This is the time of year when many people, older people in particular, face the worry and distress of illness and hospitalisation. Is the Taoiseach aware that the fears of many of these older citizens are compounded by the further fear of acquiring hospital based infections such as MRSA? Is he aware of the concerns that exist in all communities? Last month, I raised this issue on Leaders' Questions and I make no apology for doing so again on this, the last opportunity for Leaders' Questions.

We have one of the worst rates of hospital acquired infections, especially with regard to MRSA, in Europe. I ask the Taoiseach to listen to the following statement:

I would be afraid if I had to go in for an operation now, I would think twice about it. I'd be very afraid, not on account of the competence of the doctors and the nurses, but on account of the structure they have to work under.

These are the words of a missionary priest, Fr. Brendan Forde, speaking after the funeral of his sister, Barbara, who died in Beaumont Hospital after acquiring MRSA from a routine operation. Fr. Forde continued: "She went in for an ordinary operation and she came out dead from a hospital-acquired infection, which we were told was MRSA".

Where is the Government's urgency in response to this glaring need in the hospital network? Where is the special allocation of funding for the promised additional isolation units or to ensure single units in intensive care wards? These are real needs and, since I last raised the issue of MRSA, the Cork City Coroner has followed the lead of the Dublin City Coroner by requiring all deaths attributable to MRSA to be reported to him. His decision followed a landmark inquest finding, in which it was determined that a 74 year-old man died as a result of MRSA acquired at Cork University Hospital. Will the Government now do as I urged one month ago by making it mandatory to report MRSA or other hospital acquired infections as part of the process of reporting deaths to coroners? Will the Taoiseach explain why more people are noting, as the campaigning group MRSA and Families has said, that there is a wall of silence in respect of this entire issue throughout the health services and the political establishment? What will the Taoiseach do to address this very pressing and worrying matter?

I am aware that this problem has arisen at this time of the year, in particular, over recent years. This important issue has to be considered in this country and other countries. I do not think there is a wall of silence in this regard. At this time of year, representatives of hospitals in various parts of the country often issue statements to the national and local media, explaining that they have had to close sections of hospitals such as units and wards as a result of MRSA.

The prevention and control of infections which are associated with health care is a broader issue. The Department of Health and Children has ensured in recent years that this important issue is a priority for the Health Service Executive, which has published detailed guidelines on hygiene, including hand hygiene. The guidelines, which set out ways of controlling MRSA in hospital and community settings, have been well-publicised over the past two years. Anyone who has visited a hospital recently will be aware that hygiene has been stepped up throughout the health system.

The HSE has recruited essential infection control staff who are dedicated to dealing with MRSA. One could say that such staff should always have been in place, but it was deemed necessary to bring them in at a certain time, based on what was being done in countries in northern Europe, which have a better record on hospital diseases than countries in southern and western Europe.

The HSE will soon publish a three-year action plan, which will set targets for the next three years. The targets, which will be based on the HSE guidelines, will represent an attempt to reduce the level of infection in Ireland to a level that is akin to the levels found in northern Europe, where the best record in this regard is found. The recommendations on hospital hygiene standards which were included in the strategy for the control of antimicrobial resistance in Ireland, which was launched five years ago, are being implemented. The recommendations relate to the appropriate prescribing of antibiotics, active surveillance, the detection of MRSA and clinical governance structures in the area of infection control. Those who brief Deputy Ó Caoláin on these matters have probably told him that many of these problems result from the prescription and over-prescription of antibiotic drugs. I do not declare myself to be an expert on these matters. This issue has been in our system for a long time.

Two hygiene audits have been carried out to date in acute hospitals under the auspices of the National Hospitals Office. Earlier this year, in the spring or early summer, we participated in the Hospital Infection Society's survey on infections which are associated with health care in the UK and Ireland. Some 75,000 patients were surveyed in the study. It was recorded that approximately 10% of patients in the Republic who had infections which are associated with health care had an MRSA-related infection. While there is no doubt that figure of 10% is very high, the figure is higher in other countries. The survey in question found that the relevant figure in the UK is16%. The figure is far lower in northern European countries, however. We have to deal with all the issues in the reports, including the guidelines, the infections which are associated with health care, the ongoing campaign on hygiene standards, the recommendations which have been given to hospitals, the prescription of certain drugs, the surveillance of MRSA and the clinical governance structures.

Area infection controls were mentioned by Deputy Ó Caoláin in the context of providing more clean areas, such as isolation units, for people. All of these recommendations are in the process of being implemented, if they have not already been implemented. The HSE's next step will be to benchmark its guidelines against the actions which have been taken. It will try to reduce the figure I mentioned over the next three years. That will be the next step in the programme.

The wall of silence is real. Relatives are not being told — that is a fact. The last time I raised this matter with the Taoiseach, I mentioned the position in the Netherlands. The Taoiseach responded by saying that the Government would not go down that road. It is clear that one of the stark and critical differences between the system in the Netherlands and the system here is that there are more single rooms in hospitals in the Netherlands. Patients in that country do not have to tolerate this country's extent of overcrowding in absolutely inappropriate situations which leave people vulnerable to getting hospital-acquired infections, particularly MRSA.

I wish to quote Fr. Brendan Forde again:

You get great tax breaks if you build luxury hotels for the super-rich but they are incapable of building in our hospitals some individual units for the most vulnerable people, those who are in intensive care, and they will put them into a ward where there are hospital-acquired infections.

I referred to the death of Fr. Brendan's sister, Barbara. I extend my sympathy and, I am sure, the sympathy of the House to him and his family on their tragic loss. Many countless hundreds of lives have been lost in such a tragic manner as a result of this serious problem. Cleanliness is hugely important and hygiene is critical. What steps will the Taoiseach take to ensure we have single-room isolation units? We need to have the space to deal with people who are vulnerable to infection. When people are recovering after operations and other procedures, etc, they should not have to cope as part of a lumpen mass of patients.

I ask the Taoiseach to take the required steps to help to stamp out this scourge for once and for all. Nothing in what the Minister announced last week will give any hope to families who are faced this winter with loved ones who are afraid to go to our hospitals. It is time for action on this matter.

There are people in isolation units, such as intensive care facilities, in every one of our acute hospitals. I refer to people who have had operations in recent days, having suffered from various ailments. That is a fact. Deputy Ó Caoláin asked about isolation units and said we should have such good facilities for people with serious ailments who might be at risk of getting or spreading infections. It is obvious that hospitals should be dealing with this issue. It is good to have isolation facilities. Most of our new developments have more intensive care and high-dependency beds. The Deputy asked whether there should be more facilities of that nature. I do not disagree with his suggestion.

There are no beds. People are on trolleys rather than beds.

The issue of infections which are associated with health care is an important one. Deputy Ó Caoláin's point relates to whether we can feel comfortable about the fact that people are going into hospital with certain ailments and then picking up separate infections in hospital. Nobody can defend that. The Deputy asked me a fair question about what the HSE is doing about this problem. I have said that the HSE will soon publish an action plan that will set targets on the basis of its guidelines for the control of MRSA in hospital and community settings.

Professor Drumm and his colleagues on the health committee have emphasised that issues like basic cleanliness, hygiene standards, the appropriate prescription of antibiotic drugs, active surveillance for the detection of MRSA, clinical governance structures and infection control standards are hugely important. Nothing is more important to a hospital than trying to ensure there is no bacterial spreading or any other kind of spreading in the broad area of infections which are associated with health care. This area is broader than just MRSA — there are many other infections. There are wider issues like the strategy for the control of antimicrobial resistance in Ireland.

I am aware from listening to the senior members in the Department of Health and Children and the Health Service Executive that they are acutely conscious of that aspect. As we continue to put in the enormous amounts of resources we have been putting in for a number of years to the health capital programme, we must ensure that national hygiene standards as shown in national hygiene audits continue to improve.

These are important issues. I am not an expert in this area but it always amazed me, from my own days long ago when I worked in the Mater and the good Sisters of Mercy had control over it, that it would be easier to get into Fort Knox than into the hospital, with the exception of strict visiting hours. We do not appear to have the same issues around that 30 years on. It always puzzles me that large numbers of people go in for a long number of days. I would have thought that is an issue. I have raised that at other times as well but hygiene standards are vitally important and I do not disagree with the Deputy's urging to try to improve the situation.

That concludes Leaders' Questions. I appeal to leaders, when we start the next term, to examine the way Leaders' Questions go over time. We are half an hour over time this morning and I ask the leaders to make some effort to stay within the time. The interruptions prolong Leaders' Questions. It is the same five or six Members who come in every day and disrupt Leaders' Questions.

I am sorry about that.

The Chair will be left with no option but to deal with those Members because it is causing a serious problem. Yesterday, there was no facility for backbenchers to ask a question on the Order of Business because Leaders' Questions went on too long.

You got out of that nicely.

I appeal to leaders to stay within the times allotted in the next term and to the Members who continuously interrupt to desist from interrupting.

I do not want to be disruptive, a Cheann Comhairle, but——

I will not hear you, Deputy.

When will you hear me, a Cheann Comhairle?

The Chair did not name any Deputy but it is interesting that you want to get up to defend——

You were looking at me accusingly.

I have to look at somebody, Deputy. We are moving on to Taoiseach's questions.

Not getting answers to questions creates many problems.

A Cheann Comhairle, we should make priority time for interrupters — perhaps an hour at night.

We should make time for answering questions as well. That would be a big help. There would not be any interruptions then.