I presume that the Deputy is referring to the paper delivered by Professor Brian Nolan of the Economic and Social Research Institute at the Southern Health Board conference on health inequalities in Cork on Friday, 26 May 2000. International research has found that there are large differentials in mortality and morbidity between the higher and lower socio-economic groups and the conclusions from this research are that health inequalities are primarily a consequence of material differences in living standards. As Professor Nolan stated, the fact that there are differences across occupations, occupational groups and social class in death rates for men has been known for many years. Many of the causal factors of health inequalities, such as poverty and unemployment, are outside the direct control of the health services. Inter-sectoral collaboration is required to tackle these problems.
The National Anti-Poverty Strategy was published in 1997 and set out a programme to reduce poverty and social exclusion both in general and in a number of key policy areas. Although health or health targets were not included in the original NAPS targets, my Department has been involved in setting and reviewing annual work plans for NAPS. The new partnership agreement, Programme for Prosperity and Fairness, contains a commitment to update the National Anti-Poverty Strategy and review the underlying methodology, existing targets and consider new targets such as health. My Department is already engaged in establishing the necessary structures to support a wide-ranging consultation process and a working group on health. The objective is to produce an agreed final report which will identify potential health targets, health inequalities and associated outcomes including policy measures and performance indicators. As I stated at the health inequalities conference, I am committed to working in an open and constructive manner to develop a health related dimension to the National Anti-Poverty Strategy.
The poverty proofing of policies will be independently reviewed by the National Economic and Social Council with a view to strengthening that process. Following this review, poverty proofing will be extended on a phased basis to local authorities and health boards.
The overall budget for health services for 2000 excluding capital is almost £4 billion. This represents a substantial increase of just over one-third 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.
The £2 billion earmarked in the NDP for health capital for the seven year period 2000-06 represents almost a trebling of investment compared to the previous seven year period. This investment will provide a physical infra-structure to underpin a public health service characterised by ongoing improvements in quality and accessibility and will be a significant ingredient in improving the mortality and morbidity of the poorest groups in our society.
The ability of a society to create and maintain an environment which supports its people in attaining the highest level of health compatible with their natural endowment is one of the key indicators of the stage of development of a society and is recognised as such by its inclusion in the UN's list of human development indicators. Much work has already been done in Ireland on a multi-sectoral approach to poverty and social inclusion. It is essential that we continue to build and improve on the framework in place in the context of revised NAPS targets, NDP funding, and the Programme for Prosperity and Fairness.
