John Gormley

Deputy Gormley: I welcome the delegation and thank them for their presentations. The witnesses spoke about 1995 and the 55 reported cases of MRSA infection. At that time I was working with FÁS and the father of one of my colleagues died. That colleague overheard a conversation among nurses to the effect that her father was “the MRSA patient”. His death was not reported as being MRSA-related and I believe there was an enormous level of under-reporting. I simply do not believe there were only 55 cases of MRSA in 1995——

Dr. Graham:  Or 550 last year. We do not believe that either.

Deputy Gormley: We must get the reporting right. That is the first requirement.

The most fundamental hygiene standards are still not being followed. I was shocked to hear from an intern who has just started working in a Dublin hospital that he saw no hand-washing and no use of sterile gloves by staff there. We are dealing with abysmal hygiene standards in the midst of a crisis that has been so eloquently outlined to us today.

Bugs do not become superbugs unless there is real antibiotic resistance. I have raised the issue of antibiotics a number of times in the House and it is directly related to this discussion. I am concerned about doctors handing out antibiotics to patients. Antibiotics are being handed out far too freely. Can Dr. Fawsitt comment on that point? There seem to be no standards in this area. We have talked about standards in other areas but they also seem to be lacking when it comes to antibiotics. Some GPs do not hand out antibiotics willy-nilly but others hand them out like Smarties. That is part of the problem.

Dr. Fawsitt:  There have been moves by GPs over the past 20 years, nationally and internationally, and very successfully in the United Kingdom, to reduce antibiotic prescribing. Since the mid-1980s we have recognised that there is an emerging problem of antibiotic resistance. The Irish College of General Practitioners has taken the lead in trying to reduce prescription rates. However, GPs are not the only prescribers of antibiotics. For example, God only knows what is in a MacDonalds burger. At least, we are regulated and audit our members. Improvements have been made in the United Kingdom, where antibiotic prescriptions have decreased by 20% to 30% in recent years. That trend is beginning to be followed here. While we accept we have contributed to the problem, the issue should be seen as a societal one. Antibiotics have brought so many benefits during the years that problems such as MRSA were bound to arise. Unfortunately, we have known about the issue for a long time but not taken steps to address it. People are not being isolated in hospitals and we are neither washing hands nor observing EU demands to ensure beds are 2 m rather than 2 ft. apart.

MRSA is probably present in my surgery and, if not, will be before long. I have to exercise vigilance by performing risk assessments and informing my practice nurse and staff on the issue. The problem is no longer confined to hospitals but affects the entire community. How many wash their hands after using the toilet? Hygiene is a societal issue. We could complain about CEOs and standards but we are all responsible for changing our culture when it comes to hygiene. While I accept GPs have had a role in this problem, but we are not the only culprits and are doing our best to resolve it.

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