Dáil debates

Tuesday, 14 June 2005

8:00 pm

Photo of John McGuinnessJohn McGuinness (Carlow-Kilkenny, Fianna Fail)
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I raise the issue of MRSA in our hospitals and the reaction of the Health Service Executive to that problem. Some weeks ago in Kilkenny, a public meeting was attended by over 150 people, representing individuals and their families who have been affected by MRSA, the hospital superbug. The group was representative of the whole country. People travelled from Galway, Dublin, Cork and Ennis. Deputy James Breen attended and I chaired the meeting.

I was horrified by the cases recounted at the meeting. One of the issues complained of by most people was that MRSA is not even spoken about in the hospitals. In one case where a lady who had MRSA asked for her file under the Freedom of Information Act, an official stood with her as she looked through it. She noted that the nurse had put a note on the file to the effect that this lady had MRSA and was not to be told.

A wall of silence exists with the Health Service Executive on this issue. I ask the Minister for Health and Children to do what she can to expose this problem, to advise all the frontline operatives and the patients about it, and to ensure that support is given to those who have MRSA and are being cared for at home. One of the unusual requests from those who attended the meeting was that if a person died from MRSA, this should be put on the death certificate. I find all of that quite disturbing.

There were also people there who represented companies which have advised the Health Service Executive of this problem and are selling product into the system that needs to be improved. They say a better alcohol-based hand wash is where one should start. A public awareness campaign needs to be undertaken to advise all patients, or those visiting hospitals, of the problem. We need to put money into the system, so that various handwash points can be provided in wards and isolation units made available. In particular, elderly people who are patients within the hospital system should be advised and cared for in isolation units.

I was horrified when, at a recent Committee of Public Accounts meeting, the Secretary General and officials of the Department of Health and Children could not answer questions when challenged about this issue. The representatives from the Health Service Executive refused, or could not give the information, for which they were asked. The Minister answered a parliamentary question on 1 March this year by saying that full and comprehensive information would be issued by the Health Service Executive. To this date that question has not been answered. Is that any way to treat a Member of this Parliament who was asking about MRSA on behalf of a concerned public? A recent report has shown that MRSA is a serious problem in Ireland. It stated that this is one of the countries which has a problem within its hospitals. All I ask is that the Minister should engage with those who have contracted MRSA in hospital and outline how exactly she intends to deal with the problem.

I spoke to a young woman last week whose uncle had been discharged from Waterford hospital and told that he did not have MRSA. When he turned up to the nursing home he was told he had MRSA and would not be admitted as it was now active in his heel. He went back to Waterford hospital and was not admitted there. He was held for four hours in the waiting room while someone came to deal with him. When I spoke to the young woman who was trying to care for her uncle, she was in tears over problems involved in trying to have him admitted and the difficulties in dealing with the situation. That is entirely unsatisfactory. The national organisation which represents those people wants the Minister to meet with them, outline a campaign of action and state where the appropriate funding is going. I am told there is funding within the system to deal with this problem. They also want to see a plan within the hospitals for caring for patients who have MRSA.

I ask, too, that the Department respond to the complaints being made by the professionals within the system. They flagged this problem for the Department 12 months ago and to date have not received any response to what they regard as a crisis. These are the people on the frontline of our health services. I urge the Minister to take this seriously, to deal with the families concerned and make an immediate public response to the issue of MRSA.

Tim O'Malley (Limerick East, Progressive Democrats)
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I thank Deputy McGuinness for raising this matter and I am happy to have the opportunity to respond.

The strategy for the control of antimicrobial resistance in Ireland, SARI — including MRSA — was launched by the Department of Health and Children in June 2001. Since then, approximately €20 million in funding has been made available under the strategy. This SARI funding is in addition to normal hospital funding arrangements for infection control.

In 1995 a committee convened by the Department, comprising consultant microbiologists, specialists in public health medicine, general practitioners and infection control nurses produced guidelines for the management of MRSA in acute hospitals. These guidelines have been widely circulated and include an information leaflet for patients.

The infection control sub-committee of the national SARI committee recently prepared revised guidelines in relation to the control of MRSA in Irish hospitals and community health care settings. They key recommendations cover such areas as environmental cleanliness, bed occupancy levels, isolation facilities, hand hygiene, appropriate antibiotic use and protocols for the screening and detection of MRSA. These draft guidelines are based on the best evidence available internationally. The guidelines are being considered by the Health Service Executive at present and when cleared by the HSE will replace the guidelines issued in 1995.

The Deputy will be aware that responsibility for operational issues in relation to the services provided by acute hospitals now rests with the Health Service Executive. The prevention and control of hospital acquired infections, HAIs, is a priority issue for the HSE. Effective infection control measures, including environmental cleanliness and hand hygiene, are central to the control of HAIs, including drug-resistant organisms such as MRSA. The SARI infection control sub-committee released national guidelines for hand hygiene in health care settings during 2004. These guidelines have been widely circulated by the Health Protection Surveillance Centre and are available on its website.

Improving the standards of cleanliness in hospitals is a priority. One of the specific actions identified by the Minister for Health and Children in the ten point plan to improve the delivery of accident and emergency services refers to the need to address this particular issue.

My Department understands that the director of the National Hospitals Office will have a hygiene audit of hospitals carried out this summer by external consultants. The results of the audit are expected to inform the national standards for infection control and cleaning. The HSE is responsible for the follow-through on the ground of pragmatic and concrete efforts to deal with this challenge and to ensure that patients receive appropriate levels of protection. Standards of hygiene must be upheld and the Minister is committed to ensuring this.