After last week's report into the state of hygiene in Irish hospitals, the government is expecting a huge compensation bill from MRSA victims and their families

The report is now being analysed by British-based infection control experts. It's expected to bolster legal actions currently being taken by MRSA sufferers.

Methicillin-resistant staphylococcus aureus is Ireland's leading hospital superbug. It's commonly found on the skin of many people who suffer no ill effects. If it gets into the bloodstream, it can be fatal. An estimated 10,000 patients contracted the bug last year with 240 patients dying from it. MRSA is mainly spread through poor hygiene.

According to the audit, 91% of Irish hospitals do not have acceptable standards of hygiene. Several hospitals had refused to reveal their MRSA rates, and growing concern led to the independent audit being commissioned last year.

The audit, which consisted of random and unannounced visits to hospitals during July and August, showed widespread neglect of basic hygiene practices. Its results were published by the National Hospitals Office of the Health Service Executive (HSE).

Almost half of the of the 54 hospitals audited received a poor rating, 43% were rated as fair and only 9% as good. The main areas of concern outlined in the report included:

Lack of national policies and procedures. Inadequate storage facilities. Improvements in fabric of hospital buildings and upgrades in facilities required. Lack of responsibility and accountability for waste management. Dated/inappropriate cleaning equipment. Limited technical support. Requirement for in-house.

Director of the National Hospitals Office, Pat McLoughlin, said, "It is quite clear from this audit that historically there has not been a consistent national approach to hygiene within our hospitals. Previously, hygiene standards were dependent on the initiatives of local hospitals and therefore practices varied from region to region. "

Mary Harney, TD, who was responsible for commissioning the audit said, "Clean hospitals are essential for public confidence and for infection control. Patients deserve no less than top class cleanliness in every area of each hospital."

The National Hospitals Office has established a national working group to develop a set of national infection control and cleaning standards to be introduced in the New Year. Two further audits will be carried out in hospitals in 2006.

Galway lawyers are preparing a Ä3m claim from a woman in her early twenties who contracted MRSA. This is just the biggest of more than 200 cases believed to be in preparation against the Department of Health, the Health Services Executive, and a number of hospitals.

"There was always a risk that litigation would arise from a range of hospital-acquired infections," said McLoughlin. "I have been made aware by individual hospital managers of a number of cases, but we are not yet fully aware of the extent of the claims. Every case is different and will be assessed on a case-by-case basis. "

A 68-year-old grandmother from Kilkenny, became the first Irish patient to sue the government for compensation this year. As she is suffering from a critical illness, lawyers have sought an early date for the hearing of her case. The case follows a legal ruling in Britain in which an 87-year-old was awarded "substantial damages" after the hospital in which she contracted MRSA admitted it had ignored infection-control policies.

Earlier this year the Irish Society of Clinical Microbiologists, met with Harney and the State Claims Agency to discuss the threat of litigation. The SCA was warned that hospitals routinely fail to adhere to infection control guidelines. It has indicated that , it will contest all claims.

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