Bertie Ahern (Dublin Central, Fianna Fail)

There was no report before the previous two reports and the reason we wanted to tackle the hygiene problem in hospitals was that there were no benchmarks. There was no league table to help us examine the health service and enforce standards.

The point I made on my first intervention was that the method of assessment and criteria used in this report are substantially different from and more demanding than the previous audits carried out by the HSE. I support that, but my point is that they are not comparable and, therefore, neither are the results. Previous audits concentrated totally on service delivery. Issues of governance, management and the need to reduce infection must be considered. That is a better way of doing it. Nevertheless, there is huge room for improvement. The overriding message in this report is that most hospitals can and should do better. The criteria that now pertain under the national hygiene services quality review will be followed up into the future. That sets a new standard.

We have stated that we will provide, in the lifetime of this Government, additional staffing to deal with health care acquired infections, particularly MRSA. We are working to ensure the Health Information Quality Authority sets and enforces a clear standard for health and information and that the new system of licences will put a strong emphasis on infection control. HIQA will work to reduce significantly health care acquired infections in hospitals. We must take into account the need to guard against infection in the refurbishment of existing hospitals and the construction of new hospitals. The authority will establish a specific financial incentive that will reward hospitals that achieve excellence in hygiene standards, thus ensuring management concentrates on hygiene as a major issue. HIQA will continue to carry out regular hygiene audits without notice, at minimum annually, and will publish the results. It will also introduce measures to reduce the prescribing of antibiotics, which is part of the problem in terms of health care acquired infections.

It should be noted that, according to the service delivery section of the report, most hospitals achieved either extensive or exceptional compliance with the standards. The majority of hospitals have a multidisciplinary team in place to oversee hygiene practices, but most of these teams were newly established and roles and responsibilities were not clearly defined. We have some way to go to embed that culture and practice of measuring, monitoring and improving. Where risks were identified, these were notified to the individual hospitals and are receiving attention. A quality improvement plan must now be drawn up by all hospitals individually and collectively by the HSE. This will continue to be monitored by HIQA as part of its ongoing quality assurance efforts. The establishment of HIQA means we are now seeing a regulatory management system being put in place. This will force hospitals into a position where they must take account of these issues.

The issue raised by Beaumont Hospital and other hospitals regarding hygiene, particularly hand hygiene in wards, is important. One of the reasons for limited visiting hours in hospitals in previous times was to control hygiene matters. This is no longer the case and people can visit for extensive hours during the day. Hand hygiene issues are difficult to enforce when that happens, as we have been told by hospital management. It is something that must be enforced, however, because, according to this and other reports, it is one of the most important issues in maintaining hygiene standards in hospital wards.

See this speech in context