Bernard Durkan (Kildare North, Fine Gael)
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Question 80: To ask the Minister for Health and Children the progress made to date in her efforts to eliminate hospital based infections such as MRSA and clostridium difficile; and if she will make a statement on the matter. [45569/09]

Mary Harney (Dublin Mid West, Independent)
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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 continues to be a priority for the government and for the Health Service Executive (HSE).

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%.

A National Surveillance system was established by the HSE's Health Protection Surveillance Centre (HPSC) to collect data and provide information to monitor HCAIs in our health system. The number of MRSA bloodstream infections across the public and private hospital sector for the past three years are - 588 cases in 2006, 536 cases in 2007 and 435 cases in 2008. This shows a significant decrease of over 25% between 2006 and 2008. The data is collated on a quarterly basis and for the first six months of 2009 the number of MRSA bloodstream infections was 191, a reduction of over 20% from the first six months of 2008 when cases numbered 241.

Up until May 2008, Clostridium difficile was not a notifiable disease and, as a result, it was difficult to quantify the extent of infection in the healthcare system. Since May 2008, all cases are required to be notified to the relevant Department of Public Health. These are reported on a weekly basis and the number of cases reported nationally from May to December 2008 was 1,624 and from January to 14th November was 1,733. These figures which are within the range of 40 - 60 cases per week are consistent with the results of the last Prevalence Survey of HCAIs in acute hospitals in Ireland, Northern Ireland, England and Wales for 2006.

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. This year's Awareness Day on 18th November last built on last year's successful public education campaign. Data on antibiotic consumption collected by the HPSC shows a welcome decrease in antibiotic consumption in 2008 for the first time since 2000.

Earlier this year, new environmental 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. This included unannounced visits by inspection teams. The reports, which were published, represent a thorough assessment of how hygiene services are provided and managed in HSE-funded acute care hospitals. HIQA noted that the standard of 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, HIQA published its National Standards for the Prevention and Control of Health Care 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 resistance and surveillance systems as well as relevant aspects of the design of facilities. Six months has been allowed for the development by the HSE of a self-assessment tool, gap analysis and implementation plan before HIQA commences its initial review. The HSE has already made significant progress on this work and is in consultation with HIQA on the implementation of the Standards.

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