I refer the member to the answer given to question S1W-15384 on 10 May 2001.

Dr Walker's study was on the costs of hospital acquired infection (HAI). The Executive has already put in place a series of co-ordinated measures to combat HAI. That includes a mandatory framework for national surveillance of HAI and the implementation by the Clinical Standards Board of standards for infection control, cleaning services and decontamination of reusable medical devices. Hospitals are expected to meet these standards and the Clinical Standards Board will report on their performance.

Every nursing home is required to have effective policies and procedures to control and prevent the spread of infection. When private nursing homes are being inspected, checks are made to establish that these are in place and being followed. All nursing homes are inspected at least twice a yearFrom 1 April 2002, the Scottish Commission for the Regulation of Care will regulate all care homes to national standards (including, for example, hygiene) set by Scottish ministers.

The public can help tackle hospital acquired infection by following standard advice about cleanliness and hygiene already prominently displayed in NHS hospitals. In addition, the need for any further measures is for discussion at national and local level, including the role of hospital infection control teams.

The undergraduate medical curriculum is the responsibility of the General Medical Council (GMC), which is a reserved body, independent of Government. Tomorrow's Doctors, the GMC document which medical schools use to guide their curriculum development, has moved away from subject-based to a topic-based and patient-centred curriculum. Within that students are expected to come to understand the balance in the ecosystem between microbiological systems and higher life forms, between man and his environment. The GMC, as the body regulating all medical education regularly inspects medical schools to check their compliance with these recommendations.

Beds in acute specialties are not designated for specific age groups so it is not possible to identify separately the number of beds provided for care of the elderly. However, beds in NHS hospitals for geriatric assessment can be identified. The average daily number of beds which were staffed and were available for the reception of geriatric assessment in-patients and day cases are shown as follows:Year ending 31 March

1997	3,452
1998	3,707
1999	3,634
2000	3,603
2001 (provisional)	3,484

The department gained a better understanding of Dr Walker's study and in response set out a series of co-ordinated measures ministers had introduced for tackling healthcare associated infection which is much wider than the use of new antibiotics.

The figures refer to the number of home visits made by health visitors and district nurses. This represents only part of the work that they do. Recent changes in practice has included increased activity in clinical based settings rather than home visits and this is not reflected in the figures. The figures also do not reflect an increasing shift in health visiting practice towards community and group based activities or that district nurses are increasingly working jointly with social work. The increasing complexity and intensiveness of activity carried out by district nurses and health visitors is not reflected in these numbers. The numbers of district nurses and health visitors have continued to increase year by year. There were 21.9 more whole-time equivalent health visitors in 1999 than in 1997. The number of district nurses rose by 141 during the same period. In Nursing for Health, we acknowledged that the current methods of recording activity are inadequate and do not reflect changing practices. Work is on going to develop a more meaningful means of reflecting community nursing activity based on the development of an electronic primary health care patient record. Further details of proposals will be made public soon.

The nature of health visiting work has changed and will continue to change in line with the recommendations in Nursing for Health which will involve a more targetted programme of health visiting alongside a wider range of community focused activity. Starting Well is delivering a very intensive programme of health visiting within two deprived areas of Glasgow. The impact of that and the implications in terms of additional staff to replicate it remain to be evaluated. In the meantime, it is important to note that much of the intensive activity being delivered in the Starting Well Project is being delivered by community development workers, support workers and nursery nurses. All of this activity would not show up in recorded statistics in health visiting. The figures refer to the number of home visits made by health visitors and district nurses. This represents only part of the work that they do. Recent changes in practice has included increased activity in clinical based settings rather than home visits and this is not reflected in the figures. The figures also do not reflect an increasing shift in health visiting practice towards community and group based activities or that district nurses are increasingly working jointly with social work. The increasing complexity and intensiveness of activity carried out by district nurses and health visitors is not reflected in these numbers. The numbers of district nurses and health visitors have continued to increase year by year. There were 21.9 more whole-time equivalent health visitors in 1999 than in 1997. The number of district nurses rose by 141 during the same period. In Nursing for Health, we acknowledged that the current methods of recording activity are inadequate and do not reflect changing practices. Work is on-going to develop a more meaningful means of reflecting community nursing activity based on the development of an electronic primary health care patient record. Further details of proposals will be made public soon.

The arrangements set out in the 1996 guidance remain relevant in all respects.