Top management at the main teaching hospitals in Dublin have told the Government that improved hygiene and cleanliness will not be enough on their own to tackle growing MRSA rates and that additional State investment to improve facilities and tackle overcrowding will be required. Martin Wall reports
In a confidential private submission to the Tánaiste and Minister for Health Mary Harney, the chief executives of all five Dublin teaching hospitals said that, in addition to hygiene, inadequate ward infrastructure and high bed-occupancy rates were contributing to the level of hospital-acquired infections. However, they accepted that at times hygiene in their hospitals was inadequate.
The submission from the chief executives of St Vincent's, the Mater, Beaumont, Tallaght and St James's hospitals - and also signed by the chairs of the medical boards in each of the hospitals - stressed the need for additional single rooms and isolation facilities with en suite bathrooms.
The Irish Times revealed last month that at least 8,000 patients in public hospitals had tested positive in 2004 for a range of potentially fatal superbugs.
A hospital hygiene audit, ordered by the Health Service Executive, should be completed later this month.
The submission said MRSA within a hospital environment "cannot be controlled unless you have the infrastructure/environment which facilitates same". It said single rooms and isolation facilities with en suite bathrooms were needed.
"Many of the current ward facilities within the Dublin Area Teaching Hospitals fall short of the current best-practice standards for hospital ward infrastructure."
The submission said bed occupancy rates in the main Dublin teaching hospitals far exceeded current best practice. Health service managers define bed-occupancy rates as the number of patients in beds in a hospital at any one time. High bed-occupancy rates mean most beds are in use.
Most of the main Dublin teaching hospitals are thought to have bed-occupancy rates of well over 90 per cent. Senior health service sources said last night there was an internationally accepted definition that occupancy rates of more than 85 per cent constituted over-crowding.
The submission said that in countries where MRSA control had been achieved bed-occupancy rates were significantly lower.
"We do accept that work is required around improving hygiene within our hospitals. Yes, at times, cleanliness in our facilities is not adequate. But the levels of occupancy and the environment in which the hospitals operate impact on the situation," the submission stated.
The Health Service Executive will ask all the State's hospitals to report every three months on their progress in combating hospital-acquired infections.