I propose to take Questions Nos. 236 and 237 together.
Achieving and maintaining the highest possible standards of hygiene in our hospitals and health care facilities generally is a priority for this Government. The National Hygiene Services Quality Review on acute hospitals was published by the Health Information and Quality Authority (HIQA) on 13th November, 2007. The report represents a thorough assessment of how hygiene services are provided and managed in 51 HSE funded acute care hospitals. The method of assessment and criteria used are substantially different to previous audits carried out by the HSE and therefore the results are not comparable. The results do, however, set a very good benchmark for the future. Following on from the publication of the report, it is my belief that the Authority will revisit some hospitals reviewed to check that immediate measures have been put in place. The focus within the HSE at this point is to work with and support hospitals to improve practices rather than impose sanctions.
The HIQA review not only looked at the immediate service delivery elements of hygiene but also examined the critical areas of governance and corporate management. Hospitals generally performed well on hygiene in the service delivery area with most hospitals achieving either extensive or exceptional compliance with the standard. However, the results were poor on governance. While the good hygiene practice of front-line staff highlighted in the report is vital, real improvement in this whole area also depends heavily on good leadership and a system of governance. A quality improvement plan now needs to be drawn up by all the hospitals and the HSE. This will continue to be monitored by HIQA as part of its ongoing quality assurance programme.
HIQA is currently working with managers and clinicians to develop national standards for Infection Prevention and Control which should be finalised in March 2008. When completed these, along with the national hygiene standards, will provide a comprehensive framework to help reduce the spread of infection and improve the quality of our health care. In addition, the Authority has submitted views to the Commission on Patient Safety and Quality Assurance to consider measures to create an impetus for change in the form of a framework of incentives and sanctions. The work of the Commission will be finalised mid 2008 and I will examine their recommendations at that time.