Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I am taking this matter on behalf of the Minister for Health and thank the Deputy for raising it.

I just asked the Minister for Finance when the Crimean war occurred and he told me that it was around 1880. That was when Florence Nightingale decided washing one's hands and being clean were important to prevent infection. Perhaps we should call this the Florence Nightingale campaign and remind people that washing our hands is important. I wonder how many of those who work in hospitals would cook their dinner at home without washing their hands.

The prevention and control of health care associated infections, HCAIs, is one of the Minister's priorities in protecting patient safety. HCAIs represent a major cause of preventable patient harm and increased health care costs. Since late 2012, the Health and Information Quality Authority, HIQA, has been carrying out a monitoring programme against the national standards for the prevention and control of health care associated infections, 36 of which have been completed. The Minister and the Department welcome the publication of HIQA's reports and note the concerns raised in these and previous reports about hand hygiene practices, particularly among medical staff. With regard to hand hygiene, the findings of the authority suggest hand hygiene best practice needs to become more operationally embedded at all levels.

Improving patient safety is foremost about achieving a culture of patient safety, rather than the imposition of sanctions, which may be counterproductive. Achieving this culture of patient safety, in which best practice in hand hygiene is embedded, requires actions at all levels.

It is the responsibility of management and clinical leadership to make this a priority and ensure that the correct conditions to allow for the improvements in hand hygiene compliance are in place.

It must be emphasised that it is of vital importance that health care workers recognise their personal responsibility to protect patients by maintaining their own good hand hygiene. I am extremely disappointed to note that, despite the Health Service Executive's initiatives to develop an organisational culture of hand hygiene, a significant number of health care staff, including doctors, are still not adhering to the basic principles of hand washing. I very much support the HSE's ongoing work through its national programme of activity to raise awareness among staff, monitor compliance with national standards and take action to reduce HCAIs in hospitals. A key element of this programme is the HSE's continuing biannual hand hygiene audits, which occur both in the acute sector and in the long-stay area. Additionally, from July of this year it has become mandatory for all staff to receive hand hygiene training as part of staff induction, and an education programme that will take place every two years is being established.

The HSE audits have shown an encouraging improvement in hand hygiene compliance, with the most recent figure of 84.3% compliance overall at October 2012. This figure represents a significant increase from June-July 2012, when it was at 81.6%, and was just below the target of 85% for 2012. The Minister will be studying the statistics from the latest hand hygiene audits which took place earlier this year when they are published in the near future. I hope the compliance rate will have improved and will be closer to the HSE's target rate of 90% for 2013.

I am also reassured to note that MRSA rates are at their lowest level in seven years. The number of cases of MRSA has fallen by 59% between 2006 and 2012 - from 592 to 242 - and the downward trend is holding per statistical returns to date. However, there is no cause for complacency as there continues to be significant room for improvement, particularly among medical staff. With this in mind, the Chief Medical Officer of the Department of Health has written to the chair of the Health and Social Care Regulatory Forum asking that the forum consider the matter and submit proposals as to how it might adopt a common approach to raise awareness of hand hygiene, in particular, and support and reinforce compliance with this very important patient safety issue.

Finally, the licensing of health facilities Bill, which will provide for a mandatory system of licensing for public and private health service providers, will further strengthen and reinforce the actions that are being taken to ensure a culture of patient safety. The proposals are designed to improve patient safety by ensuring that health care providers do not operate below core standards, which are applied in a consistent and systematic way. Standards and other requirements will be enforceable through inspection and imposition of sanctions as necessary. Again, it is incredible that people would have to be told all of this.

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