Edinburgh MSP Alex Cole-Hamilton goes back to pigeon droppings, saying we're building hospitals in a different way to the way we used to, and questions if there's a lack of knowledge in infection control at new sites, as there are new ways for bugs to get in.

Jim Miller responds saying the NHS is an open, learning organisation, and that Health Facilites Scotland is always willing to learn.

The Lib Dem MSP wants to know if upscaling of training is taking place when it comes to new bugs.

Philip Couser says they think about how to implement their guidance all the time, and keeps an eye on what's happening in the rest of the UK and Europe.

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Mr Briggs says he hopes there will be no problems with the new sick kids hospital in Edinburgh.

The Tory MSP asks whether there are enough ventilation specialists, he says.

Mr Miller concurs there is something about the technical and scientific expertise that informs the guidance.

Lisa Summers
BBC Scotland Health Correspondent

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Health experts have told MSPs that around 10 % of healthcare infections detected over the past three years are likely to be linked to NHS buildings.

Healthcare Protection Scotland collected data from across Scotland and found 48 incidents where there are possible links to the hospital environment.

The majority of infection outbreaks are passed from person to person.

The Health and Sport Committee has been hearing evidence on NHS safety standards.

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The inquiry was launched after a series of problems were identified at Scotland's largest hospital.

The Crown Office is investigating the deaths of three patients at the Queen Elizabeth University Hospital who contracted infections linked to the hospital.

Convenor Lewis Macdonald asks whether facility standards in inspections apply to older NHS buildings in the same way they apply to new buildings.

Mr Miller from Health Facilities Scotland answers, saying that can be the case, but not all the time.

Mr Macdonald asks if that means there are different standards for different buildings on the same site, like Forresterhill in Aberdeen.

Yes, says Mr Miller, as the standards can change over time, but the building is held to the standard that was in place at the time it was built or last inspected.

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Tory MSP Miles Briggs asks if there has been sub-standard work in terms of construction of new builds.

Mr Miller highlights the hierarchy of guidance versus standards versus regulations.

The HFS representative explains the guidance is a route to compliance, but it is down to the board commissioning a new hospital.

There isn't a compliance test against the guidance he explains.

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Mr Macdonald asks what would prompt the Health and Safety Executive to start an investigation into a systemic failure.

HSE director Iain Brodie explains there are only some occasions they get involved with healthcare infection outbreaks.

COPFS would bring it to their attention ordinarily, he says, but members of the public can also do this.

Mr Couser says Health Protection Scotland has a lot of expertise but has no governance role over boards or a hospital, unless there is an outbreak.

Mr Delaney concurs saying Health Improvement Scotland has no governance role, but can raise concerns and escalate them with the health board and beyond.

There are concerns about the whistleblowing within the NHS, says Mr Whittle.

The HIS representative replies front-line staff's views are essential.

Mr Macdonald says the committee has heard evidence that medical staff have had to whistleblow within NHS Greater Glasgow and Clyde.

That would be a concern says Mr Delaney.

Mr Miller says Health Facilities Scotland would hope that all boards would follow the advice issued.

There is no compliance or assurance role at HFS, he points out.

Mr Couser concurs and says the inspection teams can explain how the guidance is put into place in hospitals.

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Tory MSP Brian Whittle says the committee has repeatedly heard clinical staff on the front-line have a lack of input into building management and safety.

Should clinical staff have some authority to raise concerns, asks Mr Whittle.

Mr Couser agrees and says building governance should never be carried out in isolation.

Some areas of Scotland's biggest hospital cannot be cleaned properly because they are awaiting repair work, a report has found.

An inspection of Glasgow's Queen Elizabeth University hospital was ordered after patients became infected with a fungus linked to pigeon faeces.

The report found 300 repair jobs were waiting to be done, but there was no evidence of a plan to complete them.

It also said the emergency department had not been properly cleaned.

Read more

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Mr Macdonald says infection control doctors and nurses at the QEUH did not have a close relationship.

Mr Delaney agrees saying that was a feature of what was found in the QEUH.

It is absolutely essential there are good relations between nursing staff and the buildings staff, he says.

Communications were not great at the QEUH on inspection, replies Mr Delaney.

The front-line staff were doing the best they could under the circumstances, the problem was systemic with management, he explains.

Several surgeries have been postponed at an Edinburgh hospital following the discovery of a bacterial infection.

NHS Lothian said a small number of patients at the Western General were being treated for the infection.

The bacteria Pseudomonas aeruginosa was discovered in a shower and some taps in a ward in the department of clinical neurosciences.

Thirty elective procedures have been postponed as a "precautionary measure" earlier this month.

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Lib Dem Alex Cole-Hamilton wants to know what the organisations do if there is a water-born outbreak on a ward, and where clean water is brought from?

Alastair Delaney from Healthcare Improvement Scotland says it's up to the health board, but says his body does have the power to close a ward to new admissions.

He says in the 10 years that HIS has had the power, that action has never had to be taken because the situation has always been dealt with properly by staff on site.

SNP MSP David Torrance asks if the guidance for ventilation systems needs to be updated.

Mr Miller says the guidance is brought together in the Scottish Health Technical Memoranda and "the guidance itself never stands still".

He explains guidance on water systems is being looked at after recent incidents of infection.

There are compliance elements relating to cleaning, Mr Miller says.

There is now an action plan about how to change the guidance around water systems, points out Mr Couser.

Is there something that we can do now to avoid tragedy and deaths and be more proactive asks Mr Stewart.

Mr Delaney says there is an improvement in monitoring since the Vale of Leven C.diff outbreak in 2007-2008.

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In 2014, Scotland's largest health board was heavily criticised by an inquiry into the country's worst Clostridium difficile (C. diff) outbreak.

The probe, led by Lord MacLean, external, looked into care at Dunbartonshire's Vale of Leven Hospital between 2007 and 2008.

Of the 143 patients with C. diff, it was a contributory factor in 34 deaths.

Lord MacLean said NHS Greater Glasgow and Clyde (GGC) had "badly let down" patients. The health board apologised unreservedly for a "terrible failure".

Read more here.

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Tory MSP Miles Briggs raises the issue of the drop off in inspections.

Alastair Delaney explains Healthcare Improvement Scotland still has vacancies that are being advertised.

He reassures the committee the plans for the coming year will see the number of inspections will rise again.

Mr Delaney goes on to says HIS has called out staffing issues in its recent report.

He warns against extrapolating trends without evidence.

Jim Miller from Health Facilities Scotland says health boards can share best practice of risk assessment, using a tool called HEI Scribe.

It can list recommendations on infection control which can be shared, he says.

Mr Stewart asks if health boards are only aware of contaminations when a patient is infected.

That is the case, confirms Mr Couser, saying that is when Health Protection Scotland receives the information.

Alastair Delaney, director of quality assurance, Healthcare Improvement Scotland agrees, and says local information is then sought and received.

Mr Couser says the focus is on the infection of patients, not the discovery of micro-organisms which are with us everywhere.

Prosecutors are investigating the death of a third patient at a Glasgow hospital.

Mito Kaur, 63, was one of two patients affected by a fungal infection, Mucor, at the Queen Elizabeth University Hospital.

Two other patients died after contracting a separate fungal infection linked to pigeon droppings.

An inspection of the hospital published last week raised concerns about levels of cleanliness.

Read more here

SNP MSP Emma Harper, a former nurse, accepts this is a difficult area to address.

Ms Harper asks how a new hospital is built and how much influence they have.

Jim Miller, director of procurement, commissioning and facilities, NHS National Services Scotland, and representative of Health Facilities Scotland explains HFS is an advisory body and the decisions on building a hospital falls to the territorial health boards.