Vol. 448 No. 2
7 Mr. Doherty asked the Minister for Health if he intends to introduce a code of practice in respect of medical nursing staff serving in hospitals or delivering services through the health boards who suffer from contagious diseases; and if he will make a statement on the matter. [1608/95]
20 Ms Keogh asked the Minister for Health, in view of the proposed policy of some health boards to introduce mandatory testing for the hepatitis B virus as a condition of employment for consultants and NCHDs, if he will direct that all health board areas adopt this policy for all hospital medical staff and patients in the interest of equity and conformity; and if he will make a statement on the matter. [1673/95]
40 Ms Keogh asked the Minister for Health, in view of the fact that, in reply to Parliamentary Questions Nos. 78, 79, 80 and 81 on 20 October 1994 regarding the compulsory immunisation against hepatitis B of health care staff who are in contact with blood, the Minister indicated that he would be consulting with the Medical Council on the matter, if he will make a statement on this consultation; and the policy he is adopting. [1672/95]
47 Mr. B. O'Keeffe asked the Minister for Health the plans, if any, he has to make it mandatory for health board managements to obtain appropriate written evidence that applicants for medical posts are not hepatitis B carriers. [1303/95]
74 Mr. Molloy asked the Minister for Health his views on the concerns of his predecessor at the recent Medical Council ruling that doctors can ethically opt out of treating patients with infectious diseases; and if he will make a statement on the matter. [1795/95]
(Limerick East): I propose to take Questions Nos. 7, 20, 40, 47 and 74 together.
I have set up an advisory group under the chairmanship of the chief medical officer of my Department to make recommendations regarding the prevention of the transmission of infectious diseases in health care settings. The screening of health care personnel for such diseases and the issues raised in the parliamentary questions of 20 October 1994 will be considered by the group. I have asked the group to consult relevant organisations including the Medical Council.
The membership of the group will include, inter alia, doctors from the health boards, the acute hospitals and the Department of Health. Following the replies to the parliamentary questions of 20 October 1994, it was decided to broaden consideration of the issues to the transmission of infectious diseases in health care settings.
In view of recent concerns about the possible transmission of infectious diseases in health care settings, I have asked the group to report to me as a matter of urgency.
Does the Minister accept that any guidelines or proposed code of practice would have to be standardised on a national basis rather than varying from health board to health board? Otherwise, it would be easy to evade detection. Also, does the Minister agree that there would be an equality of risk between patients and doctors? Does he not agree that in cases of major invasive surgery patients and doctors would have to be tested. However, it might be impractical to test all health care workers who have no direct contact with patients.
(Limerick East): As the Deputy suggested, a number of issues arise in this regard and that is why I need an advisory committee. It would not be helpful if individual health boards or agencies introduced individual guidelines. I requested my Department to write to health boards informing them that procedures introduced before the Department decides policy, arising from the advice of the advisory committee, can be introduced only on a voluntary basis and cannot be mandatory, statutory or compulsory.
There is an equality of risk in the context of certain health care facilities. To put it bluntly, there is probably as big a risk of a doctor being infected by a patient as there is of a patient being infected by a doctor. Because normally doctors are healthy and patients are ill, the risk of infection of a doctor by a patient is much greater than the other way round. That is dealt with in the code of ethics of the medical profession. I understand a doctor may object to treating a patient, but the profession outlined that a colleague will carry out the necessary treatment. I am not responsible for answering questions on medical ethics, but I hope what I said is a fair summary of the position of the Medical profession.
