I propose to take Questions Nos. 522 to 529, inclusive, together.
Multidrug-resistant infections and resistance to antibiotics are an ongoing and evolving international risk for all healthcare providers. I can assure the Deputy that the prevention and control of healthcare associated infections and antimicrobial resistance is a significant patient safety and public health priority for the Government.
I am advised that Irish hospitals, like other hospitals internationally, are taking steps to reduce healthcare associated infections and antimicrobial resistance including the prudent use of antibiotics. I am aware of the challenges in relation to tackling multidrug-resistant superbug infection rates in all hospitals including at University Hospital Limerick (UHL). UHL has confirmed that a focused Quality Improvement Plan is in place to tackle the issues of control of healthcare associated infections and antimicrobial resistance, commonly known as HCAIs and AMR. This is in line with the recommendations of the HIQA unannounced inspection reports at the Hospital on 28 November 2014 and 13 January 2015.
This includes:
- An intensive screening programme for the detection of Carbapenem Resistant Enterobacteriaceae, CRE among high risk patients;
- An isolation ward for the mitigation of any risk of cross-transmission of newly detected or known positive patients;
- Adoption of strict contact precautions, dedicated equipment and a highly intensive cleaning regimen;
- Speedy laboratory procedures to ensure results regarding infections available within 24 hours;
- Good communication amongst microbiologists and with all relevant parties on detection of a new case.
- Good communication with patients and GPs and other health care worker contacts to inform GPs of their patients’ status.
A wide range of initiatives has been put in place in the Irish health system over several years to tackle healthcare associated infections and antimicrobial resistance, covering improved surveillance of infections and prescribing and infection prevention and control processes.
It also includes antimicrobial stewardship initiatives, public and professional awareness-raising with a significant emphasis on the education and training of healthcare professionals.
Ireland is also developing a National Action Plan on Antimicrobial Resistance in line with the World Health Organisation's 2015 Global Action Plan on AMR and the European Council’s 2016 Conclusions: 'The next steps under a 'One Health' approach to combat antimicrobial resistance'.
The National Action Plan is being developed with the oversight and guidance of the Interdepartmental AMR Consultative Committee. The Committee was established in 2014 by my Department’s Chief Medical Officer and the Chief Veterinary Officer of the Department of Agriculture, Food and the Marine in recognition of the need for a ‘whole of Government’ approach to tackling the issue of AMR. This inter-sectoral approach crosses the health, veterinary and environmental spheres to encompass all stakeholders’ efforts to address what is a world-wide concern. It is intended that the National Action Plan will be published in 2017.
The Health Protection Surveillance Centre (HPSC) is Ireland's specialist agency for the surveillance of communicable diseases and is part of the Health Service Executive. HPSC works in partnership with health service providers and sister organisations in Ireland and around the world and collates, interprets and disseminates data and information on communicable diseases.
Tackling AMR will require the whole system to prioritise key initiatives, working with our international colleagues. Ireland is fully committed to and engaged in addressing resolution of the problem of AMR and will continue to collaborate at international, EU and national levels to this end.
Nationally, I expect that the HSE will place particular emphasis on prevention and management of healthcare associated infections and antimicrobial resistance in its service planning for 2017.
Protected disclosures received by the Minister for Health are managed in accordance with the requirements under the Protected Disclosures Act 2014. It would not be appropriate for me to comment on such matters.
The Deputy’s detailed queries in relation to the publication of an HPSC report into infection control at UHL, deaths due to infection at the hospital relative to deaths at other major hospitals, and regarding staff turnover are operational issues and have, therefore, been referred to the HSE for direct reply.