Health Bill

My hon. Friend makes an interesting point about the liberty argument, which our party considered. We are primarily concerned with the liberty of those who work in such environments, but where addiction is involved, we may, in many cases, being going with the grain. Individuals who want to give up but who have found it difficult might appreciate such a measure. It is not patronising or nannying. It could assist people to do something that they want to do. Perhaps the most appropriate day to introduce the ban is 1 January, although midnight might create operational problems if everyone had to stub out their cigarettes halfway through the evening. Noon on 1 January might be a better time because it would assist those who want to make a new year’s resolution to follow the grain of that decision. I asked the Secretary of State what she had said to the Cabinet and did not get the straightest of answers. However, we are reliably informed that she pressed for a total ban. If she wants that, then I agree with her. However, it means that her argument that the Labour manifesto only said that there would be a fudgy ban falls down. If she pressed to go beyond that, how did she justify going beyond the terms of the manifesto? She did so because it was right and the best policy to adopt. On smoking, the Westminster Government have got it right, but only for Northern Ireland, where there is a total ban. How, therefore, can they adopt a different approach for England? I can see nothing about the situation in Northern Ireland that would warrant its workers having a different level of protection from those in England. The Bill deals with other important subjects. On health-care acquired infections, a group of people who had been bereaved by MRSA held a lobby yesterday. That group—MRSA Action UK—presented a petition to Downing street. I think hon. Members on both sides of the House joined them. I laid a wreath with them at Westminster abbey in commemoration of their friends, relatives and loved ones who had died. One thing that the group is calling for is mandatory national reporting of all health-care acquired infections, which we do not have. The estimate is that only 6 per cent. of all infections have to be reported. That relates to bloodstream MRSA only—not all cases of MRSA have to be reported. I hope that the Minister explains why there is not more mandatory national reporting. The scale of the problem is immense and although we heard reassuring words from the Secretary of State about the progress that is being made, across Europe we have one of the worst rates of Staphylococcus aureus infection. It is about 40 per cent. in the UK—one of the highest in Europe—and the right hon. Lady’s reassurances were complacent on that front. Having met relatives of those who have died from MRSA, I urge her to listen carefully to what they say and take much more serious steps. I echo the question of the Public Accounts Committee—how can the 80 per cent. or so of infections not covered by the Department’s mandatory surveillance programme be measured and managed? If they have not even been reported, how does the Department of Health know what is going on? We have already heard about things that can be done to tackle infection and about infection control. As for bed occupancy rates, my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) pressed the Secretary of State on what trusts will do if they have two conflicting targets. The answer was ““Meet both””. I accept that that is the ideal solution, but what if one target conflicts with the other? As the hon. Member for South Cambridgeshire rightly said, what if there is pressure to close a ward because of infection, but that decision is overruled by the trust managers? There is nothing in the Bill to prevent such conflicts, so the Government must make it clear that infection control is a priority. The right hon. Member for Rother Valley, the Chair of the Health Select Committee, spoke about the Shipman inquiry, and said that the Bill will improve current practices, which we welcome. The Bill includes some worrying provisions on ophthalmology. All I can say is that if dentistry is the precedent, heaven help us. If access to ophthalmology services is cash-limited and restricted, as Opposition Members have said, many of our constituents will be concerned. The Bill was originally to be called the Health Improvement and Protection Bill. The Government dropped the words ““Health Improvement”” and ““Protection””, because this is a missed opportunity to do far more of both.