That the Joint Committee on Health and Children calls on the Minister for Health and Children to bring forward amendments to update sections 29, 30, 31, 39 and 52 and-or other relevant sections of the Health Act 1947 to take account of modern hospital-acquired infections, including MRSA; and the joint committee renews its call for the appointment of a national director of infection control, as agreed at the joint committee meeting of 5 October last.
I am delighted to move this motion. As Deputy Connolly pointed out, more than just MRSA is involved in this matter. It is shocking that in 2006, a person who goes to hospital with a minor ailment risks leaving with an acquired infection, or not leaving at all, due to the hospital's lack of hygiene and other issues rather than through any fault of his or her own.
There are 557 known cases of MRSA in hospitals, but I have examined the 2005 figures. I appreciate that some of the 572,000 inpatients in public hospitals were repeat customers, as it were, but we were officially told that the rate of MRSA incidence is 0.5%. Roughly calculated, that suggests more than 2,860 cases. These figures are open to debate, but the number of cases is under-reported. I cannot prove the exact figure but in light of how many inpatients are dealt with by the health system every year and the minimum percentage rate of MRSA incidence, the figure is higher than we know.
The most shocking aspect of the issue is that patients are not informed that they have the bug, be it clostridium difficile or MRSA. In many cases, their families find out later. Some people are lucky enough to have relatives in the health service who might by chance notice that vancomycin is on the patients' charts and who subsequently ask the health providers about the matter. Often, this is how patients find out that they have MRSA.
One in 20 patients has an infection as a consequence of his or her time in hospital. Of this total, 0.5% has an MRSA infection. This is the official figure, but I contend that it is actually higher. My colleague, Deputy Twomey, has referred to the need for a new hygiene audit to combat the MRSA problem, a matter on which I am sure he will speak later.
We must examine a number of issues. There is one nurse for every 12 patients whereas the recommended ratio is 1:4. In the public health system, there is one public health nurse for every 5,000 people in the community. When patients are discharged from hospitals, there is no back-up for them in their communities. MRSA affects everyone and is not just a hospital bug. For example, Deputy James Breen contracted MRSA in his doctor's surgery. It seems that acute hospitals, nursing homes and dischargees have no backup.
Given that there were 6,000 more beds in the public health system 26 years ago, our considerable bed occupancy levels pose a problem. Other countries have levels of 85% and have some hope of dealing with infectious diseases, but that is impossible in Irish hospitals. In 2003, the number of isolated beds in acute hospitals was 6%, but the recommended target is 50%.
Section 52 of the Health Act must be updated because it refers to the old health board system, which has been abolished and replaced by the Health Service Executive. I would prefer the situation outlined during the week, namely, a patient safety authority independent of the HSE taking cases against employees in some instances. Employees have a duty of care, but they also have the right to work in a safe environment. They should not be at risk of contracting MRSA while working.
The chosen sections relate to the general duty to take precautions against infecting others with diseases. One section's provision for a fine of £50 is clearly out of date. No employee has ever been fined for breaches of hygiene that could lead to a worsening of a patient's condition. Section 31 relates to the prevention of the spread of an infectious disease and section 39 refers to a health authority's burial of a person who died from an infectious disease.
Recently, the Dublin coroner had a few comments to make on this issue. He wanted MRSA to be cited on people's certificates of death. While it is important to note that patients do not necessarily die from MRSA, they certainly die with MRSA. Last month, the coroner, Dr. Brian Farrell, stated that cases must be reported if patients die from MRSA resulting from environmental factors in a hospital or cross-infection or if the death was unexpected or unexplained.
I hope my motion will be accepted. I realise that a great deal of work is involved, but it is important that the Department of Health and Children update the Act. At our last meeting, we agreed that a national director of infection control should be appointed, but unless the Act is updated, the director would have an impossible job.