The path to good health?
As EU health ministers gather for a partially closed meeting next week. The event places more focus on cross departmental public health policies which will reduce demand in the longer term. Column from Medical Independent on 28 February 2013.
As part of the Irish presidency, the health ministers of Europe will gather on 4 and 5 March in Dublin Castle for what is billed as ‘an informal meeting’. According to the official blurb, the meeting ‘presents an opportunity to explore some of the challenges in improving the health and wellbeing of EU citizens’. The agenda includes: childhood obesity; working towards smoke free environments; improved inter-sectoral working for health; children with complex developmental needs (including autism); patient safety, including the prevention and control of healthcare associated infections.
This strong public health dimension is welcome. While Ireland has a strong track record on smoking prevention due to the pioneering work-place smoking ban introduced in 2004, public health policy and measures have been largely ignored by Irish political and health service leaders. Despite the smoking ban, we rate amongst the top three highest smokers in Europe – 29 per cent of Irish people smoke, a rate surpassed only by Bulgaria (29.2 per cent) and Greece (31.9 per cent).
Effective prevention of obesity and smoking, as well as encouraging more smokers to quit and those too heavy to lose weight, could be the best way to lessen demand for health services. Reduced demand for health services is a definitive way of assisting us to deliver more care to more people with our declining health budget.
Ireland has a rotten track record on ‘inter-sectoral working for health’. Apart from the smoking ban, the only area where inter-sectoral working has been effective, in the interest of public health, is road safety. Interestingly, road safety was driven from a justice and law enforcement perspective, rather than a public health one.
Good inter-sectoral working would ensure that more children could walk to school due to safe walking, cycling paths and better public transport; it would make healthy food available in all communities, especially the most disadvantaged. Good inter-sectoral working is good for everyone’s health.
Ireland has never prioritised public health policy or the implementation of the narrow policies that exist. While there is much rhetoric about public health, there has been little action on it. A new public health policy has been promised for years. Now referred to as a ‘health and well-being framework’ its publication was guaranteed by this government by the end of 2012. There is still no sign of it.
The focus of European health ministers on children with complex developmental needs is good news for any parent or carer given the abysmal state of diagnosis and care services for these Irish children. Likewise, the spotlight on patient safety must be welcome. There has been recent attention and much needed action in the area of patient safety, including hospital infections, in Ireland over the last few years. However, much more needs to be done. A recent article in the New England Journal of Medicine shows one in four hospital patients are harmed by medical errors. No such Irish data exist.
The promotional blurb for the health ministers’ meeting also says that there will be a ‘working lunch, for heads of delegations only… to discuss the impact of the economic crisis on health systems and consideration of policy responses’. What will the Irish Minister James Reilly share with them? Will he tell them that the Irish people and health service have taken austerity on the chin, that it’s been hard, but we are doing it and ‘notwithstanding the difficult financial environment, examples of the very substantial progress’ are present. That’s what he told the health summit on the 13 February. The rest of his 2,000 word plus speech was the usual guff.
It is doubtful that Minister Reilly will explain that despite statements to the contrary, homehelp hours to those who need them most have been cut. Will he share with them the new ‘yellow pack’ terms and conditions for doctors and nurses which are a direct result of the economic crisis? Will he document the closed hospital wards and theatres and non appointment of primary care staff? Unlikely. But we will never know as the meeting is closed to mere mortals like you and me.
It is most improbable that Irish presidency of the EU will have any impact on Irish health policy, but if Minister Reilly was to listen and implement just one effective measure from our European neighbours, he might, just might, improve the health and well-being of Irish citizens.