Bernard Durkan (Kildare North, Fine Gael)
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Question 151: To ask the Minister for Health and Children the number of incidents of MRSA, Clostridium difficile or other similar hospital-based infections identified or suspected throughout the health services in each of the past three years to date; the action taken to address this issue; the extent to which the remedial action compares with the situation in best practice jurisdiction throughout Europe; and if she will make a statement on the matter. [26691/09]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Health Care Associated Infections (HCAIs) continue to be a challenge for healthcare systems worldwide. Ireland is not unique in this regard and tackling HCAIs here, including MRSA and C. difficile, continues to be a priority for the government and for the Health Service Executive (HSE).

Ireland participated in the Third Prevalence Survey of Health Care Associated Infections in acute hospitals in 2006 which surveyed a number of hospitals in Ireland, England, Northern Ireland and Wales. This study revealed that the Republic of Ireland was shown to have the lowest prevalence rate of both HCAIs and MRSA when compared with England, Northern Ireland and Wales. In European terms, the rates of MRSA for Ireland are better than many of the South European countries but not as low as some of the Scandinavian countries.

A National Surveillance system was established by the HSE to collect data and provide information to monitor HCAIs in our health system. The number of MRSA blood stream infection for the past three years are - 588 cases in 2006, 536 cases in 2007 and 436 cases in 2008. This shows a significant decrease of over 25% between 2006 and 2008.

Since May 2008, C. difficile has become a notifiable disease and all cases now have to be reported to the relevant Department of Public Health. This data is inputted into the National Computerised Infectious Diseases Reporting (CIDR) system, coordinated by the Health Protection Surveillance Centre. The number of notified cases from May to December 2008 was 1625 and 946 cases from January to June 2009 (this is in the expected range of 40 - 60 cases per week which is consistent with the results in the 2006 survey).

In March 2007, the HSE launched a National Infection Control Action Plan. An Infection Control Steering Group is responsible for overseeing the implementation of the plan. Over the period of the Plan the HSE aims to reduce HCAIs by 20%, MRSA infection by 30% and antibiotic consumption by 20%. The Steering Group is supported by eight Local Implementation Teams which will ensure that all local facilities are focused on achieving the national targets.

In order to introduce measures to aid in the reduction of antibiotic prescribing, education campaigns for healthcare staff and the general public around the prudent use of antibiotics commenced last year. The HSE launched a three week awareness campaign in November 2008 to highlight the importance of using antibiotics properly. This coincided with the first European Antibiotic Awareness Day. The awareness campaign included radio ads and distribution of leaflets on the prudent use of antibiotics.

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. Earlier this year, new environmental building guidelines to inform infection control policy in all new builds and refurbishments were published by the HSE.

HIQA, since its establishment in 2007, has also taken significant steps in this area. A core function of the Authority is to set standards on safety and quality of health services and to monitor enforcement of those standards in an open and transparent way. In 2007, HIQA developed National Hygiene Standards and commenced a programme of audit against these Standards. The Authority undertook a comprehensive inspection and review of hygiene in our acute public hospitals in 2007 and again in 2008. The reports represent a thorough assessment of how hygiene services are provided and managed in HSE- funded acute care hospitals. HIQA noted that the standard on front line services which was already very high in 2007 had been maintained in 2008 and that corporate governance was significantly improved.

In May 2009, the Health Information and Quality Authority published their National Standards for the Prevention and Control of Healthcare Associated Infections to provide an overall framework for health and social care providers to prevent or minimise the occurrence of HCAIs. These Standards include all key areas of importance in the control of HCAIs namely governance, hygiene, microbiological services, antimicrobial resistanceand surveillance systems. Six months will now be allowed for the development by the HSE of a self-assessment tool, gap analysis and implementation plan before HIQA commences its initial review.

I am satisfied that significant steps are being taken to reduce the rates of HCAIs generally and to treat them promptly when they occur.