Health Bill

I am always glad to try to provide reassurance not only to the noble Earl but also to the Royal College of Nursing. At Second Reading, as I think the noble Earl indicated, a number of Peers raised concerns about why the definition of healthcare-associated infection used in the Bill differed from that used by the Health Protection Agency. These concerns reflected criticism raised by the Royal College of Nursing, and, I think, by a number of other people, over the fact that the definition includes,"““any infection to which an individual may be exposed””." It argued that the code of practice should aim to reduce the risk from the micro-organisms that are present, not those that might be present. Our view is that the HPA definition is simply an easy-to-understand description of healthcare-associated infections. It does not aim to cover all possibilities and is used as a working definition to introduce the concept of healthcare-associated infection surveillance. It is not surprising that there are differences between the two definitions, as they have different purposes. Furthermore, as there is no way quickly to ascertain which pathogens are present, we must ensure that healthcare professionals take suitable precautions. These should protect against all micro-organisms which an appropriate risk assessment reveals to be a significant risk. That is the reason for the difference of view on this. Changing the definition so that the code applies only to micro-organisms known to be present would mean that staff would not be obliged to take sensible precautions against pathogens that healthcare workers knew were very likely to be present. That would hinder the code’s ability to ensure good practice in infection prevention and control and so reduce the potential benefits to patients and staff. Indeed, such a definition would reduce the capacity of the code to set out measures to tackle healthcare-associated infection to such an extent as possibly to render the code less meaningful. Ultimately, amending the definition of healthcare-associated infection in this way would not result in any great change in the content of the code that the Secretary of State plans to issue. We plan to base most of the requirements in the code on the principle that precautions should be taken against those infections which a suitable risk assessment reveals are likely to be present. However, on balance, we prefer the use of ““may””, as it makes clear that the code can deal with dangerous diseases which are rare, but which would be very harmful should they ever occur. It is only proper to want to include in the code requirements intended to prevent such diseases, particularly as we know from history that new infections can and do appear surprisingly quickly. I have set out at some length the reason—the noble Earl and others may wish to study it—we have taken a slightly different view from the Royal College of Nursing: not because we wish to dispute the wording, but because we have tried to be more all-embracing in what the code can cover. While I am on my feet, I commend Amendments Nos. 56A and 56B to the Committee. On Question, Amendment agreed to.