It is a well-known fact that MRSA in now endemic in Ireland. Today’s infection levels suggest that the guidelines for the Control of MRSA in Ireland, produced by SARI (an offspring of the HSE) were never implemented. Comprehensive updated guidelines, published by the Health Protection Surveillance Centre (HPSC) in September 2005, stated “Responsibility for the implementation of these guidelines rests with individuals, hospital executives and, ultimately, the Health Service Executive. The Infection Control Subcommittee, when reviewing the literature and the evidence, undertook to provide guidelines according to what is currently consistent with best practice. However, it is acknowledged that in many healthcare settings in Ireland, it will not be possible to implement much of what follows despite the best efforts of all healthcare professionals, because of inadequate resources, sub-optimal infrastructure and a lack of access to relevant expertise locally. Nonetheless, these are guidelines that all healthcare facilities should aspire to implement. Where it is not possible to implement some or part of the recommendations, the reasons for this should be highlighted to senior management. In this way, it is hoped that these guidelines, in tandem with other measures, will heighten the profile of infection control and prevention, and also facilitate the provision of the appropriate resources.”
What has the Minister for Health done in response to all of the above? Overall, have sufficient resources been allocated to the problem? No. Have we seen any evidence that appropriate resources have been allocated to improve the Dickensian infrastructure of our public hospitals? No. Has the problem of insufficient personnel in infection control been corrected? No. Have any senior management in the Health Service or HSE, been held accountable for their failure to implement the guidelines? No. Our Minister for Health has instead zoned in on the failure of hospital staff to wash their hands. “Hand washing is essential”, she says. She’s right, but hand washing alone won’t solve the problem!
On 22 August 2006, five years after SARI launched it’s first report, the HSE finally came out with hands up, saying it needed €20 million a year to combat MRSA. They stated that this money was needed to employ more consultant microbiologists, more infection control nurses, more antibiotic pharmacists and more surveillance staff. Recently we were told that the HSE failed to spend almost one fifth (€97.7 million) of it’s allocated budget last year. Now that sort of money would go a long way to help control the spread of MRSA in Ireland! Dealing with hospital infections costs serious money. While the MRSA problem is only one of many areas in our health service which requires an urgent allocation of resources, not dealing with this problem will cost more in the long run. Infection control is cost-effective as well as being life-saving. Prevention is always better than cure.
However, it now looks as though MRSA has reached a stage where it cannot be eradicated in Ireland. Infection control experts must have little to be optimistic about. We are well-justified to be fearful of MRSA. Superbugs rule, ok?