Liz McManus (Wicklow, Labour)
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Question 96: To ask the Tánaiste and Minister for Health and Children the figures in respect of the number of cases of MRSA in each of the past three years and to date in 2005; the number of fatalities attributable to MRSA; the steps which are being taken to reduce the incidence of MRSA; if her attention has been drawn to the view expressed by top management in the main teaching hospitals in Dublin that measures to improve facilities and tackle overcrowding in hospitals will be required to deal with MRSA; and if she will make a statement on the matter. [29482/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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There were 445 reported cases of MRSA blood-stream infection in 2002, 480 cases in 2003 and 550 cases in 2004. The figure for the first six months of 2005 is 314 cases. The increase in the reported number of cases of MRSA in recent years is mainly due to increased surveillance as a result of more laboratories participating in the reporting process. It is difficult to identify the number of fatalities attributable to MRSA as many people also have significant other medical problems. I have already asked the Health Service Executive to develop systems and methodologies of reporting of MRSA infections by hospital, so we may have a fuller picture of the location and extent of these infections.

Effective infection control measures, including environmental cleanliness and hand hygiene, are central to the control of hospital acquired infections, including drug-resistant organisms such as MRSA. Good hand hygiene is one of the simplest and most effective measures that can be used to stop the spread of MRSA and other infections.

I expect to receive a report shortly from the director of the National Hospitals Office on the national hygiene audit. The results of the audit will form the basis for the changes that are required in work environments and work practices so as to meet the highest possible standards of cleanliness in hospital settings. I have already promised that the results of the hygiene audit will be made public. The HSE will also publish national infection control standards and national cleaning standards, which are a consistent and robust set of hygiene standards for hospitals. Where previously standards may have depended on the approach of a particular hospital or health board, the HSE can now ensure every hospital will share and meet the same high standards of cleanliness and infection control. My Department is continuing to engage with the HSE to agree a series of actions over the coming period so MRSA can be effectively dealt with, so as to achieve a reduction in the incidence and effects of these infections.

Liz McManus (Wicklow, Labour)
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I thank the Tánaiste for that information. The increase in the number of MRSA cases being reported is startling and we all recognise there is under-reporting. I take it we are only talking about hospitals whereas information in regard to nursing homes and the wider community is not included. Therefore, I presume the figures should be much higher.

Does the Tánaiste accept the news that five babies in the national maternity hospital are carriers of MRSA is a matter of great concern? Is she able to state that staff within hospitals are doing what she asks, namely, washing their hands? What method has she to evaluate this? Does she accept this is not just a matter of washing hands? Indeed, she has been criticised by a senior consultant for trivialising the matter by stating it is about cleanliness and the washing of hands when there is also the issue of overcrowding. What does she have to say about the impact of overcrowding on the rate and extent of infections, such as MRSA, within our hospitals? How does she intend to achieve the OECD level of 85% bed occupancy? What are her plans in regard to these issues, which I am sure she will agree are as important as that of washing hands?

Mary Harney (Dublin Mid West, Progressive Democrats)
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I accept the issue is about more than washing hands, although all the international evidence and the expert medical advice available to me would suggest it makes the single greatest contribution. It will be a matter for the HSE. The audit, which will be published by the end of this month, will give us baseline figures and will provide interesting data, hospital by hospital, which can be measured on an ongoing basis. That will be significant.

There is now a major emphasis on hygiene and cleanliness. However, I accept the Deputy's point that more isolation wards are needed. The international average would suggest there should not be bed occupancy of more than 80%-85%. The hospital of the future will have many more single rooms than is the case at present. There have always been hospital infections. Our duty is to minimise these by using the hygiene tools available to us. We need more isolation facilities and it is clear that more beds would make an important contribution to this.

Liz McManus (Wicklow, Labour)
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The Tánaiste did not answer my question on the number of fatalities.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I do not have that data. My reply stated that many people die from underlying conditions. I do not think that information is available.

Liz McManus (Wicklow, Labour)
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I would have thought this was significant information that one should have.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I stated that while some people with MRSA die, they also have underlying conditions. I do not have a breakdown as to how many die purely from MRSA and I do not think anyone has that data.

Liz McManus (Wicklow, Labour)
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While I do not want to delay, I ask that the Tánaiste reconsider this approach. I have no doubt that people die from MRSA but it is not being attributed as the cause of death. We need to know how many because there are clearly cases of individuals who have died from MRSA. It is simply unacceptable that the Minister for Health and Children is unable to tell us how many such cases there are.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It is not only the Minister for Health and Children who is not able to tell the Deputy, nobody else can tell her either because we do not have that data recorded. People acquire MRSA in many settings and not exclusively in a hospital environment. As I said, the HSE will work on a hospital by hospital reporting mechanism. If it is possible to separate the data and establish if somebody died from MRSA as opposed to something else, clearly it would be desirable to have that data. At present we report incidence of MRSA in hospital settings and they are the figures I have.