the Government why the amendment is of the most vital concern. It cannot have escaped the Minister’s notice that the figures that I recently put into the public domain have struck a serious chord not only at a national level, but throughout all the regions and local areas. Many hon. Members have read the figures and taken up such issues with the chief executive of their hospital trust. That is the right action to have taken. We are faced with an absolute scandal.
A study undertaken by the National Patient Safety Agency in the summer of 2007 found that some of the greatest barriers to NHS staff undertaking nutritional screening were the lack of weighing scales—we shall return to that point—and the lack of time and training to allow nursing staff to support nutrition. The Healthcare Commission is meant to inspect whether nutritional needs are being met, but the 34 trusts discharging the highest number of malnourished patients actually met the Healthcare Commission’s quality requirements, so the existing system is clearly not working. I hope that the Minister agrees that a stronger legislative incentive is needed.
As we are dealing with the complementarity of the two amendments, I wish to flag up Age Concern’s “Hungry to be Heard” campaign. We are talking about not only malnutrition, but human rights. This is of the deepest concern to members of the Committee, as has been ably highlighted and articulated by the hon. Member for Luton, North. “The Human Rights of People in Healthcare”, the recent report by the Joint Committee on Human Rights, noted that malnutrition and dehydration in care settings breached articles 2, 3 and 8 of the European convention on human rights. It recommended
“that the forthcoming merged inspectorate for health, social care and mental health adopts a human rights framework”—
that is the precise issue that the hon. Member for Luton, North has sought to advance—
“with the intention that the framework informs all of the inspectorate’s work and so makes it more effective in fulfilling its statutory duties”.
Our amendment would make sure that the issue was tackled in care homes as well as by health care providers, given the wide remit of the CQC. I therefore very much hope that the Minister will recognise the power of my argument. He clearly intends the Bill to address health care-acquired infections, but why is he not equally prepared for the Bill to cover malnutrition? Given that the statistics are based entirely on the Government’s figures and show that they must be judged to be failing miserably, surely the amendment would be one of the best and most urgent ways of combating malnutrition by giving it legislative power and effect.
I hope that the Minister will recognise that we drafted the amendment in the spirit of improving the health and safety of patients. We made sure that it contained constructive proposals that would be worthy of his consideration and support.