John Perry
Question:83 Mr. Perry asked the Minister for Health and Children the reason the life expectancy rate in Ireland lags so far behind the EU average. [5841/02]
Written Answers. - Life Expectancy.
Life expectancy at birth has increased substantially for Irish men and women over the past four decades though it is still poorer for men. At the same time life expectancy in Europe has increased at a faster rate. Life expectancy in Ireland is lower than the EU average because Ireland has a high rate of premature mortality, that is, mortality of people aged under 65 years, when compared with our EU neighbours. Approximately one-fifth of all deaths in Ireland are in people aged under 65 years of age. Cancer, cardiovascular disease and accidents account for the majority of these deaths. Many of these are preventable.
Health status and mortality rates are influenced by several factors. These include people's natural endowment, the physical and emotional nurturing they receive, the lifestyle they adopt, the degree to which the health services and the wider environment support and complement their attempts to prevent disease and to improve their health as well as the access they have to quality health and personal social services in times of need.
The national health strategy, Quality and Fairness – A Health System for You, recognises that to improve life expectancy and health status generally, it is necessary to address the many factors which influence health. The strategy sets out a programme of investment and reform that will stretch over the next decade. The first goal of the health strategy is better health for everyone. Key objectives under this goal are: the health of the population is at the centre of public policy; the promotion of health and well-being is intensified; health inequalities are reduced; and specific quality of life issues are targeted.
The action plan accompanying the strategy includes a wide range of actions which will address health status and life expectancy issues. These include the following: health impact assessment will be introduced as part of the public policy process; statements of strategy and business plans of all relevant Departments will incorporate an explicit commitment to sustaining and improving health status; the national environment and health action plan will be prepared; a population health division will be established in the Department of Health and Children; a population health function will be established in each health board; actions on major lifestyle factors targeted in the national cancer, cardiovascular and health promotion strategies will be enhanced; a national injury prevention strategy to co-ordinate action on injury prevention will be prepared; a programme of actions will be implemented to achieve national anti-poverty strategy and health targets for the reduction of health inequalities; and publication of a national health information strategy, the preparation of which is at an advanced stage.
The strategy acknowledges the central role of primary care in the future development of the health services. A major refocus on primary care services is marked by the introduction of a new model of primary care involving a core interdisciplinary primary care team which will work with a wider network of health and social care pro fessionals and will offer 24 hour cover. A task force to drive the implementation of this new model is currently being established. The 15 million to 16 million visits by people to GPs each year as well as the contacts with a range of other primary care staff provide considerable opportunities for prevention of premature mortality by supporting people in their own self care; through other health promotion-prevention work; by early identification of illness and appropriate referral to hospital services. To increase people's timely access to hospital treatment the health strategy envisages the provision of 3,000 additional acute hospital beds by 2011. Commissioning is to begin immediately of 709 of these beds for public patients. Funding has been provided for the contracting of 200 beds from private hospitals for the treatment of public patients, with the objective of reducing waiting lists and waiting times.
As the main causes of premature deaths and therefore of lower life expectancy, cardiovascular disease, cancer and accidents are identified as requiring special attention if we are to achieve our national objective of moving over a period of time to the higher levels of life expectancy which are enjoyed by our European neighbours.
Cardiovascular diseases cause over 40% of all mortality in Ireland. Premature death rates from cardiovascular diseases in Ireland are significantly higher than the EU average and contribute to Ireland having a lower life expectancy than the EU average. In the first three years of an investment programme following on the adoption of the cardiovascular health strategy – Building Healthier Hearts launched by the Taoiseach in late 1999, a total of €45.71 million, revenue, has been allocated to fund the strategy. The medium-term objective of the strategy is to bring Irish levels of premature deaths from cardiovascular disease in line with the EU average at a minimum. The longer term goal is to reduce Irish rates to those of the best performers in the EU. Building Healthier Hearts, which contains 211 recommendations, is designed to achieve these goals in a systematic and sustained manner.
The national cancer strategy set a target of reducing the proportion of deaths from cancer in the under 65 age group by 15%. Since the launch of the strategy, over €103 million has been invested in the development of cancer services. This includes the provision of €23.5 million which was allocated between all health boards from national cancer strategy funding this year for the continuing development of oncology/haematology services, funding for oncology drug treatments and the continuing development of symptomatic breast disease services. Among other initiatives, this investment has enabled the funding of 64 additional consultant posts in key areas of medical oncology, radiology, palliative care, histopathology and haematology together with support staff.
In the context of the national health strategy, my Department will continue to be advised by the National Cancer Forum in relation to the planning, development and implementation of cancer services for the country. In recognition of the need to further develop cancer services, the national health strategy has identified the need for the preparation by the end of 2002 of a revised implementation plan for the national cancer strategy. This plan will be prepared by my Department in conjunction with the National Cancer Forum and will set out the key areas to be targeted for the development of cancer services over the next seven years.
The national health promotion strategy 2000-2005 focuses on three key areas in health promotion, policy development and implementation, programme development and implementation and re-orientation of the health services. The strategy addresses the needs of individuals, communities and key population groups and outlines an action programme aimed at maximising the health of the population with a view to increasing the opportunities for attaining and sustaining health in a manner that is compatible with the broadest aspirations for positive health and well-being.
This year the Government is investing over €8 billion, £6.4 billion, in the health services. This represents an overall increase for the health services since this Government came to power in 1997 of 124%. The €2.539 billion, £2 billion, at 2000 prices earmarked in the NDP for health capital for the seven year period 2000-06 represents the largest capital investment programme ever undertaken in the health sector. This investment will provide a physical infrastructure to underpin a public health service characterised by ongoing improvements in quality and accessibility and will also be an ingredient in improving life expectancy in our society.
The above mentioned strategies, and in particular the overarching framework provided by the new national health strategy, together with this Government's programme of investment, will continue to contribute to the improvements in life expectancy that have been taking place in our society.