I propose to take Questions Nos. 193, 194 and 196 to 198, inclusive, together.
A Healthy Weight for Ireland’, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland agenda.
The OPAP covers a ten year period up to 2025 and aims to reverse obesity trends, prevent health complications and reduce the overall burden for individuals, families, the health system, and the wider society and economy. Indeed it must be emphasised that every sector of our society has a role in reducing the burden of obesity and the OPAP clearly acknowledges this.
The policy prescribed 'Ten Steps Forward' that would be taken to prevent overweight and obesity. A new Obesity Policy Implementation Oversight Group was established in October 2017. The current position with implementing these is as follows:
1. Embed multi-sectoral actions on obesity prevention with the support of government departments and public sector agencies
An Obesity Policy Implementation Oversight Group (OPIOG) has been established under the Chair of the Department of Health. It is comprised of representatives from the following Departments and Agencies: Department of Agriculture, Food and the Marine; Department of Children and Youth Affairs; Department of Employment Affairs and Social Protection; Department of Education and Skills; Department of Housing, Planning and Local Government; University College Cork; the Food Safety Authority of Ireland; the Health Service Executive (HSE) - including the National Clinical Lead for Obesity; and Safefood. The OPIOG held its inaugural meeting on the 19th of October last with further meetings arranged at agreed intervals for the purposes of providing oversight to the implementation of the national Obesity Policy and Action Plan (OPAP). The OPIOG will identify processes for engaging with networks of stakeholders. It will elaborate on this aspect of its functions over the course of its work to implement the OPAP that runs up to 2025.
The OPAP recommended that proposals be developed relating to the rollout of evidence based fiscal measures, including a levy on sugar-sweetened drinks, in support of healthy eating. As the Deputy is aware the Sugar-Sweetened Drinks Tax commenced on the 1st of May. It represents a positive step in our national policy to deal with the problem of obesity. Consideration of any other relevant and similar fiscal measures - including the type of research referred to by the Deputy or relevant agricultural policies of the Department of Agriculture, Food and the Marine - can take place within the context of the work of the OPIOG.
2. Regulate for a healthier environment
The development of legislation for calorie posting to support people to make healthy choices is underway by the Department of Health. Currently, a behaviour study on how best to make the posting of calories meaningful to customers and more likely to impact on their behaviours is being carried out by the ESRI. In addition, actions in this area are being progressed through engagement with other Government Departments to support the work of stakeholders involved in planning and developing the built environment. The question of establishing a sub-group of the OPIOG for the built environment will be kept under review by the group; but in the meantime the Department of Housing, Planning and Local Government is represented on the OPIOG. In line with Actions 31 and 59 of the National Physical Activity Plan, which commit to developing guidelines and support materials for those working in developing the built environment in order to promote the importance of physical activity (31), and to develop a programme of on-going stakeholder communication and engagement to ensure delivery of the Plan (59), it is intended to hold a Stakeholder Forum in 2018. The planned Forum will focus on the theme of the Built Environment.
3. Secure appropriate support from the commercial sector to play its part in obesity prevention
At its inaugural meeting, the OPIOG agreed to establish two sub-groups for Reformulation and Healthy Eating. Further sub-groups will be established as required. Both sub-groups have already met and agreed their Terms of Reference.
The Reformulation sub-group will be technical in its work programme. The work of the sub-group will primarily set targets on reformulation of food and drink. It will include work feeding into a methodology for measuring the efficacy of the Sugar Sweetened Drinks Tax. It will also make recommendations on addressing reduction of portion sizes and on monitoring and validation procedures.
One of the priority actions under Step 3 of the OPAP was to ‘Establish a forum for meaningful engagement with industry on best practice initiatives towards a healthy food environment’. It is intended to progress this action under the auspices of the OPIOG in 2018.
A code of practice for food and beverages promotion, marketing and sponsorship has also been developed involving representatives from the food industry, advertising sector, statutory agencies, and various Government Departments. It was chaired by the former CEO of the statutory Food Safety Authority of Ireland. The Codes of Practice concerned were published in February.
4. Implement a strategic and sustained communications strategy that empowers individuals, communities and service providers to become obesity aware and equipped to change, with a particular focus on families with children in the early years
A new child obesity campaign from safe food and the HSE was recently launched. It's called the START campaign and it aims to inspire, empower and support parents to start building and persist with healthy lifestyle habits in the family to prevent childhood obesity. The first phase of the campaign advertising features on TV, radio, video on demand, outdoor and digital platforms. The next phase of the campaign was launched in April.
5. The Department of Health, through Healthy Ireland, will provide leadership, engage and co-ordinate multi-sectoral action and implement best practice in the governance of the Obesity Policy and Action Plan
As referred to at step 1 above, the establishment of an Obesity Policy Implementation Oversight Group is well advanced. New Healthy Eating Guidelines, Food Pyramid and supporting resources have already been published, disseminated and communicated in 2017, including dissemination of the new Guidelines to all primary and post-primary schools.
Work has also commenced on developing Healthy Eating Guidelines for the 1-5 year old age group. As a first step in this work, the Scientific Committee of the Food Safety Authority of Ireland (FSAI) is currently developing scientific recommendations for food based dietary guidelines for 1 to 5 year olds.
New Nutrition Standards for schools, with an initial focus on school meal programmes funded by the Department of Employment Affairs and Social Protection, have also been developed. These Nutrition Standards were published in September 2017. The Nutrition Standards were developed by the Department of Health with the assistance of safe food and the Health Service Executive, in cooperation with the members of the School Meals Programme in the Department of Employment Affairs and Social Protection and the Department of Education and Skills. And it is in the context of further discussions with both of these departments that the question of extending the Nutrition Standards to more schools will arise.
6. Mobilise the health services to better prevent and address overweight and obesity through effective community-based health promotion programmes, training and skills development and through enhanced systems for detection and referrals of overweight and obese patients at primary care level
A Healthy Eating, Active Living Programme has been established as a Policy Priority Programme within the HSE and a three-year plan for the programme has been finalised. The GP contract for the provision of free care to children under 6 years, already provides that the medical practitioner shall take an active approach toward promoting health and preventing disease through the provision of periodic assessments to child patients.
The HSE is also implementing a Breastfeeding Action Plan and a new Making Every Contact Count brief intervention framework which aims to capitalise on the opportunities that occur every day within the health service to support people to make healthy lifestyle choices.
7. Develop a service model for specialist care for children and adults
Professor Donal O’Shea was recently appointed the National Clinical Lead for Obesity. This appointment will be important in further advancing the implementation of many of the recommendations in the OPAP including the development of a national integrated service model for the health and social care of overweight and obese people and for developing quality assurance guidance for obesity services.
8. Acknowledge the key role of physical activity in the prevention of overweight and obesity
'Get Ireland Active! The National Physical Activity Plan for Ireland' (NPAP) is one of the key developments arising from Healthy Ireland, and implementation of that Plan is well underway in collaboration with the Department of Transport, Tourism and Sport and a range of other stakeholders.
9. Allocate resources according to need, in particular to those population groups most in need of support in the prevention and management of obesity, with particular emphasis on families and children during the first 1,000 days of life
The implementation of the Healthy Eating and Active Living Plan within the HSE will begin to address this action area, with a particular focus on supporting parents and families.
10. Develop a multi-annual research programme that is closely allied to policy actions, invest in surveillance and evaluate progress on an annual basis
The establishment of the national oversight structure referred to earlier will foster developments under this step of the OPAP.