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29 Oct 2002 : Column 676—continued

Kennet and North Wiltshire Primary Care Trust

8. Mr. James Gray (North Wiltshire): What the level is of indebtedness of the Kennet and North Wiltshire PCT. [75357]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): Kennet and North Wiltshire primary care trust started the current financial year with a range of financial pressures, causing an underlying shortfall of #10.89 million. It received #3.3 million after applying to the NHS bank for support. The health authority will work with the trust to develop a three-year recovery plan to address the underlying shortfall.

Mr. Gray: It is amazing how Labour Ministers manage to spin things to make even the worst possible news sound wonderful. There is an #11 million debt in respect of the PCT, and a further #22 million debt hangs over it as a result of the shambles at the Royal United hospital in Bath. I am meeting the Minister of State this afternoon to discuss a parallel crisis in mental health care funding in North Wiltshire, which has also resulted in a huge debt. What can the Minister possibly say to the people of Wiltshire, who face a deep and damaging crisis in every aspect of health provision in the county?

Ms Blears: This is a serious situation, and clearly the primary care trust will not be left to face it on its own; it is a matter on which the whole health community should work together. For the first time ever, there will be a three-year allocation to enable planning over the longer term to meet the demands of the community. I have already told the hon. Gentleman that I am perfectly happy to meet him and his colleagues to discuss the situation. He will also be aware, however, that his health community has had a massive increase in expenditure in the past few years, and that the biggest ever investment in the NHS will take place over the next three years. If he has problems about funding, I must ask him seriously why his party is not prepared to match our commitment to increasing investment in the NHS.

Care Homes

9. Dr. Julian Lewis (New Forest, East): If he will make a statement on the availability of care home places in the south-east. [75358]

The Minister of State, Department of Health (Jacqui Smith): Department of Health figures show that, as of March 2001, there were 91,895 care home places in the south-east. Figures produced by the independent analysts Laing and Buisson suggested that occupancy levels in the southern home counties in March 2002 were 90.8 per cent. in residential homes, and 91.8 per cent. in nursing homes. As my right hon. Friend the Secretary of State announced to the House in July, the provision of an extra #1 billion a year in real terms for social services

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for older people by 2006 will ensure more support to help more people who need care in residential and nursing homes.

Dr. Lewis: You would never guess from that answer, Mr. Speaker, that between April 1998 and April of this year, 916 care home places have gone in Hampshire alone—just under 10 per cent. of the total. Is that not due largely to the unrealistic demands put on care homes through the Government's legislation of 2000? Is not the fact that the Government are backtracking on that legislation an admission that they got it badly wrong?

Jacqui Smith: I will keep it snappy. We listened to the concerns of care home owners and we acted on them. The hon. Gentleman cannot complain about the support that this Government are putting into care homes: increases in fees, funded by extra investment that he and his party failed to support.

Fiona Mactaggart (Slough): There is a problem with getting GP cover for increasingly sick people in care homes in Slough, and persuading GPs to offer such cover without charging care homes substantial sums. Will the Minister encourage primary care trusts in areas where that problem exists to meet care homes to resource proper GP cover for care home residents?

Jacqui Smith: Yes, my hon. Friend makes an important point. Of course, people in care homes should have access to the general services of a GP in the same way as anybody else, but there may well be particular concerns in relation to care homes. My hon. Friend has assured me that we can consider this issue in relation to the contract, and her point about the role of PCTs in looking at the problems in particular localities is another important one, which we can consider.

Mr. Oliver Heald (North-East Hertfordshire): The Minister may have acted, but does she not realise that she has acted far too late—two years too late—after 60,000 places have been lost in care homes? Has she seen the latest figures for emergency readmissions, which show that the number of patients aged over 75 who are readmitted within 28 days has risen to 8 per cent.? Does that not show that elderly patients—if they do have somewhere to go—are being discharged too early because so many other patients cannot leave hospital? They cannot leave because, as a result of this Government's action, no care home places are available. It takes something special to have not only a waiting list to get into hospital, but a waiting list to get out.

Jacqui Smith: This Government's additional investment of #300 million over the past two years has helped to ensure a reduction of more than 1,200 in the number of older people who are stuck in hospital, and who, rightly, are better off out of it.

The hon. Gentleman has nowhere to go, however. Opposition Members complained about environmental standards, and the Government listened to the concerns expressed by those who run care homes. We acted responsibly but, in the end, capacity for the care of older people depends on investment. As my right hon. Friend the Secretary of State spelled out in July, the Government are willing to invest in choice and capacity

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for older people. That means that more care will be available for them in residential care homes and in their own homes. The hon. Gentleman opposes that investment. He has nowhere to go, and nothing to say.

Infection Control

10. Dr. Vincent Cable (Twickenham): If he will make a statement on the adequacy of infection control procedures in the NHS. [75359]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): The Government take infection control in our hospitals very seriously. We have set standards to ensure that there is a managed environment that minimises the risk of infection to patients, staff and visitors. Recent analysis of hospitals' performance in that respect shows that there has been an improvement over the past two years, but more needs to be done and actions are being taken nationally, regionally and locally.

Dr. Cable : I hope that the Minister can explain an apparent contradiction in policy. When the Government are challenged about rising infection rates, especially the fiftyfold increase in methicillin-resistant Staphylococcus aureus over the past 10 years, they point to the clean hospitals programme. That is a key part of the response. Last week, however, a departmental spokesman denied that there was any scientific link between hygiene and MRSA. Which line is correct?

Ms Blears: Research has shown that there is no direct correlation between cleanliness and MRSA. That is contrary to what many people would expect, but it is clear that there are links between good infection control and hygiene. A key part of the action that we are taking is to encourage simple, practical measures. They include disinfecting beds properly between patients, promoting more hand washing in hospitals and making sure that people use the alcohol gel where there are MRSA infections.

The hon. Member for Twickenham (Dr. Cable) knows that MRSA is not a uniquely British problem; it is common throughout Europe and the world. The systems in this country are among the best in the world when it comes to collecting the data and taking practical action to reduce the incidence of MRSA in our hospitals. We have instituted the clean hospitals scheme at a cost of #62 million, and a #200 million scheme to improve the decontamination of instruments and equipment. They are helping reduce the incidence of these very serious infections.

Dr. Nick Palmer (Broxtowe): Will my hon. Friend the Minister welcome the state-of-the-art marrow transplant unit to be established at Nottingham's City hospital? The unit will have a very high level of protection against infection. Does she agree that only sustained investment in the NHS over a period of years will resolve the problem, not a sustained investment in rhetoric?

Ms Blears: My hon. Friend is right. Throughout the world, the incidence of infection will increase as more complex procedures are introduced and more

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vulnerable patients treated. As we get more successful at treating more vulnerable people, we must be extremely careful when it comes to monitoring infection rates. I am delighted to welcome the establishment of the unit in my hon. Friend's constituency, which, as he noted, will be state of the art. However, this is a long-term problem. It requires long-term solutions and a commitment to long-term investment. We are determined to make sure that that investment happens.

Michael Fabricant (Lichfield): I am delighted that the Minister has spoken about the need for hygiene and for hand washing, although she is doing no more than echo what Florence Nightingale said 160 years ago. However, she is wrong to say that the problem faces hospitals in countries around the world. Is she aware that the European anti-microbial survey found that people were more likely to catch MRSA and associated diseases in British hospitals than in those of any other European country?

Ms Blears: The hon. Gentleman knows that this is a worldwide problem. The authorities in America are very worried about it, and recent estimates are that as many as 50,000 or 60,000 people there could die from MRSA infections. I am sure that he is aware that other European countries face problems similar to ours. However, we now have a mandatory system for recording the relevant data. That has not existed before. We want to get to the truth of the matter so that we can take appropriate action and do not have to work in the dark. For the first time, we have proper data and are taking action nationally, regionally, locally and at the level of health trusts. Some of the actions involved, such as promoting hand washing and better infection control and disinfection, are very simple, but we also want to spread good practice across the health service, in community settings as well as in hospitals. Unfortunately, MRSA is probably with us to stay, but good control can help to reduce the incidence of infection by between 15 and 30 per cent., and thereby make people's time in hospital a lot safer.

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