Session 2
Irish Medical Organisation

Scientific Session 2

Prof Anthony Staines, DCU School of Nursing

Missing Presumed Forgotten: Neglected Areas of Health Reform

Health Promotion and Prevention is a key area where obvious long term savings can be made Governments seem reluctant to commit any funding. Prof Anthony Staines, Lecturer in Health Systems at DCU School of Nursing explained why prevention programmes should be higher on the list of priorities.

Prof Staines took a single case study - food, obesity and cardiovascular health. Obesity is a major looming health issue. There is a risk that our children will die younger than us, because of spiralling levels of obesity. Prof Staines argued that much of the heavy burden of cardiovascular disease is caused by dietary intake of sugar, salt, and fat, especially trans-fatty acids. These are food elements which are hard for the consumer to regulate as much of the daily intake of these items is hidden in processed food, notably breakfast cereals. These foods are very heavily promoted to children, with predictably bad consequences.

The standard food industry response to these charges is 'consumer choice'. As they had sabotaged EU proposals for comprehensible food labeling (traffic lights), and have replaced these with the '% recommended daily intake labels', which consumers do not understand, Prof Staines does not see any need to take the industry seriously.

The Food Safety Authority of Ireland has a voluntary scheme with spotty participation, to reduce salt (only) in food. This is too slow, and too uncertain. The US and Denmark have shown the way with bans on toxic trans-fatty acids. There is good evidence that cheap affordable regulations could have a major effect on cardiovascular disease risk, and we cannot afford to pass up any cheap wins for our health.
 

Dr William Flannery – Consultant Psychiatrist in Addictions, Chair of the Faculty of Addictions, College of Psychiatry of Ireland.

What Direction for Addiction?

‘One drink is too many for me, and a thousand not enough’ – Brendan Behan

Dr Flannery today presented his perspective on addiction services in Ireland, detailing the size of the problem and what is required to meet current and future demand.

First presenting the science behind addiction, Dr Flannery gave a brief outline of the evidence associated with the influence of genetic risk and the environmental risk factor associated with the use of drugs. Dr Flannery also went on to discuss the evidence of effective treatment, highlighting a number of programs.

Neglected concepts such as what actually is addiction, and the broad spectrum of alcohol and substance abuse disorders are often forgotten, particularly the lower end of the scale disorders.

Dr Flannery discussed the significant demand for treatment in Ireland, but acknowledged the difficulty in assessing the real need due to geographic dispersion of addiction and the concentration of treatment in urban areas of Ireland.

Looking at what has been done, and the ‘Good versus Bad Plans’ that have been presented by government, professional bodies and interest groups is an important step in looking to the future. Dr Flannery identified a number of positive and influential papers, such as the IMO’s own position paper on Mental Health.

Dr Flannery then discussed Methadone as template for developing addiction services. As Methadone was a program developed by health professionals, which needed to be matched by civil service structure and came from a crisis that required political action. These are valuable in looking forward to the development of further addiction services.

Moving forward, Dr Flannery discussed the direction for addiction, citing a combined plan with leadership from the CPI, IMO, ICGP etc and the role of doctors in advocating for this particular group of patients. A supportive civil structure is also required to provide a foundation for these services.

Professor Desmond O'Neill - Associate Professor in Medical Gerontology, TCD and Consultant Physician in Geriatric and Stroke Medicine AMNCH

Missing Presumed Forgotten: Neglected Areas of Health Reform. Meeting the Long-term Care Needs of an Ageing Population.

The collective ageing of our populations has been one of the great advances of the last century. For medicine, the biggest challenge is that the healthcare professions have not yet adequately adapted to the added complexity that increasing numbers of older people bring to the system. Much of healthcare provision still reflects a mindset of single-organ disease, a failure to factor in functional losses (eg, cognition, mobility and continence), and limited understanding of chronic disease.

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