Mary Harney (Dublin Mid West, Progressive Democrats)

I propose to take Questions Nos. 118, 121 and 254 together.

Tackling all health care associated infections, including MRSA and C. difficile, continues to be a priority for the Government and the Health Service Executive. Health care acquired infections are not a new phenomenon and have always been a potential complication of medical treatment, especially in hospitals. That is the case worldwide.

As the Deputies will be aware, the HSE launched a national infection control action plan in March 2007. The aim over the period of the plan is to reduce health care acquired infections by 20%, MRSA infection by 30% and antibiotic consumption by more than 20%.

A new national surveillance system has been established to collect data and provide information on health care acquired infections in our health system. These data covers four areas, namely, bloodstream infection, antibiotic consumption, alcohol gel use and, from 2008 onwards, MRSA surveillance in intensive care units.

Data in respect of the first three areas have been compiled and published for 2006 and 2007. This report provides essential data that will serve as a benchmark for assessing progress in the future. I firmly believe that you cannot manage what you do not measure. With this system we have now begun a very useful measurement process. The results so far show some improvement in 2007 over 2006. The overall bloodstream infection rate was lower in 2007 compared to 2006. The overall proportion of MRSA was also lower in 2007 compared to 2006, down from 42.4% to 38.5%.

Since 4 May this year, C. difficile has become a notifiable disease and all cases now have to be reported to the relevant department of public health. The Health Protection Surveillance Centre of the HSE published guidelines for the surveillance, management and control of C. difficile associated diseases in May 2008. This publication gives national guidance and deals with the isolation of C. difficile ribotype 027 for the first time in Irish hospitals. The guidelines will be a valuable resource in assisting in the prevention, management and control of this infectious disease.

Other measures taken to reduce the incidence of health care acquired infections include the appointment of additional infection control staff, education campaigns for health care staff and the public around the prudent use of antibiotics and the use of designated private beds for isolation purposes where required for patients who contracted health care acquired infections. In addition, new environmental building guidelines to inform infection control policy in all new builds and refurbishments are to be published shortly by the HSE.

An important part of infection control is hygiene. The Health Information and Quality Authority, undertook a comprehensive review of hygiene in our acute hospitals in 2007 and published its report last November. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute-care hospitals. HIQA is following up on this review to ensure that deficits identified during that process are rectified and the authority has already commenced a further national review this month. HIQA is also due to publish infection prevention and control standards later this year. When finalised, these, along with the national hygiene standards, will provide a comprehensive framework to control infection in all health care settings. I believe this process is sufficiently robust to achieve the required improvements in this area and further enforcement provisions are not necessary at this time.

While accepting that not all health care acquired infections are preventable, I am satisfied that significant steps are being taken to reduce the rates of health care acquired infections generally and to treat them promptly when they occur.

See this speech in context