2.45 pm
Baroness Pitkeathley My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a survivor of MRSA.

The Question was as follows: To ask Her Majesty’s Government what is their response to reports that tests for methicillin resistant staphylococcus aureus (MRSA) may be falsely positive as a result of using a single laboratory.

The Minister of State, Department of Health (Lord Warner): My Lords, I am sure that the whole House congratulates my noble friend on that.

Laboratories doing microbiological investigations should be accredited or registered for accreditation. Tests must be undertaken in accordance with

30 Nov 2005 : Column 210

approved standards and operating procedures. The results should be validated by process controls, internal quality control and participation in an external quality assurance program. It is disappointing that test results for MRSA produced by unsound methods are given wide publicity in the media. This causes unnecessary public concern and wastes NHS resources in countering them.

Baroness Pitkeathley: My Lords, I thank my noble friend that helpful reply. Does he agree that the continued use of one particular laboratory which has questionable qualifications and results by the tabloid press shows more interest in criticising the NHS than in reporting the facts? Is he further concerned that this particular laboratory appears to derive most of its income from selling disinfectants to combat MRSA and thus might perhaps be seen to have a vested interest in achieving positive results?

Lord Warner: My Lords, I entirely agree with my noble friend’s concerns about the laboratory in question and the uncritical acceptance of its results by parts of the media. The main source of the misleading information in the media is Chemsol, which is run by a person who is not qualified in microbiology, is not a member of a recognised professional body and whose so-called laboratory does not meet UK accreditation standards. The methods used in this laboratory do not distinguish between harmless bacteria found on the skin and the potentially harmful MRSA.

Baroness O’Cathain: My Lords, if the laboratory does not reach accreditation standards, why do the Government not close it down?

Lord Warner: My Lords—

Noble Lords: Oh!

Lord Warner: Wait for it, my Lords; there is quite a good answer.

Dr Malyszewicz, the owner and operator of this so-called laboratory—and I am using the term advisedly—is not a member of a recognised professional body as a microbiologist. Nor is he a registered healthcare scientist or medical doctor. His laboratory is not accredited as a diagnostic laboratory. In those circumstances, he is not actually claiming to be any of the things for which we could take professional action against him.

Baroness Neuberger: My Lords—

Lord Soley: My Lords—

Lord Rooker: My Lords, it is the Liberal Democrats’ turn.

Baroness Neuberger: My Lords, given what the Minister has said, what else could be done to indicate to the public and the media more widely the concerns

30 Nov 2005 : Column 211

that we obviously share around the House about people passing themselves off as experts in microbiology when they are not?

Lord Warner: My Lords, I would certainly commend to the House the work done by the BBC in its program “You and Yours” on Radio 4 on 14 November, which exposed the circumstances involved. We sent down our inspector of microbiology as long ago as July 2004 to inspect these facilities, which were described as a “garden shed” on the Radio 4 programme I mentioned. We have written to the media to explain the circumstances and given them copies of the inspector of microbiology’s report. We expect some parts of the media to behave with a little more responsibility when we have given them this information.

Lord Soley: My Lords, is that not the core of the problem? The MRSA scandal is not the first example of a media scare, with people being genuinely worried and scared by a story that had virtually no substance to it. There have been many other examples of science being misreported in this way. It is not for this House or even the Minister but perhaps for the scientific bodies and, inadequate as it is, the Press Complaints Commission to start looking at how hopes are raised unrealistically and fears are raised unreasonably by press stories that show no scientific understanding. That also undermines public confidence in scientific thought and method.

Lord Warner: My Lords, I agree entirely with my noble friend’s remarks. We all accept that there are some serious issues around MRSA in this country, as there are throughout the whole of Europe, that have to be tackled; but they have to be tackled responsibly and not irresponsibly as has been the case in this area.

Baroness Tonge: My Lords—

Lord Skelmersdale: My Lords—

Baroness Masham of Ilton: My Lords—

Lord Rooker: My Lords, it is the turn of the Cross Benches.

Baroness Masham of Ilton: My Lords, would it not be a good idea to make MRSA a notifiable condition so that a qualified person would sign the form?

Lord Warner: My Lords, consideration has been given to that although it is not the situation at the moment. However, I would say to the House and the noble Baroness that we are the first government to introduce a mandatory surveillance reporting scheme on all healthcare-associated infections. We publish the results on MRSA as part of that. The scheme is being conducted by the Health Protection Agency.

Lord Skelmersdale: My Lords, I understand that the laboratory which has been so rightly criticised by your

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Lordships today is not the only one involved in this report. The Minister talked about “validation”. I assume that he meant validation not of laboratories but of tests. In the days of the Public Health Laboratory Service, difficult tests were almost invariably checked in other labs within the service. What is the position now?

Lord Warner: My Lords, there is an arrangement for accreditation, and I can send noble Lords the full particulars. As I said in my Answer, they are based on quality assurance, quality controls and participation in an external quality assurance scheme. So people are not just self-regulating. They are applying in a similar way to that which the noble Lord mentioned.

Baroness Tonge: My Lords, has the Minister read Florence Nightingale’s Notes on Nursing, which was written in 1860 before bacteria were even discovered? It contains an excellent blueprint for hospital hygiene and good nursing care. I wonder whether he would undertake to send it to all hospital managers for Christmas this year.

Lord Warner: My Lords, I certainly would not want healthcare managers to be diverted from their current tasks in managing the NHS and achieving financial balance. However, I shall undertake to read the book if the noble Baroness will undertake to make a full study of all the measures that the Government have taken to improve hand hygiene and tackle MRSA.

They should have drummed the issue home by explicitly referencing the fact that the lab results have never been significantly replicated by independent investigators.

Just my two cents.

MINISTER HITS OUT AT `MISLEADING INFORMATION’ ON MRSA
By Anthony Looch, PA Lords Staff
The Government today hit out at “misleading information in the
media” about hospital killer bug MRSA and singled out a company for
criticism.
The claims were levelled at Lords question time by Health Minister
Lord Warner who named Dr Christopher Malyszewicz of Chemsol
Consultancy Ltd.
He said: “The main source of this misleading information in the
media is Chemsol which is run by a person who is not qualified in
microbiology.
“He is not a member of a recognised professional body and his
so-called laboratory does not meet UK accreditation standards.
“It is disappointing that test results for MRSA, produced by
unsound methods, are given wide publicity in the media.
“This causes unnecessary public concern and wastes NHS resources
in countering them.”
Lord Warner was replying to Labour’s Baroness Pitkeathley, who had
asked what the Government’s response was to reports that tests for
MRSA “may be falsely positive as a result of using a single
laboratory”.
Lord Warner told her: “Laboratories doing microbiological
investigations should be accredited or registered for accreditation.
“Tests must be undertaken in accordance with approved standards
and operating procedures and results should be validated by process
controls, internal quality control and participation in an external
quality assurance programme.”
Lady Pitkeathley asked: “Would you agree that the continued use by
the tabloid press of one particular laboratory, with questionable
qualifications and results, shows more interest in criticising the
NHS than reporting the facts?
“Are you concerned that this particular laboratory appears to
derive most of its income from selling disinfectants to combat MRSA
and so might perhaps be seen to have a vested interested in achieving
positive results?”
Lord Warner replied: “I entirely agree with you about the
laboratory concerned and the uncritical acceptance of its results by
some parts of the media.
“The main source of this misleading information in the media is
Chemsol which is run by a person who is not qualified in
microbiology. He is not a member of a recognised professional body
and his so-called laboratory does not meet UK accreditation
standards.
“The methods used in this laboratory do not distinguish between
harmless bacteria found on the skin and the potentially harmful
MRSA.”
Tory Baroness O’Cathain asked: “If this laboratory does not reach
accreditation standards, why not close it down?”
Lord Warner replied: “Dr Malyszewicz, who is the owner and
operator of this so-called laboratory – I am using that term
advisedly – is not a member of a recognised professional body as a
microbiologist nor is he a registered health care scientist or a
medical doctor.
“His laboratory is not accredited as a diagnostic laboratory. In
those circumstances, he is not actually claiming to be any of the
things for which we could actually take professional action against
him.”
end

Because from where I am typing, you are using the bad practice of one person to smear an entire branch of investigation. The work on dust and floors is decades old, and specific to dust and floors. Your claims about MRSA on surface don’t bear much scrunity either.

Wagenwoort (JHI, 45, pg 231-234) found MRSA strains survived longer than 6 months on surfaces. Outbreak strains survive even better. They have high salt and dessication tolerance which helps too. As you will be aware, disinfectants aren’t used to clean wards, detergents are. Detergent don’t have anti-bacterial properties (except QACs which aren’t used either)

Too many papers for me to type have recovered MRSA from surfaces, including
Floor, Bed linen, Patient gown, overhead table, Blood pressure cuff, side rail,
bathroom doorhandle, infusion pump handle, room doorhandle, nurse gowns, nurse gloves, Furniture, Floor, Medical equip, Bed and frame, Flat surfaces, Door handle, Ventilation grill, Radiator Nurse call button, strecher, wheelchair, shower chair, bathtub, footwash, bowl, shower handle, shower curtain, Examination tables, Nurse keyboard, Telephone reciever, Tap, Working table and many other. All in published literature, none with Dr M. Not exhaustive either, I got bored copy and pasting.

So please don’t tell me that MRSA isn’t on surfaces and that it can’t survive there. The link to infections isn’t proven and maybe there isn’t one. But it isn’t Bad Science to try and find out., if you do it properly. Dismissing it without investigating it is.

*The Baroness Pitkeathley—To ask Her Majesty’s Government what is their response to reports that tests for methicillin resistant staphylococcus aureus (MRSA) may be falsely positive as a result of using a single laboratory.

Lord Warner (DoH) is due to reply.

Hospitals actually do spend a great deal of time and resource isolating and typing Staph. aureus from patient samples. They don’t spend much time looking for it (methicillin sensitive or resistant) on hard surfaces as it just doesn’t survive there. S. aureus, although it may be antibiotic resistant, is very susceptible to cleaning materials and the stress of not being above 30 deg C. It’s a skin/nose/mucous membrane micro-organism. I’m not saying it isn’t a problem in our hospitals – of course it is: our hospitals are full of people – but it’s not associated with dust on the floor.

Now if you want to look for trouble – a pathogen with the ability to survive on hard surfaces and a risk to the immunocompromised – look for a Gram negative environmental microorganism like Acinetobacter sp.

“Sadly I had 2 government official advisors from John Reid who
came to inspect my privately owned laboratory and to check my new methods of MRSA determination.

They went away with nothing apart from the surprise at what expense and effort I had gone to with correct equipment for the job!”

I’m guessing that would be surprise at how little expense and effort he had gone to?