Olwyn Enright (Laois-Offaly, Fine Gael)
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Question 97: To ask the Minister for Health and Children the response structures in place in hospitals when a MRSA case is detected; if each hospital has its own plan; if there is national policy of best practice, the way same is monitored; and if she will make a statement on the matter. [26511/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I would like to assure the Deputy that tackling Healthcare Associated Infections (HCAIs), including MRSA, continues to be a priority for the Government and for the Health Service Executive (HSE). The Strategy for the control of Antimicrobial Resistance in Ireland (SARI) was launched in 2001. This strategy, which is based upon best international practice, represents a road map for tackling antibiotic resistance as well as HCAIs. Guidelines on The Control and Prevention of MRSA in Hospitals and in the Community were produced by a SARI Infection Control Subcommittee in 2005. In drawing up these guidelines, the subcommittee reviewed the 1995 Irish Guidelines and utilised guidelines produced in other countries including the UK, USA, New Zealand and the Netherlands. Responsibility for the implementation of these guidelines rests with individuals, hospital executives and, ultimately, the HSE.

The HSE launched a National Infection Control Action Plan in March 2007. An Infection Control Steering Group is responsible for overseeing the implementation of the plan. Over the next 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. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets. 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, from 2008 onwards.

This data (excluding MRSA in ICUs) has been compiled and published for 2006 and 2007. The report represents a significant step forward in terms of providing essential data that will serve as a benchmark for assessing progress in the future. I firmly believe that you cannot manage what you do not measure. We have now with this system begun a very useful measurement process.

The results so far show some improvement in 2007 over 2006. The overall S. Aureus bloodstream infection rate was lower in 2007 (0.36) compared to 2006 (0.37). The overall proportion of MRSA was also lower in 2007 (38.5%) compared to 2006 (42.4%). The overall acute in-patient antibiotic consumption rate is marginally up in 2007 over the 2006 rate by 2.4%. The overall alcohol gel use is up by a significant 50%. This data has many limitations that does not allow for direct comparison between hospitals. Also, areas like the antibiotic prescribing are calculated on a bed-days usage basis and are affected by the different procedures and data collection and processing systems applied in hospitals. However, the results are soundly based and will provide a good benchmark to enable us to measure the progress of each hospital. From now on, this data will be available on a quarterly basis. Data available from the EARSS Report Quarter 1 of 2008 indicates that the proportion of MRSA was at the same level as overall for 2007.

Since 2006, over 30 new staff in posts of Senior Pharmacists, Senior Infection Control Nurses and Surveillance Scientists have been appointed specifically to enhance infection control. I have instructed the HSE that designated private beds should be used for isolation purposes where required for patients who contract HCAIs. New environmental building guidelines to inform infection control policy in all new builds and refurbishments are expected to be published by the HSE later this month.

The Health Information and Quality Authority (HIQA) undertook a comprehensive review of hygiene in our acute hospitals in 2007 and published its report last November. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE-funded acute care hospitals. This allows individual hospitals identify strengths and areas for improvement. 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, on 3rd June HIQA published draft Infection Prevention and Control Standards for public consultation. When finalised, these, along with the National Hygiene Standards, will provide a comprehensive framework to control infection in all healthcare settings.

While accepting that not all HCAIs are preventable, I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur.

Olwyn Enright (Laois-Offaly, Fine Gael)
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Question 98: To ask the Minister for Health and Children the number of children who have received orthodontic treatment from the Health Service Executive each year for the past three years in each county; and if she will make a statement on the matter. [26512/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Deputy's question relates to the funding, management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004. Accordingly, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.

Olwyn Enright (Laois-Offaly, Fine Gael)
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Question 99: To ask the Minister for Health and Children the projects being assessed or examined for inclusion on a site (details supplied) in County Laois being developed by the Health Service Executive; and if she will make a statement on the matter. [26513/08]

John Moloney (Laois-Offaly, Fianna Fail)
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Operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive under the Health Act 2004 and funding for all health services has been provided as part of its overall vote. The Executive, therefore, is the appropriate body to consider the particular matter raised by the Deputy. My Department has requested the Parliamentary Affairs Division of the Executive to arrange to have the matter investigated and to have a reply issued directly to the Deputy.