Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I thank the Ceann Comhairle for the opportunity to raise the matter of the crisis in our hospitals with the continuing proliferation of MRSA and other fatal hospital-borne infections. I was prompted to raise this matter when it was revealed yesterday that Beaumont Hospital is so overcrowded and lacking in beds that it is unable to provide isolation facilities for a third of its patients with MRSA.

This is a shocking and scandalous matter. Beaumont Hospital is a large teaching hospital serving the population not only of the north side of Dublin, but for many services the entire north-east region, including Cavan, Monaghan, Meath and Louth. It is a national centre for renal dialysis and kidney transplant, a national centre for neurosurgery and it is planned to locate one of the promised centres of excellence for cancer care at Beaumont.

The 2006 annual report of the infection control team in Beaumont states that because of a lack of beds it was not possible to isolate or ring-fence one in three patients colonised by or infected with MRSA. The report contains the following paragraph, which I can only describe as frightening:

The physical resources of the hospital are under enormous pressure to deliver a quality service and serious questions remain about the safety of patients in certain situations, for example non-MRSA patients being cared for in ward areas with MRSA-positive patients due to inadequate isolation facilities and a cramped, out-dated intensive care unit.

That is absolutely shocking. The report states clearly that facilities are inadequate in the hospital for the control and prevention of MRSA and other infections. Beaumont has clearly identified the need for additional beds and without these it cannot provide isolation units and single rooms, which are absolutely essential for the treatment of MRSA and to prevent its further spread throughout our hospitals.

In other countries, such as the Netherlands, where hospitals have a far greater proportion of single rooms, there have been great advances in stamping out these infections. On the other hand, we are still living with the legacy of the overcrowded Victorian ward system. Action is needed to provide the facilities to address this grave threat to patients in our hospitals.

The critical issue regarding MRSA and other major infections has been thrown into stark relief by the release yesterday of the first national hygiene services quality review by the Health Information and Quality Authority. This also makes frightening reading. It states the majority of public hospitals in Ireland need to dramatically improve their hygiene standards. Just seven of 51 hospitals have good hygiene standards and none was found to have very good standards. Nine hospitals are rated as poor and the remaining 35 as fair.

HIQA has indicated these findings show that most hospitals must take measures to improve standards. In welcoming the audit, the Health Service Executive stated it reflects significant improvements in hygiene and is a validation of the focus it has placed on the matter in the last two years. That may well be so and I commend all those who have made increased efforts to improve these standards in our hospitals. However, the HSE statement begs the question as to what hospitals were like prior to this two-year drive, if yesterday's HIQA report is seen as a sign of improvement.

It was revealed last June that as far back as May 2001, the infection control committees for University College Hospital and Merlin Park Hospital in Galway were expressing anger and dismay at the non-implementation of policies to combat MRSA. These revelations confirmed that if concerted action had been taken at an early stage, MRSA would probably not have become as widespread as it is now throughout the hospital system. The need for many more single rooms and isolation units was clearly identified as long ago as 2001 but no action was taken.

The continuing high prevalence of MRSA in Irish hospitals is a national scandal. A total of 587 MRSA bloodstream infections were reported last year, compared to 592 in 2005. These figures represent only a proportion of people infected with MRSA as it does not include those with wound infections.

This is a damning indictment of successive Governments, particularly the Fianna Fáil-PD coalition of the last ten years, which has favoured privatisation over the upgrading of the public hospital system. The high incidence of MRSA is a direct result of overcrowding, a lack of beds and a shortage of personnel in our public hospitals. The prevalence of MRSA is one of a number of reasons the promised 3,000 additional beds must be delivered, including single rooms and isolation units. I appeal to the Minister and Ministers of State to use their influence to have this important need addressed.

Jimmy Devins (Sligo-North Leitrim, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children.

I share the Deputy's concerns about MRSA and health care infections generally. I reiterate my commitment to ensuring that high-quality care is made available to all patients and to the further development of our health services, in particular the issue of patient safety.

Tackling health care associated infections, HCAI, including MRSA, is a priority for the Government and for the Health Service Executive. The HSE has established a national infection control action plan. It has put in place an infection control steering group, chaired by Dr. Pat Doorley, the national director of population health, to oversee the implementation of the plan. Over the next three to five years the HSE aims to reduce HCAIs by 20%, MRSA infections by 30% and antibiotic consumption by 20%. These targets will be achieved through the development of national and local level action plans to reduce the potential for spread of infections in health care settings. The steering group is supported by eight local implementation teams which will ensure that all local facilities are focused on achieving the national targets.

The availability of isolation facilities is an important factor in the overall solution to this issue. In that context, the Minister has already agreed with the HSE that designated private beds should be used where isolation facilities are required for patients who contract MRSA and this policy has been adopted by the HSE. New environmental building guidelines are being prepared by the HSE to inform infection control policy in all new builds and refurbishments.

The infrastructure of our current stock of hospitals is an issue but it is impossible to simply take an existing building like Beaumont Hospital and convert it into single rooms. There will be, however, an additional 28 single rooms in a new building planned for Beaumont Hospital that will address this issue which is due for completion next year. There will also be another four rooms in the new high dependency unit and two in the new intensive care unit.

The report the Deputy refers to relates to 2006 and many positive things have happened since then in the whole area of hygiene and infection control. Beaumont Hospital participated in the national acute hospitals hygiene audit in 2005 and again in 2006. The hospital's score of 83% in the 2006 audit was a considerable improvement on the 62% recorded in the first audit and just two points off the "good" category. This improvement was the result of enormous commitment and effort by staff throughout the hospital. In yesterday's hygiene assessment report by the Health Information and Quality Authority, Beaumont Hospital emerged as one of seven hospitals with a "good" rating.

That is a significant improvement, probably the biggest we have seen for any hospital. It shows that the approach of using audits to focus attention where it needs to be clearly works. I commend Beaumont Hospital on that achievement.

Beaumont has also introduced a new electronic alert mechanism on its computer system to notify staff of patients with MRSA on readmission. This has also been incorporated into the emergency department and hospital information systems. It allows bed managers to isolate potentially infective patients more effectively and earlier, where this is possible.

Not all HCAIs are preventable but significant steps are being taken to reduce the rates of infection and to treat them promptly when they occur. While there is much more work to be done, I note the improvements to date that Beaumont has achieved and expect this trend to continue in the best interests of patient care.