Three of the four . . . Mary McDonald, Bridie O'Brien and James Bolger . . . died at St Columcille's Hospital in Loughlinstown, Dublin, after contracting the infection while being treated there. The hospital, the inquest into their untimely deaths heard, has a woefully inadequate infection control system. Bridget Frasier, meanwhile, contracted c.difficile, an infection that attacks the gut and which is resistant to antibiotics, at St James's Hospital These people were elderly and frail but, as doctors told Dublin county coroner Kieran Geraghty, the illnesses for which they were admitted were not necessarily life-threatening. Either they were killed directly by the infections they caught on the wards, or these infections were major contributing factors in their deaths.

As hospitals have a duty of care to the patients they treat, the least we should expect is that when things go wrong, as they did on these occasions, there should be a serious examination of the mistakes made, combined with the speedy introduction of new infection control policies to ensure other patients aren't exposed to similar risks.

This, however, is not the case. The coroner has written to one hospital manager asking about the appointment of a consultant microbiologist so that infection controls can be implemented. He has not even received a reply. Hospital-acquired infection, it seems, is almost a fact of ward life. And if you are old and it kills you, so be it.

The cases bear a remarkable similarity to the deaths of 90 elderly people in the south-east of England. There, a full investigation castigated infection control procedures, hygiene on the wards, and failure to implement an infection control policy which could have avoided the catastrophic outbreak.

The senior executive with responsibility for these hospitals resigned.

Here, the four elderly people whose inquests were heard last week represent a tiny fraction of the real numbers involved. More than 1,000 people a year are affected by c. difficile . . . twice as many as by MRSA.

The Department of Health and the HSE are well aware of the reforms needed. The National Hygiene Audit has helped clean up wards but standards are still too low.

The body charged with framing an infection control strategy, the Health Protection Surveillance Centre, has identified five areas where infection control can be markedly improved. We score poorly on all five, from screening, to provision of isolation wards, to the appointment of microbiologists and an infection reference laboratory.

The slow pace of change is proving fatal. But of course, nobody here is resigning.