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Dáil Éireann díospóireacht -
Thursday, 9 May 1996

Vol. 465 No. 2

Adjournment Debate. - Discovery of Organisms in Bone Marrow Transplant Unit.

Today's media reports on the discovery of a penicillin resistant bacteria in the new bone marrow transplant unit in St. James's Hospital raise a number of serious questions. Why was this information covered up since 29 March? In the public interest, it should have been disclosed. How did the bacteria get into the water system of a new isolation building at St. James's Hospital? Were patients in the unit made ill before it was discovered? Have all patients who were in the unit been notified? Was that done prior to the publication of the story this morning and were staff informed?

It appears the existence of this bacteria was a closely guarded secret at the hospital. It also appears that most staff and patients at St. James's were not informed of its existence. If that is the case, the hospital, the Eastern Health Board and the Minister for Health acted irresponsibly. Patients and staff should have been given full information.

Patients in the unit are at serious risk of infection because their immune systems have been suppressed to prevent the rejection of bone marrow transplants. It is incomprehensible that such a bacteria could have existed in the water supply of an isolation unit in a hospital. For it to be discovered in an isolation unit for bone marrow transplant patients makes it all the more grave.

I question the statement issued late last night by the Department of Health claiming that the bacteria is innocuous. As it is penicillin resistant the Minister knows it can have serious consequences. If it is innocuous why is the hospital afraid to use the water in the unit? Why are patients, who are supposed to shower twice a day and who are cut off from the rest of the world in a sterile environment for up to three weeks, forced to use water from outside the unit? Why have all kinds of anti-infection procedures been introduced? Will the Minister also clarify if the number of patients taken into the isolation building has reduced significantly since the discovery of the bacteria?

The bacteria discovered normally exists in decaying organic matter. This implies there is something dead or decaying in the water system of the new unit, which cost £1.5 million to install and was opened today by the Minister for Health. One would not expect such infection to creep into a new building. Will the Minister outline the examinations that took place on the building prior to the admission of patients? Was outside assistance recruited to deal with the infection?

This episode raises more questions about the absence of a system of co-ordinated audits for hospitals and health agencies. This matter arose, first, in regard to the Blood Transfusion Service Board which breached its standards by knowingly using the blood of a woman with infectious hepatitis. There were not any checks and balances in place to prevent or detect that. Questions about the absence of audits also arose in a recent case where doses of chemotherapy were administered to a cancer patient. There does not appear to be an independent system of auditing standards and practices in hospitals generally. Such a system must be set up urgently so that hospitals, health agencies and so on can be monitored in a proper fashion.

I want the Minister to outline the circumstances surrounding the infection of the water system in the isolation unit at St. James's Hospital and to allay public concern about it.

I welcome this opportunity on behalf of the Minister for Health to reassure the public on this matter.

The Minister has received a full report from St. James's Hospital regarding the presence of pseudomonas organisms which had been detected in the water supply at the bone marrow transplant unit. The organisms in question are commonplace. For this reason, quality assurance inspection control procedures are in place in hospitals as a matter of routine. This means that samples of water are regularly tested for organisms such as pseudomonas.

On this occasion, the presence of pseudomonas was identified through this quality assurance system and not as a result of clinical infection in any individual. In fact, no clinical illness related to pseudomonas has been identified in the unit.

From the medical advice he has received, the Minister is satisfied the organisms in question are not a frequent cause of illness. Their existence in the water system was identified prior to today's official opening of the new unit and the clinical decision to open the unit was taken in the knowledge of the existence of those bacteria and because it is believed the risks posed to patients undergoing bone marrow transplant is minimal in such circumstances. The benefits of bone marrow transplantation for patients with leukaemia far exceed the potential minimal risk of infection posed by such commonplace organisms.

I am glad to be able to reassure the House and the members of the public as to the thoroughness of the quality control procedures in place at St. James's Hospital and which led to the detection of the organism in question. Patients and their families can have full confidence in the safety arrangements and precautions in the new transplant unit at St. James's Hospital.

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