Bernard Durkan (Kildare North, Fine Gael)
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Question 239: To ask the Minister for Health and Children the extent to which a trend in respect of incidents of MRSA show an increase or decrease on a monthly basis in the past three years; and if she will make a statement on the matter. [9769/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 240: To ask the Minister for Health and Children the procedures in place to combat MRSA; and if she will make a statement on the matter. [9770/08]

Bernard Durkan (Kildare North, Fine Gael)
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Question 241: To ask the Minister for Health and Children if the prescription of lower strength antibiotics is necessitating repeat treatments and thereby causing susceptibility to superbugs; and if she will make a statement on the matter. [9771/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 239 to 241, inclusive, together.

I assure the Deputy that tackling all Health Care Associated Infections (HCAIs), including MRSA, continues to be a priority for the Government and for the Health Service Executive. The Health Protection Surveillance Centre of the HSE collects data on MRSA which are published on a quarterly basis. In 2007, 43 Irish laboratories serving 64 acute hospitals (public and private) participated in their data collection system representing an estimated 98% coverage of the Irish population. The number of MRSA cases recorded over the last five years was 445 cases in 2002, 480 cases in 2003, 553 cases in 2004, 592 cases in 2005, 588 cases in 2006 and 432 cases by the end of the 3rd Quarter in 2007. The HSE launched a National Infection Control Action Plan in March 2007. An Infection Control Steering Group, chaired by Dr. Pat Doorley, National Director (Population Health) is responsible for overseeing 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%. Achievement of these targets will benefit all patients who are at risk. These targets will be achieved through the development of national and local level action plans to reduce the potential for spread of infections between persons in health care settings, and, in addition, will focus on reducing antibiotic use in Ireland. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.

Appropriate antibiotic prescribing is an important element in the effective treatment of all infections. Antibiotic stewardship programmes form a key part of the HSE Infection Control Action Plan. While there has not been any direction about prescribing "lower strength antibiotics", the HSE advises the use of narrow spectrum rather than broad spectrum antibiotics and this is aided by knowing the bacterial sensitivities in the local community. A National Surveillance System has been established by the HSE to collect data and provide information on a quarterly basis on four key areas and to monitor HCAIs in our health system. It is focusing on Staphylococcus bacteraemia; Antibiotic consumption; Alcohol gel use; and MRSA surveillance in Intensive Care Units. The HSE intends to publish available data on the above for 2006 and 2007 in April this year and then quarterly thereafter. The data will be listed by individual hospital and in due course, as appropriate, by each Local Health Office. This will greatly assist in the monitoring of improvements in infection control. It will in particular highlight recent trends in the key areas identified and represent a benchmark against which we can assess progress in the future and particularly when and where that progress is being achieved. Improvements on hygiene are critical to effective infection control.

The Health Information and Quality Authority (HIQA) undertook a comprehensive review of hygiene in our hospitals in 2007 against hygiene standards developed by the Irish Health Services Accreditation Board. HIQA published its report, the National Hygiene Services Quality Review, on 13 November 2007. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute care hospitals. Hospitals generally performed well on hygiene in the service delivery area. Most hospitals achieved extensive or exceptional compliance with the standard in the service delivery section of the report. However, the results were poor on governance. While the good hygiene practice of front line staff highlighted in the report is vital, real improvement in this whole area also depends heavily on good leadership and a system of governance. HIQA is working with managers and clinicians to develop national standards for Infection Prevention and Control. When completed these, along with the national hygiene standards, will provide a comprehensive framework to help reduce the spread of infection and improve the quality of our health care.

The availability of isolation facilities is another important factor in the overall solution to the issue of reducing incidence of infection. I have instructed 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 have been prepared by the HSE to inform infection control policy in all new builds and refurbishments. A process of consultation on the draft guidelines is ongoing. The HSE is committed to ensuring that such facilities are in line with best international practice including the provision of adequate numbers of single units. While accepting that not all HCAIs are preventable, I am satisfied that significant steps are being taken to reduce the rates of infections and to treat them promptly when they occur.