Written Answers. - Public Health Programmes.
Bernard Allen
Question:
268
Mr. Allen
asked the
Minister for Health and Children
the proposals he has for the improvement of the area of public health over the next 12 months; and the programmes undertaken in that area over the past 12 months.
[26358/02]
A number of public health initiatives aimed at improving public health is currently under way. These will continue to operate and be further developed next year along with some new initiatives.
In the area of population screening programmes, BreastCheck, the national breast screening programme, commenced in March 2000 with phase one of the programme covering the Eastern Regional Health Authority, Midland Health Board and North Eastern Health Board areas. My Department is in discussions with the executive of BreastCheck in relation to the phased expansion of the programme and the linkages with the symptomatic services. I have invested substantially in the development of symptomatic breast services and further development is required.
Phase one of the cervical screening programme is under way in the Mid-Western Health Board since October 2000. This is a major undertaking with significant logistical and additional resource implications. The experience gained from phase one will assist in planning and implementing a national programme towards which end consideration is currently being given to the carrying out of an external review of phase one during 2003. In addition, other issues relating to management of the national programme, are also being examined by the chief executive officers of the health boards.
The "Best Health for Children" report recommends a core child health surveillance programme for those in the zero to 12 age group. Additional funding to date, in excess of €2 million, has been used to employ key people at regional level to drive the implementation process and also to pilot projects aimed at establishing best practice in the area. One of the priority areas identified in the report requiring attention is that of training of staff involved in delivering the core surveillance programme. With a view to facilitating the efforts of boards in implementing the recommendations of the report, particularly with regard to the provision of training, an additional €700,000 has been provided for 2003.
Routine antenatal testing was introduced in 1999 and is effective in identifying women who are HIV positive at an early stage in pregnancy. These women can be treated with highly active anti-retroviral therapy, which reduces the risk of the baby acquiring HIV by up to 66%. Since its introduction, when the positive HIV status of the mother is know antenatally, the perinatal transmission rate has so far been less than 1%. Anonymous unlinked testing of HIV is also taking place. The aim is to have an above 90% uptake rate of the linked programme before discontinuing the unlinked testing.
In regard to immunisation a number of key programmes are under way. The primary childhood immunisation programme is a key element of the public health service in Ireland today. The programme provides for the immunisation of children against a range of potentially serious infectious diseases. Under the system parents may have their children immunised free of charge by a general practitioner of their choice.
The national immunisation programme against Group C meningococcal disease commenced in October 2000 with the objective of immunising the population up to 22 years of age.
Phase 1 of the programme targeted those at greatest risk, that is, children under five years of age and young persons aged 15 to 18. Phase 2 of the programme commenced in March 2001 and targeted primary school children as a priority as well as post-primary students aged 12 to 14 years. Young persons aged 19 to 22 years were targeted when phase 2 was completed. All phases of the catch up programme were completed in 2002.
The vaccine has been incorporated into the primary childhood immunisation programme for children up to two years of age. Since the introduction of the vaccine there has been a dramatic reduction in Group C meningococcal disease in Ireland. There have been no deaths due to Group C meningococcal disease to date in 2002 compared to three deaths for the same period last year (2001). None of the three people who died had received the meningitis C vaccine.
In the area of environmental health, a draft national environment health action plan, NEHAP, "A Shared Vision for Quality of Life", has been prepared by a review group established under the aegis of my Department. In many countries NEHAPs are seen as a tool for achieving sustainable development and implementing integrative approaches and local actions to the benefit of the population.
An advanced draft of the NEHAP has been circulated to Departments and lead agencies involved in environmental health for comment and observations. The draft will be amended in the light of observations received and will then be submitted to Government with a view to publication as soon as possible.
In the area of fluoridation I established the Forum on Fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was recently launched and its main conclusion was that, subject to the recommendations of the forum, the fluoridation of public piped water supplies should continue as a public health measure.
Since publication, I have asked my Department to establish an expert body as recommended by the forum to oversee the implementation of the wide-ranging recommendations made and advise me on all aspects of fluoride going forward.
In the area of tobacco control, I intend introducing further measures to protect the public from the effects of tobacco, particularly in the area of environmental tobacco smoke. In this regard the Deputy may wish to note that the Public Health (Tobacco) Act passed all stages in the Oireachtas earlier this year and became law on 27 March 2002. Part 2 of the Act has been brought into operation and the Office of Tobacco Control has been established.
In the area of health promotion, the health promotion unit of my Department has responsibility for the implementation of the Health Promotion Strategy 2000-2005 and the cardiovascular strategy, Building Healthier Hearts. This has resulted in the development of a wide range of health pro motion programmes, initiatives and campaigns aimed at improving health. These programmes and campaigns will be further developed next year.
In the area of food safety the European Commission's White Paper on Food Safety sets out plans for a proactive new food policy aimed at modernising food legislation into a coherent and transparent set of rules, reinforcing controls from the farm to the table, and increasing the capability of the scientific advice system. Over the past 12 months my Department has played, and over the next year will continue to play, an active role in the development of legislative proposals arising from the White Paper through its representation on various EU working groups and through participation at the Standing Committee for the Food Chain and Animal Health.
I believe that the ongoing programmes in public health that I have outlined are important and worthwhile initiatives which will contribute to improving people's health and quality of life.
