Written Answers. - Health Protection.
Denis Naughten
Ceist:
340
Mr. Naughten
asked the
Minister for Health and Children
his plans to establish a health protection agency similar to that in the UK; if a structured public health on-call system will help to address the current lack of preparation for a bio-terrorism attack or an infectious disease outbreak such as SARS; and if he will make a statement on the matter.
[12730/03]
I have no plans at present to establish a health protection agency. The National Disease Surveillance Centre, NDSC, in existence since 1998, is Ireland's leading specialist centre for the surveillance of infectious diseases. The aim of the NDSC is to improve the health of the population by the collation, interpretation and provision of the best possible information on infectious diseases. This is achieved through surveillance and independent advice, epidemiological investigation, research and training. The NDSC works in partnership with the health boards and with international organisations to ensure that up to date information is available to contribute to the effective control of infectious diseases.
In the wake of the events of 11 September 2001 in the USA, I established an expert committee under the chairmanship of Professor William Hall, director of the Virus Reference Laboratory, to develop a contingency plan which would be implemented in the unlikely event of a biological attack here. In preparing the plan it was necessary for the committee to identify the level of risk of such an attack. The committee considered that the secondary consequences of an attack in another country was the most likely threat.
On 17 October 2001, I launched a protocol for dealing with a suspected anthrax attack in Ireland. The protocol was prepared by the expert committee and deals with the procedures to be adopted in the event of a suspected anthrax attack including patient treatment and management, post exposure guidelines and so on. Included with the protocol are guidelines for individuals and companies on how to deal with a suspect package believed to contain anthrax. The document is available on my Department's web site: www.doh.ie.
A detailed protocol in relation to category A agents, including smallpox, botulism, plague and tularaemia entitled Biological Threats – A Health Response for Ireland was issued in May 2002 to all health board chief executive officers and directors of public health for circulation to all relevant personnel. The chief executive officers were requested to circulate the document to appropriate medical personnel and to ensure that each board's emergency plan was reviewed and updated to take account of the protocol. This document is available on my Department's website: www.doh.ie/pdfdocs/biothreat.pdf.
The National Disease Surveillance Centre issued a document entitled Biological Threat Agents – this document was aimed at informing all medical staff, but particularly GPs, in order to assist in the diagnosis of anthrax, plague, botulism and smallpox. This document was agreed by the expert committee and was circulated in May 2002.
It was agreed by the expert committee that a sub-group, representative of health boards, consultants in emergency medicine and infectious diseases, public health doctors as well as the NDSC, was required to examine operational issues arising from the document Biological Threats – A Health Response for Ireland. This sub-group was established in October 2002 and was requested to examine several key issues including the designation of hospitals for treatment of smallpox cases, development of protocols in relation to transport of patients, samples and so on. It has submitted a number of reports to the expert committee for consideration.
A high level containment facility has recently been constructed at the National Virus Reference Laboratory. The facility is designed to a BL3+ standard to allow for containment of a range of infectious agents including smallpox and to ensure increased safety. In addition, protective clothing for use by frontline staff in the event of an attack as well as specific equipment for use by the VRL have been secured. In the event of a biological threat occurring, the expert committee will provide advice on the management of the situation, including the issue of vaccine use, based on the specific circumstances prevailing at the time.
The National Virus Reference Laboratory provides a national diagnostic virology service for Ireland, employing a wide range of methodologies for the identification of viral infection in humans and the determination of anti-viral immune status. The VRL also provides information about viruses and the infections they cause in Ireland and throughout the world.
As the Deputy will be aware, I established an expert group in mid March 2003 to advise me on issues related to severe acute respiratory syndrome. The deliberations and recommendations of this expert group are based on a number of sound, well tried infectious disease surveillance, control and prevention principles which are internationally accepted and are exemplified in the guidance on this issue published by the WHO, the Centres for Disease Control and Prevention in the USA and a number of other reputable international public health institutes. Protocols and guidance for hospitals and health professionals which describe the syndrome and provide advice on how suspect cases should be managed have been developed. In addition, information for the public and health care workers as well as guidance for aircraft cabin and aircraft cleaning staff has also been provided.
This material is reviewed and updated by the expert group on an on-going basis and the most up to date information is available on my Department's website (www.doh.ie). A large amount of other relevant information in relation to SARS has also been placed on my Department's website including a Frequently Asked Questions document which should help to inform the public and to address public concerns.
The public health review, also known as the Brennan review, commenced in 1999 and was charged with reviewing the operations of public health departments and community public health medical services of the health boards in the context of the 1994 memorandum of agreement between my Department and the Irish Medical Organisation and to consider future developments for this service. The group comprised representatives of my Department, the health boards and the IMO. It published its report in April 2002.
There was agreement on many of the matters considered by the group, including the need for a formally structured out-of-hours arrangement. The issues central to the public health doctors' dispute have been the subject of negotiations between the Irish Medical Organisation and management, comprising officials from the Health Service Employers' Agency, HSEA, my Department and the health boards over the past 12 months, initially through joint discussions and in more recent times under the aegis of the Labour Relations Commission. Since the commencement of strike action by the IMO, efforts have been made at the highest level to reach a satisfactory conclusion. In this regard, management has made a substantial offer to the IMO.
I have already acknowledged on a number of occasions that the professional input made by public health doctors to the management of infectious diseases and other public health threats is significant. I have also made clear my belief that the response of the health system is significantly hampered by the absence of that input. I, and my Department, have done and are doing all in our power to facilitate the resumption of negotiations on outstanding issues. I again take the opportunity to appeal to the IMO to call off their industrial action and, in accordance with the terms of Sustaining Progress, to participate meaningfully in negotiations under the recognised industrial relations machinery, with a view to having outstanding issues resolved as speedily as possible.
