Séamus Kirk (Louth, Fianna Fail)
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I thank the Ceann Comhairle for giving me this opportunity to raise a most important issue that has arisen on foot of the HIQA report into a possible outbreak of Legionnaire’s disease at Our Lady of Lourdes Hospital in Drogheda. Legionnaire's disease is a potentially fatal form of pneumonia which can affect anybody but which principally affects those who are susceptible because of age, illness, immunosuppression or smoking. Legionella bacteria are found in many types of water systems. They multiply in warm and stagnant water such as that found in air conditioning cooling towers and certain plumbing systems, especially showers. Approximately ten cases are reported in Ireland each year on average. This HIQA report is very worrying for the patients and staff at Our Lady of Lourdes Hospital in Drogheda.

I would like to take this opportunity to ask the Minister of State a number of questions. How often are the water systems at Our Lady of Lourdes Hospital and other hospitals in the country checked in order that the threat of Legionnaire's disease can be prevented? What immediate action is the Minister taking in relation to the Legionnaire's disease outbreak at Our Lady of Lourdes Hospital? On a national level, how does this country deal with an outbreak of Legionnaire's disease? What are the contingency plans? What are the roles of hospital management and the Department of Health? What are the protocols for dealing with Legionnaire's disease? How do we deal with problems facing Our Lady of Lourdes Hospital? Where is the Minister's five-point plan for hospitals generally?

I am aware that we have a general election coming up. I do not doubt that promises will be made. I urge the Minister of State to find a workable solution to the problems at Our Lady of Lourdes Hospital. It is basic common sense. The HIQA report states that shower heads were removed from patient bathrooms 18 months ago and not replaced. This is simply not good enough. I concur wholeheartedly with the statement in the HIQA report that it is "essential that management of legionella risk at Our Lady of Lourdes Hospital Drogheda is effectively managed, with a particular focus placed upon protecting patients who may be especially vulnerable to infection". There is a need for further care for the patients of Our Lady of Lourdes Hospital. Just last week, I spoke in the Chamber about the crisis in the hospital's emergency area. This week the issue is different. The hospital seems to be continually in the news for one reason or another.

I put it to the Minister of State, Deputy English, that we need an action plan for Our Lady of Lourdes Hospital in Drogheda. We cannot continue to play politics with people’s lives. The Minister of State is well aware that the total population of the two counties served by this major hospital - my county and his county - is approximately 300,000. In addition, many people from north County Dublin and counties Monaghan and Cavan come to Drogheda in emergency circumstances. We need action in this regard. I am sure capital expenditure is required with regard to the plumbing system. I recognise that some money has been spent on it over a period of time. It is quite clear that more money needs to be spent. It is unsatisfactory that the shower units do not have a proper dispersal system at the end. It is certainly not suitable for the people in the hospital who are using it. This sends out the wrong message and needs to be addressed. If additional capital is required to address the issue, the Government should provide it immediately.

Damien English (Meath West, Fine Gael)
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I am responding to this Topical Issue matter on behalf of my colleague, the Minister for Health, Deputy Varadkar. I thank Deputy Kirk for giving me an opportunity to address the House on the important issue of the HIQA report on the threat of Legionnaire's disease at Our Lady of Lourdes Hospital in Drogheda. I would like to apologise on behalf of the Minister, Deputy Varadkar, who generally tries to be present to respond to Topical Issue debates that relate to his area of responsibility. I hope the Deputy understands that he is unable to be present today. The Minister will communicate that to the Deputy as well.

HIQA identified a number of issues during an unannounced inspection of Our Lady of Lourdes Hospital in Drogheda on 11 June last. A reinspection was carried out on 16 July. The hospital has acknowledged the issues raised in the HIQA report relating to the national standards for the prevention and control of health care associated infections following inspections of the hospital in June and July 2015. The Minister is pleased to note that the hospital management team and the staff of the hospital have made a number of improvements and a great deal of progress in respect of all issues raised during HIQA's initial visit. The hospital has a robust governance structure in place for the management of all aspects of the national standards for the prevention and control of healthcare-associated infections. It has developed a quality improvement plan to address the remaining outstanding issues raised in the HIQA report. I understand the hospital has a system in place to manage actively all the processes that minimise the likelihood of Legionella bacteria being in the water supply. This is to ensure a high level of protection for all patients and staff. I am also informed that the hospital is compliant with the Legionella L8 approved code of practice. It is worth noting that there have been no hospital-acquired infections associated with Legionella bacteria at Our Lady of Lourdes Hospital in Drogheda.

I would like to mention some of the measures that are in place at the hospital to ensure the quality of water supply. Water quality at the hospital is managed and governed by a multidisciplinary group that includes a consultant microbiologist. Copper-silver treatment of water is undertaken to eliminate Legionella bacteria. The flushing of all low-use outlets is in place on a daily basis. The efficiency of treatment processes is subject to ongoing measurement, with monthly sampling of water. The Deputy asked how often it is sampled. Additional external independent sampling of the water supply for Legionella takes place in accordance with the national standard. Monthly random testing is done at the point of water supply. I understand that in the past year, three samples have returned with a bacterial level that is higher than accepted norms. In all cases, the reasons for this have been identified and remedial action has been taken. The hospital has taken other steps to address issues arising from the HIQA report, including completing minor maintenance works, undertaking risk assessment in relation to access to sinks and making improvements with regard to staff training, audit and information display to ensure compliance with hygiene standards.

I assure the House that the senior management team at Our Lady of Lourdes Hospital has an internal audit programme to assess compliance with the standards. The hospital is committed to providing health care services in an environment that maximises safety, quality and accountability and drives a culture of responsibility and accountability among all staff involved. The Deputy raised a number of additional questions that were not necessarily outlined in his initial submission for this Topical Issue debate. I will try to get all those answers for the Deputy over the next day or two and I will bring back his requests to the Minister, Deputy Varadkar.

Séamus Kirk (Louth, Fianna Fail)
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I thank the Minister of State for his response. It would be advantageous when Topical Issue debates are taken in this Chamber if a Minister or Minister of State representing the relevant Department could be present. I do not mean that as a criticism of the Minister of State, Deputy English. I know he is deputising for the Minister. I fully accept that Ministers and Ministers of State can be drawn away somewhere else. Their non-attendance can pose a problem, however, when we are discussing important issues. There is no point in minimising this one.

The subliminal message from the phrasing of the text of the reply read by the Minister of State is that we should move on because there is nothing to worry about or see here. The reality is that there is. The HIQA report identified issues that need to be addressed urgently. I am sure it involves the expenditure of money on the plumbing and water supply and distribution systems within the hospital network. I ask the Minister of State to convey to the Minister the sentiment of the House that this matter needs to be addressed urgently. Our Lady of Lourdes Hospital is one of the busiest hospitals in the country. It caters for a huge population in its catchment area. It is simply unsatisfactory in this day and age to have the threat of Legionnaire's disease hanging over the patients and staff of the hospital. I ask the Minister, Deputy Varadkar, to address this.

Damien English (Meath West, Fine Gael)
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The Deputy has raised a matter of the utmost concern. He will accept that the Minister always tries to be here for Topical Issue debates when he can. His diary did not permit his attendance here today. He is certainly taking this issue very seriously. I will bring back to him the Deputy's additional questions and requests for information. It is important to point out that the hospital has implemented step changes since the report in July. Additional follow-up analysis has been done by HIQA. There are other steps being taken as well. I will certainly keep the Deputy updated on these matters. I will ask the Minister to engage with him with the full information as well. I thank the Deputy for raising this issue.