Mary Harney (Dublin Mid West, Progressive Democrats)

We had a long debate on the matter and there is a strategy in place, in particular to recruit infection control nurses, surveillance scientists and antibiotic pharmacists. I have said many times that hygiene is a significant issue in our hospitals. It has a role to play in respect of infection. Hand hygiene is the most important form of hygiene in this regard, but hygiene in general is important. The two hygiene audits that have been carried out have thrown up some very interesting results. First, they have shown that it was not a question of the hospitals that outsourced performing worse than hospitals that had their cleaning service in house. Equally, the audits showed that it was not a question of old hospitals performing worse than new ones or that hospitals with microbiologists performed better than those without them. What it did show was that it did not matter whether the hospital had insourced or outsourced services or a combination of both or whether the hospital was old or new. Hospitals that were well managed performed extraordinarily well. The good thing about the second audit was that there was a huge improvement across the hospitals, which is very encouraging. It proves that one can manage what one measures.

Clearly, this feeds into wider issues. We know the biggest issue affecting MRSA is the over-prescribing of antibiotics. Senator Henry gave an excellent speech here last week on many of these issues. Among the issues being dealt with by the HSE is a programme of education for general practitioners which must include patients as well. The countries I have looked at which do very well in this area, for example, the Netherlands, place huge emphasis on informing and educating general practitioners and patients. We all tend to become a little obsessed with the need for antibiotics if we start sneezing. The number of people I know who have antibiotics in their hand bags is incredible. To be honest, before I got this job, I would have thought that having antibiotics is a good thing because one gets over the cold quickly and that is the end of it. If we do not need them, we should not take them because we become resistant.

In respect of swabbing patients when they go into hospital, one could have MRSA in one's nose but not on one's hands or vice versa. Dr. Neligan, who is not a fan of mine and writes about me at least every second week and sometimes every week, recently addressed a Fine Gael meeting in the midlands. I will probably encourage him to write about me again. A friend or two of mine attended the meeting, during which he told the audience that half of them were carrying MRSA and I believe they were very shocked. They were not carrying MRSA because they were members of Fine Gael, but the reality is that we all carry it. When people are sick, they are more vulnerable and when one is in an environment where is a lot of sickness, one is clearly more vulnerable. In respect of isolation, the hospital of the future, which it will take quite a long time to reach, will probably be one with single rooms. The new children's hospital we are building will have single rooms for these kind of reasons.

The decision on the children's hospital has been made and endorsed by the Government. There is no perfect site. One thing we do need is a national children's hospital for very sick children with cancers or who require heart surgery. As Linda Dillon, a woman from Crumlin who tragically lost her daughter, Alice, to cancer last year, said to me in my office and subsequently on "Morning Ireland" recently: "Get on with it. Let us not have any more reviews, delays, analysis. We have been waiting a long time for get what our children need, which is a world-class hospital". We are going to get on with it. The consultants are currently scoping out what will be in the hospital, but I hope it will be a hospital with single rooms so that as we move with new hospital developments, we cater for the issues that arise with serious illness and infection. I have had discussions with the HSE and my officials in this respect.

It is a pleasure to be here. I apologise to my officials for having to write this wonderful script. If anybody wants it, they can have it. There is a considerable amount of regulation. The Medical Practitioners Bill is being moved in the other House on Friday. Its purpose is to regulate the medical profession. This Bill is long overdue because it is 30 years since we had the last Bill. The Cabinet cleared the Pharmacy Bill yesterday. Believe it or not, we are reforming an Act from 1875. I understand that 30 years ago, a predecessor of mine informed an annual dinner that it would be done in the following six months. This has been a minefield and is a great tribute to the officials who have worked very hard on it.

The Health Bill 2006 will establish the Health Information and Quality Authority, a new State body responsible for authoritative information, setting standards and inspecting against those standards. There is a huge amount underway on the legislative side, as well as on change at HSE level.

My aim and that of the Government, and I believe, everybody in this House, is to have a world-class health system in Ireland and to have people visit this country in the future to see how we did it in the same way they visit today to see how we created our economic success. This is the ambition we have set for ourselves and there is no doubt it is achievable. It is not achievable overnight and will not be achieved next year or the year after. It will take quite some time to get there, but get there, we will.

We have fantastic people working in our health system and can attract some of the world's leading physicians and nurses. Recently in our public hospital system, a therapy known as brachytherapy has been introduced for prostate cancer in University College Hospital, Galway by Dr. Frank Sullivan, an Irish doctor who has returned home. Until then one could have that procedure only in a private hospital in Dublin and a few years prior to that one could not have it in Ireland. Wonderful things are happening. We have fantastic world class clinicians. We want to put in place a contract of employment, working arrangements and facilities to match that expertise at every level in the health system. We are lucky we have the resources to be able to do that. As we invest, through reform we will deliver and get closer to the day we achieve that world class health system to which we all aspire.