Bertie Ahern (Dublin Central, Fianna Fail)

I am aware that this problem has arisen at this time of the year, in particular, over recent years. This important issue has to be considered in this country and other countries. I do not think there is a wall of silence in this regard. At this time of year, representatives of hospitals in various parts of the country often issue statements to the national and local media, explaining that they have had to close sections of hospitals such as units and wards as a result of MRSA.

The prevention and control of infections which are associated with health care is a broader issue. The Department of Health and Children has ensured in recent years that this important issue is a priority for the Health Service Executive, which has published detailed guidelines on hygiene, including hand hygiene. The guidelines, which set out ways of controlling MRSA in hospital and community settings, have been well-publicised over the past two years. Anyone who has visited a hospital recently will be aware that hygiene has been stepped up throughout the health system.

The HSE has recruited essential infection control staff who are dedicated to dealing with MRSA. One could say that such staff should always have been in place, but it was deemed necessary to bring them in at a certain time, based on what was being done in countries in northern Europe, which have a better record on hospital diseases than countries in southern and western Europe.

The HSE will soon publish a three-year action plan, which will set targets for the next three years. The targets, which will be based on the HSE guidelines, will represent an attempt to reduce the level of infection in Ireland to a level that is akin to the levels found in northern Europe, where the best record in this regard is found. The recommendations on hospital hygiene standards which were included in the strategy for the control of antimicrobial resistance in Ireland, which was launched five years ago, are being implemented. The recommendations relate to the appropriate prescribing of antibiotics, active surveillance, the detection of MRSA and clinical governance structures in the area of infection control. Those who brief Deputy Ó Caoláin on these matters have probably told him that many of these problems result from the prescription and over-prescription of antibiotic drugs. I do not declare myself to be an expert on these matters. This issue has been in our system for a long time.

Two hygiene audits have been carried out to date in acute hospitals under the auspices of the National Hospitals Office. Earlier this year, in the spring or early summer, we participated in the Hospital Infection Society's survey on infections which are associated with health care in the UK and Ireland. Some 75,000 patients were surveyed in the study. It was recorded that approximately 10% of patients in the Republic who had infections which are associated with health care had an MRSA-related infection. While there is no doubt that figure of 10% is very high, the figure is higher in other countries. The survey in question found that the relevant figure in the UK is16%. The figure is far lower in northern European countries, however. We have to deal with all the issues in the reports, including the guidelines, the infections which are associated with health care, the ongoing campaign on hygiene standards, the recommendations which have been given to hospitals, the prescription of certain drugs, the surveillance of MRSA and the clinical governance structures.

Area infection controls were mentioned by Deputy Ó Caoláin in the context of providing more clean areas, such as isolation units, for people. All of these recommendations are in the process of being implemented, if they have not already been implemented. The HSE's next step will be to benchmark its guidelines against the actions which have been taken. It will try to reduce the figure I mentioned over the next three years. That will be the next step in the programme.

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