Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 126: To ask the Minister for Health and Children the action he will take in view of the recent outbreak of the Klebsiella pneumoniae carbapenemase, KPC, bug at the Mid-Western Regional Hospital, Limerick; if measures will be taken to address overcrowding in our acute public hospitals, including the reopening of closed beds and wards; and if he will make a statement on the matter. [6124/11]

James Reilly (Dublin North, Fine Gael)
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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 is a priority for the Government and the HSE. The recent occurrence of the Carbapenem resistant Enterobacteriaceae (CRE), in the Mid-Western Regional Hospital Limerick is of concern as CRE are highly resistant to almost all antibiotics. KPC referred to by the Deputy is one type of CRE. CRE has been identified in eight patients in the Mid-Western Regional Hospital. Two other cases have been reported in a hospital in Dublin. One involves a patient who had been an inpatient in Limerick. No new cases have been detected since mid-March.

To date travel to countries where CRE has been reported such as India or Greece was considered the main risk factor for their acquisition. The recent occurrence of CRE here is therefore significant. The expert guidance in the interim National SARI Guidelines, issued in January 2011 has informed the HSE's response to the CRE occurrence. The European Centre for Disease Control and Prevention has also provided international expert advice in relation to this. The prevention of CRE includes laboratory detection, enhanced surveillance, adherence to standard precautions, appropriate antimicrobial stewardship and the institution of strict patient isolation and transmission-based precautions when CRE is isolated.

A range of measures have been put in place in the Mid West Regional Hospital in line with this guidance including an improved surveillance strategy for detecting CRE and the enhancement of hospital cleanliness through a programme of deep cleansing of affected areas and ensuring that hand hygiene requirements are strictly adhered to. Visiting restrictions are also in place at the hospital. Guidance has also been issued to the HSE Regional Directors of Operations for circulation to all acute hospitals and to consultant microbiologists to ensure that appropriate measures to prevent CRE are put in place. It is also planned to undertake an assessment of the prevalence of CRE in all regions. I am satisfied that significant steps are being taken to reduce the rates of Health Care Associated Infections such as CRE and to treat them promptly when they occur.

The Deputy also raises the issue of acute bed utilisation particularly bed closures. Beds in acute hospitals may be closed for a number of reasons including infection control, refurbishment or cost containment. While the management of beds at hospital level is an operational matter, access to appropriate care for patients is not simply about the number of beds in the hospital system. It is about the efficient use of resources to provide quality care and optimum outcomes for patients. Increasing the proportion of work that hospitals do on a day basis, and appropriate reductions in length of stay in the case of inpatients are important in this context.

I am being briefed by my Department and the Health Service Executive (HSE) on the organisation of acute services in each region and on the important clinical programmes being developed by the HSE. These inter-related programmes aim to improve service quality, effectiveness and patient access and to ensure that patient care is provided in the service setting most appropriate to individuals' needs. I will consider the matter of bed utilisation further in this context.