Health Bill

It may help the Committee if I say that I know where the noble Baroness is coming from. However, I will have one more go at the point that I was trying to get across. It is important to separate out a mandatory surveillance, which is actually about getting everybody to complete the returns so that you know what is going on, and other areas where you pick up information. The Health Protection Agency is good at picking up this information. You subject it to scrutiny in a smaller group of hospitals and subject it to expert judgments about associated risk factors. You go through that process—I certainly went through it when I was in my previous job—before you impose a mandatory surveillance system on the NHS. It is not that we are unwilling to have mandatory surveillance systems, but if they are not targeted and not scientifically based, we will not get good responses from the NHS. That is the thinking behind the targeted approach that I was suggesting. However, I am happy to give more chapter and verse on that in a letter. I went into the issue of bed occupancy and infection rates for MRSA very thoroughly, and there was no good correlation until you get up to 100 per cent occupancy month in, month out. Our average occupancy rate is around 85 per cent in acute hospitals. Some places with average occupancy have low rates of MRSA and some with low rates of occupancy have high rates of MRSA. There is no perfect correlation between occupancy and infection rates. On the subject of ties, we know that practice is variable. I do not want to get on the ““Today in Parliament”” programme as the Minister who recommended bow ties. I do not want to go down in history for that, but I will look at the point that the noble Baroness raised and return to her on it.