Dáil Éireann debate -
Thursday, 28 Jun 2001

Vol. 539 No. 3

Ceisteanna–Questions. Priority Questions. - Hospital Infection Control.

Gay Mitchell

Question:

4 Mr. G. Mitchell asked the Minister for Health and Children the measures he will introduce to reduce the threat to the lives of hospital patients from the super bug MRSA; his views on whether a key cause of the spread of infection in hospital patients is the overcrowding in hospitals and the lack of separate facilities for infectious patients; the measures he proposes to introduce to control the use of antibiotics; the measures he proposes to introduce to educate the public to use antibiotics properly; the programmes in place for the training of hospital staff; if he will introduce educational programmes for all health care workers on infection control; if he will establish a network of laboratories around the State to monitor infection by drug resistant microbes; and if he will make a statement on the matter. [19449/01]

Mr. Martin:

MRSA is a significant infection which occurs in hospitals and the community. It is a major issue for health care systems in all countries. There are many contributing factors, including the use of antibiotics and the control of infection in our hospitals.

MRSA is part of the broader issue of anti-microbial resistance which is being addressed in a number of ways. Guidelines for acute hospitals and other facilities in relation to the control of MRSA were developed and circulated to health boards and other relevant parties in 1995. In 1999 a North-South study of MRSA prevalence was undertaken, under the direction of the Eastern Regional Health Authority. This was a follow-up to a previous study carried out in 1995. This study provided much useful data and also made a range of recommendations for the control of MRSA. This included identification of a wide range of issues which needed to be addressed at hospital level. The guidelines issued in 1995 suggest a variety of options for nursing patients with MRSA but did not state single rooms were essential.

In 1999 my Department also asked the National Disease Surveillance Centre to evaluate the problem of anti-microbial resistance in Ireland and formulate a strategy for the future. The NDSC has given detailed consideration to these issues and drawn up a strategy for the control of anti-microbial resistance in Ireland, SARI, which I launched on 19 June last. This report contains a wide range of detailed recommendations to address the issues, including those referred to by the Deputy. These can be grouped into the following four categories: surveillance of resistance and antibiotic use; hygiene and prevention of infection; judicious use of antibiotics in hospitals and the community; and education of health care workers, patients and the general public.

I welcome the recommendations in this report and I am committed to ensuring their implementation. Tackling the problem of anti-microbial resistance is a multi-faceted issue which will require action on a number of fronts. As a first step, in the current year £2 million has been provided for the health boards for anti-microbial resistance measures, taking into account the recommendations in SARI and the North-South study of MRSA in Ireland 1999.

The boards have been asked to address, in particular, infection control strategies and staffing in both hospitals and the community, the development of surveillance systems for the collection of anti-microbial resistance data and information on antibiotic prescribing in hospitals. In addition, funding has been provided for the establishment of an MRSA reference laboratory at St. James's Hospital, Dublin, which, it is envisaged, will come into operation later this year.

Mr. G. Mitchell:

The Minister did not tell the House that Ireland has a high rate of MRSA in comparison to other European countries and, according to a leading professor at the Royal College of Surgeons, a key cause of the spread of infection among hospital patients is the unfortunate overcrowding in hospital and the lack of separate facilities for infectious patients. What does he intend to do about this? He did not even refer to it in his reply.

Mr. Martin:

I did.

Mr. G. Mitchell:

Is it the case that one in ten patients in our hospitals develop an infection during their stay, partly because of poor facilities which lead to hospital staff not washing their hands often enough? According to this leading professor—

An Leas-Cheann Comhairle:

It is not appropriate to quote at Question Time. The Deputy is aware the time for taking this question has been reduced and I ask him to give way to the Minister.

Mr. G. Mitchell:

The professor says there will be a return to the pre-antibiotic era of untreatable infections unless this matter is taken in hand now. This problem has been growing since 1980. Before the Minister blames his predecessor, Deputy Cowen, or the previous coalition, we were only in government for two and a half of the past 14 years and—

An Leas-Cheann Comhairle:

The Chair facilitated the Deputy by adding some of the time for this question to the time for taking the previous question. I ask him to not to abuse the concession made to him by the Chair.

Mr. Martin:

The strategy to which I alluded was prepared under the aegis of the NDSC and will be the key driving force behind our policy on MRSA in hospitals. We are taking the issue seriously and it will be addressed in a comprehensive and strategic way. Major structural investment is being made in hospitals throughout the State in terms of the equipment that will be used and this will improve conditions. Major projects have been sanctioned for hospitals in Dublin, including the Mater Hospital, Temple Street Hospital, St. Vincent's Hospital, James Connolly Memorial Hospital and St. James's Hospital. For example, significant investment has been made in the leukaemia bone marrow unit in St. James's Hospital to provide more modern, separate facilities to prevent the spread of all forms of infection.

Mr. G. Mitchell:

If everybody washed their hands the same way the Minister washes his—

An Leas-Cheann Comhairle:

I call Question No. 5.