Written Answers. - National Health Strategy.
Bernard Allen
Ceist:
153
Mr. Allen
asked the
Minister for Health and Children
the steps he proposes to take to deal with the situation where the life expectancy in Ireland is the lowest of all the 15 EU countries and the biggest issue in relation to the inequality in health is that between the rich and poor.
[19471/00]
Cardiovascular disease, cancer and accidents are the major causes of premature death in Ireland. A range of measures in place to reduce mortality and morbidity from these and other causes. In keeping with the principle of equity – one of the key principles of the national health strategy – many of these measures have a specific focus on improving the health status of people in lower socio-economic groups.denise.
At age 65, Ireland has the lowest life expectancy in the EU with the single biggest contributor being heart disease. When the cardiovascular health strategy was launched in July last year, my Department set a medium-term objective – to bring our levels of premature deaths from cardiovascular disease in line with the EU average at a minimum. Our longer term objective is to reduce our rates to those of the best performers in the EU.
The challenge now is to implement the recommendations of the cardiovascular health strategy group by developing structures and mechanisms which promote cardiovascular health, reduce inequalities, ensure a high quality of service provision and reduce variations in access to and quality of services. A sum of £12 million has been provided to commence the implementation process in 2000. I am confident that over the coming years the necessary funding will be provided to allow us to achieve our goals in implementing the various actions set out in the strategy.
The national cancer strategy set a target of reducing the proportion of deaths from cancer in the under 65 age group by 15%. Funding, totalling £40 million to date, has been invested in a range of service developments under the strategy, to the benefit of all, including in particular those socio-economic groups at a greater relative risk of contracting cancer due to environmental or lifestyle factors.
The national health promotion strategy for the years 2000-05 supports and complements both the cardiovascular and cancer strategy recommendations. It specifically highlights the impact that socio-economic factors have on population health. There is clearly a need for a greater inter-sectoral and multi-disciplinary approach to address these external and structural determinants of health. The new health promotion strategy is calling for a more comprehensive policy of "health proofing" to ensure that the determinants of health, beyond the remit of health services are dealt with. This action will contribute to narrowing the gap between lower and higher socio-economic groups with respect to attaining maximum physical, mental and social well-being.
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. 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 waiting list initiative is aimed at ensuring that no adult has to wait longer than 12 months and no child longer that six months for access to an acute public hospital procedure. The achievement of these targets, which is being pursued through the implementation of a comprehensive set of short, medium and longer term measures, would represent an important improvement in access to care for those in the lower socio-economic groups, and others relying on public hospital services.
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 workplans for NAPS.
The new partnership agreement the 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 in Cork last May, 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 pro vide 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.
