IRELAND plans to ‘eliminate’ cervical cancer by 2040, according to new targets announced by Health Minister Stephen Donnelly.
Elimination means fewer than four cases per 100,000 women and requires a 10% increase in vaccination rates for girls up to age 15 from the current 80% to 90% by 2030; along with cervical screening coverage by CervicalCheck at or above 73%; and the number of women receiving treatment within the first year of diagnosis at above 97%.
It is an ambitious progressive policy to reduce the impact of cervical cancer on Irish women that causes 300 deaths a year.
After a litany of devastating tragedies on Irish roads, Junior Transport Minister Jack Chambers brought details of a comprehensive speed-limit review to Cabinet this summer in an attempt to reduce fatalities and injuries.
Under new proposals, limits will be lowered to 80kmh on national secondary roads, 60kmh on local and rural roads and 30kmh in town centres and housing estates.
A comprehensive, coherent government policy to follow the science that reducing speed limits results in plummeting RTA deaths.
However, when it comes to alcohol policy government policy is illogical, incoherent and smacks of the influence of the hugely powerful lobbyists within the industry.
Alcohol causes 1,500 deaths a year in Ireland. About 15% of the population have an alcohol use disorder (AUD). That is one in seven people - 600,000 people, with 90,000 having a severe problem. AUD is a medical condition characterised by an impaired ability to stop or control alcohol use despite adverse consequences in social, occupational and health terms.
Six thousand babies are born every year with Foetal Alcohol Spectrum Disorder, a tenth of whom have Foetal Alcohol Syndrome - the most severe form. Added to that are the hundreds of thousands of families across Ireland that are impacted by alcohol harm. The OECD estimates this harm amounts to billions of euros and 1.9% of GDP. Treatment services are grossly inadequate with only 3,265 new cases receiving treatment in 2022.
“If we do not create and fund a positive recovery programme, yet more deaths from more alcohol will occur and the generational impact will be enormous,” said CEO of Alcohol Action Ireland (AAI), Dr Sheila Gilheany.
In response to the overwhelming burden of alcohol harm on individuals, families, health services and the economy, the Government passed the Public Health (Alcohol) Act in 2018 and has introduced evidence-based legislation to reduce consumption. This includes influencing alcohol sales by raising the price; limiting marketing and advertising; and requirements for labelling of alcohol as harmful to health.
It is hard to fathom government strategy amid increased warnings about violence and lawlessness on city streets, and alarming increases in road deaths.
Unbelievably, the Government plans to increase opportunities for alcohol use with the passing of the Sale of Alcohol Bill in 2024.
The Joint Committee on Justice, in its Report on Pre-Legislative Scrutiny of the General Scheme of the Sale of Alcohol Bill 2022, was published recently with a number of recommendations. Committee Cathaoirleach James Lawless TD welcomed the intention to introduce “wide-scale reform, modernisation and streamlining of Ireland’s licensing laws”.
The Committee acknowledged that the introduction of this legislation “is timely following the exceptionally difficult conditions for the hospitality and entertainment sector during the pandemic and shares the desire expressed by stakeholders and witnesses that this legislation would help to revitalise the cultural and night-time economy generally”.
Recommendations by the Committee to address alcohol harm include: that consideration be given to the introduction of a levy on the industry to contribute towards the costs of alcohol-related harms to the State and for a health impact assessment of the bill.
In response, Alcohol Action Ireland questioned who will carry the burden of increased harms from more alcohol sales in Ireland that will ensue from the Sale of Alcohol Bill.
AAI called on the Minister for Justice Helen McEntee to detail how she has responded to these recommendations.
In response to a parliamentary question in October, 2022, the Minister said: “The Department of Justice continues to engage with the Department of Health on the development of the Bill and will fully consider its assessment of the health implications.”
However, under FOI, AAI has identified very little interdepartmental discussions about the bill over the past year.
“Given the apparent dearth of discussion between the departments, even though the joint Oireachtas Justice Committee heard from a range of experts on issues that will arise in terms of public order, emergency services, health of children and families, it raises serious questions at to the consideration of public health within this bill,” Dr Gilheany warned.
Dr Owen Keane, Honorary Secretary of the Irish Association for Emergency Medicine, said in times of severely limited acute hospital bed capacity, it was imperative that every effort is targeted towards avoiding additional strains on emergency care services.
“Increasing the availability of alcohol risks adding significant and avoidable demands on already overstretched EDs. It is vital a thorough Health Impact Assessment is carried out to ensure any potential impacts of the measures proposed in this Bill on emergency care services are identified and fully costed.”
Dr Gillheany reiterated that this Bill is an example of “shocking policy incoherence across government. On the one hand, the Department of Health is seeking a reduction in alcohol use and has legislation to bring this about - the Public Health (Alcohol) Act 2018 which has measures such as controls on alcohol advertising. However, these have still not been introduced, five years after the law has passed. Meanwhile, the Minister for Justice is rushing to increase alcohol consumption.”
A recent Irish Heart Foundation and UCC report identified that a radical new approach to preventing chronic disease would save thousands of lives each year and protect our stretched health service.
Five core risk factors for cardiovascular disease and many chronic diseases were identified by UCC’s Prof Ivan Perry as smoking, physical inactivity, poor diet, obesity and (yes) alcohol consumption.
The paper called for greater political will to implement population-based strategies to prevent chronic disease and that these upstream strategies were more effective, cost-effective and equitable than ‘downstream’ treatments.
“We need to change the narrative away from hospitals and waiting lists, and campaigns that focus on individual behaviours and so-called lifestyle choices,” said Janis Morrissey, Director of Health Promotion at the IHF.
The Sale of Alcohol Bill is a mistake. It is an effort to appease the alcohol industry and wave the magic wand of further economic growth. A health impact assessment is needed and the industry should pay for the inevitable increased costs of societal and health harms.
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