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Dáil Éireann debate -
Thursday, 25 Oct 2001

Vol. 543 No. 1

Written Answers. - Health Inequalities.

Proinsias De Rossa


100 Proinsias De Rossa asked the Minister for Health and Children if his attention has been drawn to the recent report, Inequalities in Health in Ireland - the Hard Facts, published by the Department of Community Health and General Practice at TCD which found that unskilled male workers are twice as likely to die prematurely than those working higher professional areas; the steps he will take to address the inequalities in health identified in the report; and if he will make a statement on the matter. [25595/01]

I am aware that the report, Inequalities in Health – the Hard Facts, found that in 1996 unskilled manual men were twice as likely to die prematurely between the ages of 15 and 64 as men who are higher professionals. A number of reports, including the 1999 report of the chief medical officer, have drawn attention to the links between lower socio-economic position and poor health status.

This problem must be addressed on a number of fronts – providing equitable access to health services, including to health education and health promotion, and ensuring that policies outside the health sector take impact on health into account. Many of the factors which lead to the gap in health status lie outside the remit of the health sector. For example, the report to which the Deputy refers found that men in the unskilled manual groups were eight times more likely to die from an accidental cause than men in the highest professional group. Reducing deaths from accidents requires a multi-sectoral approach.

Higher death rates from cancer and cardio vascular disease, two major causes of premature deaths, also contribute to the difference in health status between higher and lower socio-economic groups.
There are strategies in place to address both of these diseases. Over £60 million, 76.24 million, has been allocated under the national cancer strategy since 1997, to the benefit of all, including in particular those socio-economic groups at greater relative risk of contracting cancer due to environmental or lifestyle factors. Work has commenced on implementation of the report of the cardiovascular health strategy group. A new health promotion strategy for 2000-05 is being implemented to address the many lifestyle factors such as smoking, excessive alcohol use and unhealthy eating habits which are more prevalent among lower socio-economic groups.
The overall budget for health services for 2001 is over £5 billion, 6.35 billion. This represents a 48% increase over the past two years and is a clear recognition of the Government's commitment to provide a high quality health service directed at those most in need. Likewise, a total of £2 billion, 2.54 billion, was made available to the Department of Health and Children at the launch of the national development plan in January 2000 for the period 2000-06. This investment will provide a physical infrastructure to underpin a public health service characterised by ongoing improvements in quality and accessibility and will be a significant ingredient in improving mortality and morbidity of the poorest groups in our society.
The national anti-poverty strategy is the Government's major vehicle for addressing the needs of people in poverty or experiencing social exclusion. Although health or health targets were not included in the original NAPS published in 1997, my Department has been involved in setting and reviewing annual work plans for NAPS. More recently the Government gave a commitment in the Programme for Prosperity and Fairness to review the NAPS across all relevant Departments and to develop NAPS targets in the health area with an associated monitoring and implementation framework. My Department established a working group on NAPS and health which included the social partners and the Combat Poverty Agency and sought the assistance of the Institute of Public Health with research and consultation aspects of the exercise.
An extensive public consultation was carried out and the assistance of the community and voluntary pillar and the Combat Poverty Agency was sought to try to ensure that the consultation was as inclusive as possible of people who are poor or socially excluded. The working group completed its report in July last. The report is currently being integrated with the NAPS reports from other Departments with a view to the adoption by Government of a revised NAPS later this year. Concurrently, the report of the NAPS and the health working group is informing the new national health strategy.