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Dáil Éireann díospóireacht -
Wednesday, 13 Dec 2006

Vol. 629 No. 4

Leaders’ Questions.

Over the past months, Opposition parties warned the Government of the danger of innocent people being gunned down on the streets because of the increase in internal gangland warfare, principally over drugs and money. This has now happened, unfortunately, in a number of tragic cases from Donna Cleary to Anthony Campbell and Alan Cunniffe, with another death in County Louth occurring this morning, apparently linked to a spate of car hijackings.

The Government was warned by the Opposition parties that it was not doing enough to meet this scourge head-on when there is evidence of people driving on the M50 with flak jackets firing machine guns across lanes, innocent people being gunned down and people being assassinated in broad daylight. It is time for the Government to get serious about this extremely serious problem.

The Taoiseach consistently told us he received security briefings in recent months and pointed out that Mr. Hyland's name came up in all of them. If that is the case, and the Taoiseach has been briefed about this, why did the Government not grant sufficient resources or imprimatur to the gardaí and the CAB to place these people under surveillance? Why was the CAB not in a position to follow the money trail to its conclusion? How can shipments of drugs be ordered by mobile phone from prison? Why, after ten years of knowledge of the activities of the assassinated Mr. Hyland, were he and his fellow drugs barons not put out of business when children lie orphaned as a consequence of their actions?

In the Taoiseach's briefings, was he given information by the gardaí or the Army that Mr. Hyland, the assassinated drug baron, was directly involved in the recent murder of the Latvian woman, Baiba Saulite, who left two young children behind? Did the briefing include evidence this person was directly linked to that murder?

Again, I sympathise with the families of all of those killed in recent times, in Kilkenny last week, Dublin yesterday and as a result of the overnight gang activity on the Border.

In reply to Deputy Kenny, the Government has at all times given the gardaí full resources and statutory powers to deal with this issue, particularly the gang warfare that has been going on since the summer of 2005. Most of the 23 who have died this year and the 21 who died last year were victims of gun crimes directly related to a web of gangs that operate in the city and county and some of the surrounding counties.

Just over a year ago, based on intelligence, the Garda told the Government it was setting up Operation Anvil. The Garda Commissioner augmented the organised crime unit, the National Bureau of Criminal Investigation, with an additional 55 gardaí to address the problem of criminal gang activity. Enforcement by the unit has resulted in firearms being seized and people being arrested, disrupting their criminal activity. There has also been an increase in Garda monitoring and targeting of individuals and groups involved in armed crime. We have also strengthened our legislation, with ten year sentences for people caught in possession of a moderate amount of drugs at today's going rates. The gardaí have operated these systems.

Deputy Kenny will appreciate that I cannot give a full account of security briefings but the nucleus is that the gangs are operating against each other in severe conflict and most of the issues I have mentioned are related to that fact.

To deal with that, the gardaí had quietly and effectively established Operation Oak, named after the location where these gangs operate — people in the district would know from where the name comes. Arising from that, the gardaí have achieved 40 arrests. The operation was based around the late Martin Hyland and, as a result, many criminal elements were arrested and there were more than 20 large seizures of guns and drugs. The gardaí and the Department of Justice, Equality and Law Reform gave the figures yesterday — they recovered 30 kg of heroin, 35 kg of cocaine, 1,500 kg of cannabis, stolen vehicles, handguns, AK-47s, sawn-off shotguns, rifles, ammunition and cash as a result of that operation.

Some of the work in that operation led to reports in the national press about the attempted kidnapping of a person and further seizures of drugs on a farm in Meath. All these operations centred on that. The Garda found that because it had closed in on this gang, death threats were being made against Martin Hyland. Even though the Garda was closely watching him, it had to inform him he was being threatened in the interest of natural justice. The Garda knew some of the people threatening him because of its own successful operation when one examines the full briefing of the force's break up of this gang. However, that creates its own problems and difficulties relating to the gang. The Garda has appointed its top assistant commissioner, who has been very effective on gangland crime, to take charge of this. The Tánaiste told the gardaí more than 18 months ago that resources are not an issue, but significant resources are taken up, including the use of the best detectives in the force. They have to provide 24-hour cover.

The obvious question is if so many gardaí were watching Martin Hyland, how did others get him but he was moving around because he knew he was a target. When one looks at the security briefing, it highlights a sophisticated web of activity involving a number of gangs who cross each other. The Garda is doing its utmost within the powers of the law and in the context of human rights.

Gardaí know the key players but it must play by the legal system. Martin Hyland was known for a long time but he was good at dodging Garda surveillance.

No human rights were extended to Anthony Campbell yesterday, unfortunately. The public perception of the way the Government parties have acted on this issue is that they have either lost the bottle to do the business or they are not giving this sophisticated unit of the Garda sufficient impetus to do its job. Nobody can understand after ten years the failure to put away this drug baron, who was assassinated, and others. The former Minister for Justice, Equality and Law Reform, Deputy O'Donoghue, as an advocate of zero tolerance, would have been completely apoplectic about a hell of a lot less than this. However, fewer of these crimes are being detected and no drug baron has been put behind bars over the past five years. If Government members know who these people are on the basis of the briefings they are given, why is it not possible for the security forces of this country to have Government backing to implement its primary responsibility to keep our citizens safe? Innocent people are being mown down as a result of internal gangland feuds involving drugs and greed. The Government's operations are not working. What new measures does the Taoiseach intend to take to ensure they work?

The question I asked earlier related to Baiba Saulite. Did the information given to the Taoiseach in briefings indicate whether Mr. "Marlo" Hyland was directly involved in her murder? It has been brought to my attention that the late Mr. Hyland was paying serious protection money to the Provisional IRA because of internal gangland feuds. Can the Taoiseach confirm, on the basis of evidence given to him through briefings by Army or Garda personnel, that the Provisional IRA was involved in the murder of Mr. Hyland or was associated with him in that respect? According to the terms of the Good Friday Agreement, that outfit is supposed to be extinct and not involved in further criminality. Do the Taoiseach's briefings extend to information that the Provisional IRA was in receipt of protection money from the late Mr. Hyland and may have been involved in his murder?

In fairness to the Garda, the Government and the House have done their job in legislative terms. The Garda has been told by the Tánaiste over the past 18 months that there is no difficulty or question about resources.

That is untrue.

The Government has not provided resources.

Allow the Taoiseach to speak without interruption.

The Garda has confirmed that is the case.

The figures are there.

That is rubbish. That is not true. That is not what the Garda is saying.

Deputy Durkan should note it is his leader's question. He is entitled to hear the answer and he should afford him the courtesy of hearing the answer.

This is a fiction.

The Taoiseach, without interruption, please.

We want an answer, not bluster.

The Garda Commissioner has confirmed that is the case.

What else would he say?

There is no doubt that, as a result of the Garda operation, the net was tightening around Martin Hyland and he was losing his grip on his criminal activities. A total of 43 of his associates have been arrested. It is not true for Deputy Kenny to say the Garda has not been successful.

There was no conviction in five years.

That is also untrue.

That is a fact.

Two dozen of them have been charged. The Deputy should not come into the House without the facts. A total of 43 have been arrested and 24 have been charged with serious offences within a year.

What about convictions?

Based on intelligence and criminal operations, €23 million worth of drugs and property have been confiscated.

With regard to the Latvian woman in Swords, I have no evidence of that. All I have heard is rumours but it is well known that the gun operation in Dublin and beyond was closely associated with Martin Hyland. The Deputy can work out the rest.

I have seen nothing that implicates anyone in the Provisional IRA. Deputy Kenny will be aware that the name, Operation Oak, is based on a location in my constituency. The recent abduction took place close to where I am. A significant former paramilitary was in the company of Martin Hyland over the summer, but the person is not associated with the Provisional IRA nor has he been.

Gun rules okay.

The Deputy should be serious about this.

I ask Deputy Durkan to allow Deputy Rabbitte to proceed without interruption.

Last week the Minister of State at the Department of Health and Children put through the Health (Nursing Homes) (Amendment) Bill 2006, which permits nursing homes to cause clients to sell their family home. He said he had no flexibility on this and he was doing so on the instruction of the Cabinet and on the advice of the Attorney General. There is now statutory underpinning to force the sale of the family home if one's parent is in a nursing home. Yesterday, the Minister for Health and Children announced a new scheme, which provides for a charge to be levied against the family home. It is not clear whether the senior and junior Ministers are ad idem on this or whether the junior Minister was being hanged out to dry or where we stand, but there is no clarity about it.

The scheme the Minister announced contains a number of fundamental changes. For example, nobody can be referred to a nursing home unless he or she has been medically assessed. In the normal course of events, having been medically assessed, one can be referred to an acute hospital or a nursing home. If one is referred to an acute hospital, there is no facility to compel the sale of the family home or to make a charge against it, but there is if one is referred to a nursing home. Why is the family home only included for the purposes of the means test because a person is old? Will the Taoiseach explain to the House why such a distinction is made between one type of medical institution and another? One may not enter a nursing home until one has been medically assessed, so what happens to the rest of our older people? Are they left alone to bear the entire cost of private residential care or will the Taoiseach tell me they will be eligible for home care packages? What home care packages will these people be eligible for and where are they?

In terms of the charge that can be levied, where does the carer left in the family home stand while the person being cared for is in a nursing home? What is to stop people transferring assets when so advised? Why should a person, because he or she is old, live in fear of remortgaging or selling his or her house? Why did the Government enact a law last week permitting the sale of the family home if it is not the intention to resort to that law at some stage? Some of the Taoiseach's backbenchers do not have time to follow every piece of legislation that passes through the House and the legacy being left by the Progressive Democrats is only beginning to dawn on them. The Taoiseach should now perform the sort of U-turn he has done on a number of issues recently, before old people are caused greater anxiety by the situation the Government has created.

I do not need to debate last week's legislation but the arrangements enacted in this case to support nursing home residents have been in place since 1993. Deputy Rabbitte's colleagues pointed out at the time the legislation was going through that it was deeply unfair. People with the same means and care needs can face greatly different costs in public and private homes and the Government decided a new, fairer deal should be created. It will take a year for this initiative to put that in place but the Minister for Health and Children, Deputy Harney, outlined the scheme on Monday.

In accordance with Towards 2016, the plan will ensure the same level of support for public and private nursing home residents and will involve co-payments between care recipients and the State. It will ensure that care is affordable for all, which is not the case at present as some people are forced to remortgage and sell their homes.

(Interruptions).

The Taoiseach will be putting sons and daughters out on the street.

I ask Deputies to be silent and allow the Taoiseach to speak. Deputy Rabbitte was entitled to two minutes speaking time and had four and a half minutes to submit his question. The Taoiseach is entitled to be heard in silence.

I was asked approximately 20 questions. I merely mentioned that Deputy Howlin, as Minister, introduced this scheme and sought to point out its unfair elements.

Who was Minister for Finance at that time?

I ask Deputy Stagg to be silent.

This plan will ensure that care is affordable for all and that nobody will be forced to sell or remortgage his or her home to pay for care, which is not the case at present. A major change is that, in future, when a person makes his or her contribution the State will meet the balance of costs and take the risks associated with price increases. The scheme will be transparent with the same standardised means of assessment of need and individual contributions will be based on income and assets. The individual will be expected to contribute 80% of disposable income at the time of receipt of care. Most old people have modest incomes and the average income of a person over 65 years of age in 2006 has been calculated to be €234 per week.

Deputy Rabbitte said this will apply only to old people going to nursing homes but, at present, it does not relate to age and would be the same for a person below 65 years of age. A deferred charge of up to 5% of residential costs will apply. At present, many people applying for subvention must produce 5% of the value of their houses in cash for an indefinite period of care. This is very unfair, causes great distress and makes it an almost impossible target for people to meet.

Perhaps the Taoiseach could take the roofs from their houses.

Under the new system no cash based on a house's value will be required in the lifetime of the individual. The charge will be limited and will be deferred until a settlement is reached regarding an estate.

What about sons and daughters in the house?

Deputy Wall should be aware that this is Leaders' Questions.

If a member of the family lives in the house, payment can be deferred.

That is not what the Minister for Health and Children, Deputy Harney, said.

(Interruptions).

Deputy Stagg may not answer on behalf of the Taoiseach and he is not the leader of the Labour Party. I fail to understand why he is interrupting proceedings to this extent.

The Taoiseach is not answering the questions very well.

Despite the interruptions I am trying to answer Deputy Rabbitte's questions. Nursing homes will be approved based on quality and price and a medical assessment will apply, the operation of which the Minister for Health and Children, Deputy Harney, has outlined.

Regarding quality standards, the homes must be registered and satisfy inspections carried out as we have had a number of debates in this House during this session on the importance of assessment and inspections.

A new residential care unit within the National Treatment Purchase Fund will be established and will negotiate fixed prices with private nursing homes bringing stability in the area. Legislation will be required on this next year and Members will have plenty of time to give their points of view.

The Taoiseach should try to get through the election first.

The Minister for Health and Children, Deputy Harney, said recently that there will be a consultation process. Importantly, the basic rate of subvention for 2007 will be increased to €300 per week, which will cost an extra €85 million overall.

Deputy Rabbitte asked where the home care packages are and we have announced residential care funding of more than €400 million for day care and home care packages for this year and next year.

It is not true to say that this applies to this year.

We are putting a great deal of resources into that scheme. Last week's budget included 2,000 home care packages and the full year cost of this is €55 million. An additional 780 hours of home care services at a cost of €18 million has been provided for and many additional people will work under these home care packages.

A Deputy

Where is the money going?

The tax inspectors will be going to funerals.

A Deputy

Deputy Ring will be there before them.

They will never get to as many as Deputy Ring does.

Deputy Rabbitte asked how many additional people will be employed in services for the elderly next year and this figure will be just short of 1,000. There will be €120 million for services for old people and a further €50 million the following year, giving a total cost of €170 million. I can see nobody on the Opposition bench is interested in what we do for the elderly.

This is all smoke and mirrors to get the Taoiseach through the election.

I have called the leader of the Labour Party and Deputy O'Keeffe might allow him put a question.

The Taoiseach says it is wrong that, at present, people may be forced to remortgage or sell the family home. That is exactly what the Government is providing for with the action it has taken. If the Taoiseach wants to say it went through the Fianna Fáil Parliamentary Party and that Members were fully aware of what they were doing, so be it.

The Progressive Democrats won.

The situation is clear in terms of the price that will now be paid for the scheme, so I will only summarise it. With regard to the Taoiseach's remark about the regulations introduced by Deputy Howlin when he was a Minister in 1993 in the aftermath of the gutting of the health services by the outgoing Fianna Fáil-Progressive Democrats Government, the regulations introduced were consistent with the amount of money provided by the then Minister for Finance. The Minister for Finance at that time was the current Taoiseach, Deputy Bertie Ahern.

The Labour Party must have been following the new agenda.

The Government gave us the new agenda last week.

It introduced a death tax.

Deputy Rabbitte without interruption.

Deputy Rabbitte was still on the old agenda.

Members on the Government side should allow Deputy Rabbitte to speak without interruption.

That was a rabbit punch.

Age Action Ireland states:

Older people, many of whom have paid their taxes for 40 years, did so in the belief they had a social contract with the State which included provision for their basic health needs. That contract cannot now be torn up. In many cases, older people have spent their entire savings to pay their nursing home bills and their home is their last asset.

Age Action Ireland believes that people of all ages should be treated equally by the State when it comes to health care. If a person in their 30s or 40s were to become seriously ill, leaving them in need of nursing home care for the rest of their lives, the State would not force them to sell the family home. Neither should older people in need of nursing home care.

The Labour Party concurs with Age Action Ireland. People should not be forced to remortgage or sell the family home, yet that is what the Government is doing to sons and daughters in many cases, with the result that older people are being caused needless anxiety and distress.

Deputy Rabbitte is causing anxiety by misrepresenting the issue.

It is another of Deputy Rabbitte's famous letters.

The Minister of State should read the legislation.

There is not yet any legislation.

The House will have plenty of time to debate the details but what is wrong with the current system, according to the detailed document which the Minister of Health and Children published the other day, is that although only 4.6% of people over the age of 65 are in nursing homes, a sizeable number of those have had to use their entire savings and assets, including a property, to access comparatively low levels of accommodation.

They will still have to spend their entire savings.

They were subjected to the full force of the law last week.

Let the Taoiseach answer.

Why did the Government introduce it?

They will have to remortgage their houses.

Allow the Taoiseach to continue without interruption.

Why, when I try to reply to Deputy Rabbitte, does the rest of his party make noise? I just want to explain to Deputy Rabbitte, who asked a good question, that it is fundamentally unfair to force a person to use his or her savings and income and I think the Deputy would agree. We are trying to design a system for the future that will make sure there are equal——

It is equally unfair to everybody now.

Everybody's house will be at risk.

I ask Deputies to listen.

It is hard to listen to the Taoiseach.

People will be treated equally——

That is what is wrong.

——in all ways and while a person would make a contribution to a capped amount, it could not be taken during his or her lifetime. We could debate that point but the basis of what we are doing is to end the situation in which an old person in one part of the country is treated fundamentally differently from someone in another part of the country on the same income and in the same circumstances.

They will share the misery.

That is what we are trying to do. If we have not got every little bit of it right, we have plenty of time to legislate.

The Government made it law last week.

We are trying to bring prices——

Old people are being directed to private nursing homes.

It was made law last week.

Deputy Stagg could learn if he listened. We are trying to work on a number of fronts to provide better regulated and inspected accommodation and to find better home care packages, more home care hours and better facilities for the elderly. We are going to spend €1 billion on that, while at the same time providing a system in which people can have certainty. We will have a legislative opportunity during 2007 to deal with the issue but it is fundamentally unfair now and we are doing our best and damnedest to make it fair for the future.

(Interruptions).

Is that not a good idea?

The Government continues to discriminate against older people.

What are the Labour Party's policies?

The Government is ageist.

It is a whitewash.

I call Deputy Ó Caoláin.

I see the Government's need to get through the election.

Leaders' Questions are confined to the three leaders in Opposition. There is no provision for backbenchers from either side of the House to continue to interrupt.

There are about six interrupters opposite.

Deputy Ó Caoláin without interruption.

This is the time of year when many people, older people in particular, face the worry and distress of illness and hospitalisation. Is the Taoiseach aware that the fears of many of these older citizens are compounded by the further fear of acquiring hospital based infections such as MRSA? Is he aware of the concerns that exist in all communities? Last month, I raised this issue on Leaders' Questions and I make no apology for doing so again on this, the last opportunity for Leaders' Questions.

We have one of the worst rates of hospital acquired infections, especially with regard to MRSA, in Europe. I ask the Taoiseach to listen to the following statement:

I would be afraid if I had to go in for an operation now, I would think twice about it. I'd be very afraid, not on account of the competence of the doctors and the nurses, but on account of the structure they have to work under.

These are the words of a missionary priest, Fr. Brendan Forde, speaking after the funeral of his sister, Barbara, who died in Beaumont Hospital after acquiring MRSA from a routine operation. Fr. Forde continued: "She went in for an ordinary operation and she came out dead from a hospital-acquired infection, which we were told was MRSA".

Where is the Government's urgency in response to this glaring need in the hospital network? Where is the special allocation of funding for the promised additional isolation units or to ensure single units in intensive care wards? These are real needs and, since I last raised the issue of MRSA, the Cork City Coroner has followed the lead of the Dublin City Coroner by requiring all deaths attributable to MRSA to be reported to him. His decision followed a landmark inquest finding, in which it was determined that a 74 year-old man died as a result of MRSA acquired at Cork University Hospital. Will the Government now do as I urged one month ago by making it mandatory to report MRSA or other hospital acquired infections as part of the process of reporting deaths to coroners? Will the Taoiseach explain why more people are noting, as the campaigning group MRSA and Families has said, that there is a wall of silence in respect of this entire issue throughout the health services and the political establishment? What will the Taoiseach do to address this very pressing and worrying matter?

I am aware that this problem has arisen at this time of the year, in particular, over recent years. This important issue has to be considered in this country and other countries. I do not think there is a wall of silence in this regard. At this time of year, representatives of hospitals in various parts of the country often issue statements to the national and local media, explaining that they have had to close sections of hospitals such as units and wards as a result of MRSA.

The prevention and control of infections which are associated with health care is a broader issue. The Department of Health and Children has ensured in recent years that this important issue is a priority for the Health Service Executive, which has published detailed guidelines on hygiene, including hand hygiene. The guidelines, which set out ways of controlling MRSA in hospital and community settings, have been well-publicised over the past two years. Anyone who has visited a hospital recently will be aware that hygiene has been stepped up throughout the health system.

The HSE has recruited essential infection control staff who are dedicated to dealing with MRSA. One could say that such staff should always have been in place, but it was deemed necessary to bring them in at a certain time, based on what was being done in countries in northern Europe, which have a better record on hospital diseases than countries in southern and western Europe.

The HSE will soon publish a three-year action plan, which will set targets for the next three years. The targets, which will be based on the HSE guidelines, will represent an attempt to reduce the level of infection in Ireland to a level that is akin to the levels found in northern Europe, where the best record in this regard is found. The recommendations on hospital hygiene standards which were included in the strategy for the control of antimicrobial resistance in Ireland, which was launched five years ago, are being implemented. The recommendations relate to the appropriate prescribing of antibiotics, active surveillance, the detection of MRSA and clinical governance structures in the area of infection control. Those who brief Deputy Ó Caoláin on these matters have probably told him that many of these problems result from the prescription and over-prescription of antibiotic drugs. I do not declare myself to be an expert on these matters. This issue has been in our system for a long time.

Two hygiene audits have been carried out to date in acute hospitals under the auspices of the National Hospitals Office. Earlier this year, in the spring or early summer, we participated in the Hospital Infection Society's survey on infections which are associated with health care in the UK and Ireland. Some 75,000 patients were surveyed in the study. It was recorded that approximately 10% of patients in the Republic who had infections which are associated with health care had an MRSA-related infection. While there is no doubt that figure of 10% is very high, the figure is higher in other countries. The survey in question found that the relevant figure in the UK is16%. The figure is far lower in northern European countries, however. We have to deal with all the issues in the reports, including the guidelines, the infections which are associated with health care, the ongoing campaign on hygiene standards, the recommendations which have been given to hospitals, the prescription of certain drugs, the surveillance of MRSA and the clinical governance structures.

Area infection controls were mentioned by Deputy Ó Caoláin in the context of providing more clean areas, such as isolation units, for people. All of these recommendations are in the process of being implemented, if they have not already been implemented. The HSE's next step will be to benchmark its guidelines against the actions which have been taken. It will try to reduce the figure I mentioned over the next three years. That will be the next step in the programme.

The wall of silence is real. Relatives are not being told — that is a fact. The last time I raised this matter with the Taoiseach, I mentioned the position in the Netherlands. The Taoiseach responded by saying that the Government would not go down that road. It is clear that one of the stark and critical differences between the system in the Netherlands and the system here is that there are more single rooms in hospitals in the Netherlands. Patients in that country do not have to tolerate this country's extent of overcrowding in absolutely inappropriate situations which leave people vulnerable to getting hospital-acquired infections, particularly MRSA.

I wish to quote Fr. Brendan Forde again:

You get great tax breaks if you build luxury hotels for the super-rich but they are incapable of building in our hospitals some individual units for the most vulnerable people, those who are in intensive care, and they will put them into a ward where there are hospital-acquired infections.

I referred to the death of Fr. Brendan's sister, Barbara. I extend my sympathy and, I am sure, the sympathy of the House to him and his family on their tragic loss. Many countless hundreds of lives have been lost in such a tragic manner as a result of this serious problem. Cleanliness is hugely important and hygiene is critical. What steps will the Taoiseach take to ensure we have single-room isolation units? We need to have the space to deal with people who are vulnerable to infection. When people are recovering after operations and other procedures, etc, they should not have to cope as part of a lumpen mass of patients.

I ask the Taoiseach to take the required steps to help to stamp out this scourge for once and for all. Nothing in what the Minister announced last week will give any hope to families who are faced this winter with loved ones who are afraid to go to our hospitals. It is time for action on this matter.

There are people in isolation units, such as intensive care facilities, in every one of our acute hospitals. I refer to people who have had operations in recent days, having suffered from various ailments. That is a fact. Deputy Ó Caoláin asked about isolation units and said we should have such good facilities for people with serious ailments who might be at risk of getting or spreading infections. It is obvious that hospitals should be dealing with this issue. It is good to have isolation facilities. Most of our new developments have more intensive care and high-dependency beds. The Deputy asked whether there should be more facilities of that nature. I do not disagree with his suggestion.

There are no beds. People are on trolleys rather than beds.

The issue of infections which are associated with health care is an important one. Deputy Ó Caoláin's point relates to whether we can feel comfortable about the fact that people are going into hospital with certain ailments and then picking up separate infections in hospital. Nobody can defend that. The Deputy asked me a fair question about what the HSE is doing about this problem. I have said that the HSE will soon publish an action plan that will set targets on the basis of its guidelines for the control of MRSA in hospital and community settings.

Professor Drumm and his colleagues on the health committee have emphasised that issues like basic cleanliness, hygiene standards, the appropriate prescription of antibiotic drugs, active surveillance for the detection of MRSA, clinical governance structures and infection control standards are hugely important. Nothing is more important to a hospital than trying to ensure there is no bacterial spreading or any other kind of spreading in the broad area of infections which are associated with health care. This area is broader than just MRSA — there are many other infections. There are wider issues like the strategy for the control of antimicrobial resistance in Ireland.

I am aware from listening to the senior members in the Department of Health and Children and the Health Service Executive that they are acutely conscious of that aspect. As we continue to put in the enormous amounts of resources we have been putting in for a number of years to the health capital programme, we must ensure that national hygiene standards as shown in national hygiene audits continue to improve.

These are important issues. I am not an expert in this area but it always amazed me, from my own days long ago when I worked in the Mater and the good Sisters of Mercy had control over it, that it would be easier to get into Fort Knox than into the hospital, with the exception of strict visiting hours. We do not appear to have the same issues around that 30 years on. It always puzzles me that large numbers of people go in for a long number of days. I would have thought that is an issue. I have raised that at other times as well but hygiene standards are vitally important and I do not disagree with the Deputy's urging to try to improve the situation.

That concludes Leaders' Questions. I appeal to leaders, when we start the next term, to examine the way Leaders' Questions go over time. We are half an hour over time this morning and I ask the leaders to make some effort to stay within the time. The interruptions prolong Leaders' Questions. It is the same five or six Members who come in every day and disrupt Leaders' Questions.

I am sorry about that.

The Chair will be left with no option but to deal with those Members because it is causing a serious problem. Yesterday, there was no facility for backbenchers to ask a question on the Order of Business because Leaders' Questions went on too long.

You got out of that nicely.

I appeal to leaders to stay within the times allotted in the next term and to the Members who continuously interrupt to desist from interrupting.

I do not want to be disruptive, a Cheann Comhairle, but——

I will not hear you, Deputy.

When will you hear me, a Cheann Comhairle?

The Chair did not name any Deputy but it is interesting that you want to get up to defend——

You were looking at me accusingly.

I have to look at somebody, Deputy. We are moving on to Taoiseach's questions.

Not getting answers to questions creates many problems.

A Cheann Comhairle, we should make priority time for interrupters — perhaps an hour at night.

We should make time for answering questions as well. That would be a big help. There would not be any interruptions then.

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