The former chief executive of the Northern Health Trust has said health officials told her during the C. diff outbreak, that negative publicity about the health service was unwelcome.
The inquiry was also told that the Trust was under-resourced both in financial and staffing terms.
An independent panel is reviewing an outbreak in Northern Trust hospitals between June 2007 and August 2008.
It has established that 31 people died from the outbreak.
As chief executive of the Northern Health Trust, Norma Evans, had overall responsibility for what happened during the C. diff outbreak.
She told the inquiry that the old structures of some of the buildings made it difficult to try and contain the infection.
Ms Evans said attempts were also hampered by poorer levels of nursing, medical and domestic staff.
The former chief executive said while she had regular meetings with departmental officials, including the Health Minister, Michael McGimpsey, it was made clear to her that negative publicity about the health service was unwelcome.
She said while support was offered, it felt more about the department being seen to be offering help rather than actually giving it.
Ms Evans was also critical of the money given to fight hospital acquired infections.
She said the £9m was announced with great fanfare but in the second year failed to materialise.
Norma Evans resigned from her post in June 2009 after the trust was turned down for additional government funding.
The Trust’s medical director Dr Peter Flanagan told the inquiry on Friday that there was no proper C. diff surveillance in place at the time of the outbreak in the Northern Health Trust.
Dr Flanagan said initially, infections were monitored using a manual reporting system.
He said there was a time lag between between cases being reported and the overall figures being collated.
Between August 2007 and January 2008, with the exception of one month, Dr Flanagan said he was aware of a growing number of cases.
He said on 15 October, three months before a formal declaration of the outbreak, an action plan was developed.
Dr Flanagan said a Serious Adverse Incident report was sent to the Department of Health, which requested that a regional alert be issued about the 027 strain of the infection as this was the first time it had been identified in Northern Ireland.
While he acknowledged the outbreak has served as a wake-up call to the local health system, Dr Flanagan said it was an extremely stressful time for everyone involved.
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