The NHS has “no idea” how many patients are dying from 80% of healthcare-associated infections in hospitals because the Department of Health is refusing to introduce mandatory surveillance, say MPs.

In its third report on progress in reducing healthcare-associated infections in hospitals, published today, the House of Commons Committee on Public Accounts (CPA) acknowledges the success achieved by setting national targets for the reduction of methicillin-resistant staphylococcus aureus (MRSA) bloodstream and Clostridium difficile infections which, in 2004, had seemed to be “an intractable problem.”

However, the Department has “taken its eye off the ball regarding all other healthcare-associated infections,” which actually account for 80% of all such problems, say the MPs. “The best available evidence is that other – just as deadly but also avoidable – infections, such as surgical site infections and pneumonias, have increased,” they say.

“Progress in combating these other infections is being bedevilled by a lack of potentially life-saving information,” commented Edward Leigh, Conservative MP for Gainsborough and chairman of the Committee, as the report was published. “The Department is refusing to introduce mandatory surveillance of all hospital-acquired infections, as we have recommended twice. If it had, it would now have a better grip on what is going on and be able to reduce the risks of patients getting these infections. And the NHS still has no idea how many patients are dying from the other healthcare-associated infections,” he added.

Every year, more than 300,000 patients in England acquire such an infection while in hospital, at a cost to the NHS of over $1 billion. These infections are caused by a variety of organisms and lead to a range of symptoms, from minor discomfort to serious disability, and for some they can be fatal. In 2007, there were 9,000 deaths recorded with MRSA or C difficile infections as the underlying cause or a contributory factor.

The MPs’ report applauds the Department’s hands-on approach to dealing with these two targeted infections; hospital cleanliness has improved and the priority given to reducing them has started to have an impact on overall infection prevention and control within hospital trusts, they say.

However, it adds, this progress has not been matched on other such infections, and the best available evidence suggests that they may be increasing.

Progress on improving information on and understanding of hospital antibiotic prescribing has also been limited, and the available evidence on other bloodstream infections – which can be just as serious as MRSA – suggest that the problem may be growing and that antibiotic-resistance organisms are increasing, the MPs add.

“Antibiotic resistance constitutes one of the greatest threats to controlling infection, and yet the Department has chosen to ignore yet another recommendation in our previous report – that there should be a national electronic prescribing system. This would link data on infections to prescribing to make sure antibiotics are being used effectively,” said Mr Leigh.

Responding to the Committee’s report, The British Medical Association (BMA) said it agreed that the government must take more decisive action to tackle other potentially fatal infections which are still on the increase - as well as MSRA and C difficile. The BMA also backs the MPs' calls for the Department to strengthen surveillance of all infections and develop strategies to ensure that antibiotics are being used effectively.

Safety must take precedence over political targets, said Dr Mark Porter, chairman of the BMA consultants’ committee. “With winter around the corner, hospitals will be working at full capacity. Targets need to be more flexible so that doctors are not pressurised to turn around patients too quickly. While patients obviously want to be treated quickly, we believe they also want to be treated safely. Putting patients close together in time and space risks cross infection. The NHS must commission and design hospitals with more single rooms rather than larger wards and bays,” said Dr Porter.