Jan O'Sullivan (Limerick East, Labour)
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Question 208: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to provide additional staffing to deal with health care acquired infections, in particular MRSA; and if she will make a statement on the matter. [18326/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 209: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to ensure the Health Information and Quality Authority sets and enforces a clear standard on health care acquired infections and that the new system of licensing will put a strong emphasis on all infection control; and if she will make a statement on the matter. [18327/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 210: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to significantly reduce health care acquired infections in hospitals and take into account the need to guard against infection in the refurbishment of existing hospitals and the construction of new hospitals; and if she will make a statement on the matter. [18328/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 211: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to establish a specific financial incentive which will reward hospitals that achieve excellence in hygiene standards; and if she will make a statement on the matter. [18329/08]

Jan O'Sullivan (Limerick East, Labour)
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Question 212: To ask the Minister for Health and Children the progress in regard to the commitment given in the programme for Government to introduce measures to help reduce the prescribing of antibiotics; and if she will make a statement on the matter. [18330/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 208 to 212, inclusive, together.

Tackling all Healthcare Associated Infections (HCAIs) continues to be a priority for the Government and the Health Service Executive (HSE).

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 healthcare settings, and, in addition, will focus on reducing antibiotic use in Ireland. Work has already been advanced on producing and promoting guidelines on antibiotic prescribing in hospitals and it is planned that this will be extended, in due course, to community and primary 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.

At a European level, the European Antimicrobial resistance Surveillance System (EARSS) was established in 1999 in response to the growing threat of antimicrobial resistance in Europe. EARSS comprises a network of over 800 microbiological laboratories serving some 1,200 hospitals in 30 countries that collects routinely generated antimicrobial susceptibility testing data on invasive infections caused by seven important bacterial pathogens. As of final quarter of 2007, 44 Irish laboratories serving 65 acute hospitals (public and private) participate in EARSS representing 100% coverage of the Irish population.

In quarter 4 of 2007, 28.8% of Staphylococcus Aureus isolates were Methicillin resistant compared to 40% in quarter 3 of 2007. This is a statistically significant difference. The annual trends indicate that the portion of MRSA in Ireland levelled off at approximately 42% between 2002 and 2006. In 2007, preliminary data indicate that this has dropped to 38.5%.

If the trend for 2008 remains downwards, it will indicate that our policies relating to control of healthcare associated infections and antimicrobial resistance in Ireland are having a positive impact.

In 2006, 52 posts were approved by the HSE to enhance infection control in the country's hospitals. These posts included Senior Pharmacists, Senior Infection Control Nurses and Surveillance Scientists. To date, a total of 34.5 WTE (whole-time equivalent) positions have been filled. Efforts are being made to fill the remaining 17.5 infection control staff posts as soon as possible but the availability of suitably qualified people for specific locations is proving somewhat more difficult.

A new National Surveillance System has recently been established by the HSE to collect data and provide information on a quarterly basis on four key areas, to monitor HCAIs in our health system:

1. Staphylococcus bacteraemia (blood stream infections);

2. Antibiotic consumption;

3. Alcohol gel use;

4. MRSA Surveillance in Intensive Care Units.

The HSE intend to publish available data on the above for 2006 and 2007 in the near future and then quarterly thereafter.

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 HCAIs and this policy has been adopted by the HSE. New environmental building guidelines have also been prepared by the HSE to inform infection control policy in all new builds and refurbishments. It is expected that these guidelines will be published in June.

The Health Information and Quality Authority (HIQA) undertook a comprehensive review of hygiene in our acute hospitals in 2007. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute care hospitals. The review provided a detailed assessment of performance across the entire range of areas that impact hygiene. This allows individual hospitals identify strengths and areas for improvement. Hospitals generally performed well on hygiene in the service delivery area, however the results on governance were poor. While 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 to ensure that efforts at identifying, managing and reducing infection are sustained and successful over time. HIQA is following up on this review to ensure that deficits identified during that process are rectified and the Authority will be undertaking a further national review this Autumn.

In addition, HIQA, in conjunction with major stakeholders, is currently in the process of producing infection prevention and control standards. It is hoped that these standards will be ready for publication by mid-2008. 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.

In relation to financial incentives for achieving excellence, while it is a matter for the Health Service Executive to decide on funding priorities, I favour, of course, the allocation by the Executive of resources to best ensure the delivery of high quality services.

I expect to receive the report of the Commission on Patient Safety and Quality Assurance in July which will comment on, amongst other matters, licensing. It will be appreciated that I am not in a position to comment on the report until I receive its recommendations.