Dáil Éireann díospóireacht -
Wednesday, 4 Dec 1996

Vol. 472 No. 4

Adjournment Debate. - Hospital Alert.

Mrs. Geoghegan-Quinn

Tá mé fíor bhuíoch as ucht an deis a thug tú dom an cheist thábhachtach seo a ardú ar an Athló tráthnóna.

It gives me an opportunity to allow the Minister of State, on behalf of the Minister, to give a full explanation for the delay in implementing a report on the testing of doctors for infectious diseases. Last week's episode at the Mater Hospital might not have happened if some of the recommendations in the report had been implemented. The Minister must accept responsibility for his failure to attend to this matter in the 14 months since the report was completed.

Last week's alert at the Mater Hospital and the Blackrock Clinic was most disturbing and a matter of major public concern to the 400 plus cardiac surgery patients who were involved. The alert arose after a doctor who had operated on the patients or assisted at the operations later tested positive for hepatitis B. This is the second such scare in recent times in the Republic. The last one, two years ago, followed the jailing in Britain of an Indian doctor who had worked at several Irish hospitals and who had continued to carry out surgery in the UK when he knew he was carrying the hepatitis B virus.

Following that revelation the Minister for Health established an advisory committee in February 1995 to report on the transmission of infectious diseases. That committee reported in September 1995 but its report has never been published and its recommendations have not been implemented. I want the Minister to explain why he has taken no action on that report which deals with testing doctors for hepatitis B and other infectious diseases. In sitting on the report the Minister has been grossly negligent on an issue of major public importance.

Given the ongoing hepatitis C controversy, the Minister could not but be aware that action on this report was still outstanding. The hepatitis C controversy must also have underlined for him the seriousness of the issues involved with the transmission of infectious diseases in a health care setting. While I accept that the issues involved are complex and that there is a necessity for consultation with the various groups involved, one would expect that after a year some headway would have been made. This is not the case and the Minister appears to be deliberately putting the report on the long finger so that he can avoid taking decisions.

Mr. Currie

I thank Deputy Geoghegan-Quinn for raising this issue and giving me an opportunity to deal with it. On 21 November the Mater Hospital informed the Department of Health that a registrar in the cardio-thoracic service had tested positive for hepatitis B. As a precautionary measure the hospital, with the involvement of the public health department of the Eastern Health Board, implemented a "look-back" screening programme for the limited number of cardiac patients whose procedures this doctor attended since last February when the doctor concerned began working in the hospital.

Prior to taking up this position at the Mater, the doctor had some involvement in procedures in the Blackrock Clinic and the Mater Hospital is also co-ordinating the screening programme for this hospital. Following compilation of a list of all patients, information packs and letters of notification were sent to all referring GPs throughout the country asking them to contact their respective patients and outline the details of the screening programme. This programme involves blood testing and a follow-up counselling service. Some 444 letters were issued to the patients' GPs and to date some 70 people have been tested either through their GPs or in the Mater Hospital. Results are available for 30 patients, all of which are negative.

I assure members of the public who attended the hospital for any other type of operation or procedure that they have absolutely no cause for concern. Patients who have been contacted in relation to the screening programme are being asked to participate as a precaution only. The report of the infectious diseases advisory group raised many serious and complex issues in the whole area of infectious diseases. Some issues were specific to the nature of the hepatitis B virus while some concerned other infectious diseases. There was considerable clarity and agreement on the steps to be taken in regard to testing new employees likely to be employed in high risk clinical settings. There was less clarity on the approach to be taken in regard to existing employees. It, therefore, has taken some time to translate the recommendations of the advisory committee into clear guidance to be given to employing authorities. This process is now reaching completion and the Minister hopes to be in a position to issue the appropriate guidelines at an early date.