James Reilly (Dublin North, Fine Gael)

I acknowledge there is a serious problem here. I echo the concerns of my colleague, Deputy Shatter, at the approach being taken. The Minister mentioned Holland, but there is a lot more going on there than just the prescription of fewer antibiotics. When patients are admitted to hospital there they are kept in a separate area from other patients until their status is known. If they are found to be MRSA positive they are put into isolation rooms, but we do not have sufficient isolation rooms. The Minister is right in saying that our health service has been chronically underfunded in the last 20 years and we have only recently been catching up. What can we do, however? We could start by putting Perspex divides between beds in wards to try to create a clinically clean area around each bed. We could also start to reduce overcrowding by, as I alluded to earlier, getting some of the people who no longer need to be there out of hospital into community facilities, by reinstigating the home-first service and by making beds available in the community to transfer patients from our public hospitals. Overcrowding is one of the biggest issues concerning cross-infection.

The Minister is also correct to say that hand-washing is important, but while alcohol-gel works for MRSA it will not work for clostridium difficile. I welcome the Minister's comments about patients' interpretation of general practice. I do not know how many times I have heard people say, "Well, that was a waste of time, I didn't get an antibiotic." It is not about wasting time, however, it is about getting an opinion on what is wrong and what is necessary to get a person better, which does not always entail an antibiotic. The Minister is absolutely right in that regard.

Does the Minister intend to invest in some of the measures to which I have alluded? With 526 cases of MRSA in 2007 and 780 cases of clostridium difficile as of May 2008, what will the medical-legal bill be for all this if we do not act a lot faster than is intended?

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