Chamber and committees

There are currently no Scotland-wide arrangements in place for monitoring hospital acquired infection (HAI), including those which become apparent after patients have been discharged from hospital. A Scotland-wide surveillance system for HAI is under active consideration by a sub-group of the Advisory Group on Infection and I will shortly be considering the further steps necessary to introduce such a system.There are recognised difficulties in monitoring HAI which becomes apparent after discharge, and there is currently no UK or world-wide consensus on an appropriate approach. Experts from Scotland are taking part in UK-wide discussions about developing methods of post-discharge surveillance of HAIs. The sub-group which is considering HAI surveillance has identified the issue of post-discharge surveillance as a priority and studies to evaluate alternative methods are being developed.

There is insufficient data at Scottish level to demonstrate either correlation or lack of correlation between rates of hospital-acquired infection (HAI) and resources applied to infection control by NHS Trusts.Preventing and controlling HAI is an important issue for the NHS in Scotland and is a key part of the responsibilities of every NHS Trust. The Scottish Health Plan, Our National Health: A plan for action, a plan for change, published in December last year, makes clear that every local healthcare system will be expected to deliver the service standards to be established by the Clinical Standards Board for Scotland on infection control, cleanliness, and other matters. A joint Health Department/ NHS working group is currently reviewing existing guidance and preparing relevant standards. These standards will be applied to NHS Trusts once the work is complete.

These matters are under consideration by a sub-group of the Advisory Group on Infection, which was asked by the Scottish Executive to develop proposals for a national system of surveillance for hospital-acquired infection (HAI) in Scotland. During the course of its work, the group has considered a wide range of issues including definitions of HAIs and approaches to monitoring their incidence. I will shortly be considering the further steps necessary to introduce a Scotland-wide surveillance system for HAIs.

At present there are no requirements on NHS Trusts to publish such data, although it is open to them to do so. A Scotland-wide surveillance system for hospital-acquired infection (HAI) is under active consideration by a sub-group of the Advisory Group on Infection and I will shortly be considering the further steps necessary to introduce such a system.The Scottish Executive Health Department is also currently considering the inclusion of a measure of the incidence of HAI in NHS hospitals in the new NHS performance assessment framework outlined in Our National Health: A plan for action, a plan for change.

The Scottish Centre for Infection and Environmental Health holds data about cases of methicillin resistant staphylococcus aureus (MRSA), including MRSA bacteraemias (blood borne infections), and of other bacteraemias detected in laboratory specimens examined in Scottish public health and hospital laboratories. Infections in these groups may have been acquired while the infected person was in hospital or may have been present on admission. It is not at present possible to distinguish and count separately those infections acquired in hospital.A sub-group of the Health Department's Advisory Group on Infection has been developing plans for a national surveillance system for HAI, including MRSA, in Scotland. The group is expected to provide recommendations to the department shortly. The sub-group recognises the priority that needs to be attached to infections caused by MRSA. Once their report is received, I will be considering what further steps are needed to introduce surveillance of HAI across Scotland. On present plans, systematic collection throughout Scotland of information on selected infections attributable to MRSA would begin in autumn 2001. Monitoring data would become available approximately a year later.

I refer the member to the answer given to question S1W-14557.

I refer the member to the answer given to question S1W-14557.

I refer the member to the answer given to question S1W-14557.

As part of their allocations from the £26 million Health Improvement Fund, health boards are tasked with supporting the provision of fruit to infants, and breakfast clubs and fruit/salad bars in schools according to local needs.A reliable estimate of the cost of a uniform national scheme is not available. The Glasgow "Fruit to Schools" project estimates that it will cost £722,150 a year to provide one piece of fruit three days per week to 56,129 primary pupils. The 1997 school census reported a total of 452,500 primary school pupils in Scotland. The cost per pupil would be higher in less densely populated and more remote areas of Scotland.

I refer the member to the answer given to question S1W-14557.