Mary Harney (Dublin Mid West, Progressive Democrats)

I propose to take Questions Nos. 90, 125, 175, 191, 196, 199, 206, 367 and 368 together.

While it is an unfortunate fact that health care associated infections are not preventable in all cases, I assure the House that every effort is made to minimise the incidence of such infections. The Health Service Executive has appointed an assistant national director of health protection as the lead person nationally to address the issue of MRSA. Since its establishment, the health protection group has concentrated on a number of key issues, including the development of a three-year action plan and overseeing its implementation, as well as putting a high quality governance structure in place.

The Health Service Executive is also appointing a number of new infection control nurses, surveillance scientists and antibiotic pharmacists. These staff will strengthen specialist support for infection control and facilitate the development of the national surveillance system. Some posts have already been filled and the remainder are currently being recruited. The Health Service Executive has also initiated a number of other actions, including a two-year national publicity campaign on health care associated infections and antibiotic resistance which will use the full range of media at national and local levels, the development of a national surveillance system, a national infection control education programme, information for patients and the public, a new hygiene assessment scheme, a GP education initiative on antibiotic prescribing and measures to tackle overcrowding.

I have asked the Health Service Executive to set up a national helpline through which patients and their families can report incidents of poor infection control in our hospitals. If, for example, patients are unhappy that a hospital staff member is not disinfecting his or her hands between patients, they or their family members can call the helpline if they feel they are not in a position to raise the matter directly with staff in the hospital. This is not about blaming people, but about helping all of us, including patients, visitors and health care staff, to play our part in improving patient care.

Although MRSA is not a notifiable disease, the health protection surveillance centre of the Health Service Executive collects data on it as part of the European antimicrobial resistance surveillance system. The European surveillance system collects data on the first episode of blood stream infection per patient per quarter. The Irish data from the European surveillance system which are published on a quarterly basis by the Health Service Executive show there were 445 cases in 2002, 480 in 2003, 553 in 2004, 592 in 2005 and 435 up to the end of the third quarter of 2006. It is difficult to identify the number of fatalities attributable to MRSA as many people also have significant co-morbidity factors.

In 2006 Ireland participated in the Hospital Infection Society's prevalence survey of health care associated infection in the United Kingdom and Ireland. The survey which included 45 Irish acute adult hospitals, including eight private hospitals, provides accurate and comparable data for the prevalence of health care associated infections, including MRSA. Preliminary results of the study are now available. The overall prevalence of health care associated infection in the United Kingdom, excluding Scotland and Ireland, is 7.9%. The figures for England, Wales, Northern Ireland and the Republic of Ireland are 8.2%, 6.3%, 5.5% and 4.9%, respectively.

No figures are available for the number of staff diagnosed with MRSA. Routine screening of staff is generally not recommended because staff colonisation with MRSA is rarely implicated in MRSA transmission. Compliance with good practice, including the wearing of protective clothing and hand hygiene measures, should minimise the risk of cross-infection.

A primary element of the fight against health care associated infections involves changing practices and procedures and the manner in which many health care staff go about their daily work. Accordingly, it is unrealistic to try to isolate the overall cost of implementing such a strategy. The reduction in the incidence of such infections will both improve patient care and generate savings in the cost of service delivery. While accepting that many health care associated infections are not preventable, I am satisfied that significant steps are being taken to reduce the rates of infection and treat them promptly when they occur.

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