IPH response to Revised Regional Transportation Strategy 2011

The increase in population and vehicles has placed significant pressures on Northern Ireland’s transportation networks coupled with fiscal constraints and the need to reduce our environmental impacts.  The revised Strategy concentrates on moving people rather than vehicles, creating space on the networks for people and also for freight and on maintaining what is in place and using it in a smarter way.  At its core is a move towards greater sustainability which will contribute positively to growing the economy, improving the quality of life for all and reducing the transport impacts on the environment.

IPH response to Department for Regional Development Regional Transportation Strategy Review

Travel behaviour can make a significant contribution to physical activity levels and subsequent risk of poor health including conditions such as obesity.  DRD can play a key role in tackling obesity in Northern Ireland through the Regional Transportation Strategy. This is the IPH's response. The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  The Institute promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. IPH acknowledges that health is influenced by a wide range of social determinants, including economic, environmental, social and biological factors.  Transport is one of the key determinants of health and IPH welcomes the opportunity to comment on the Department for Regional Development (DRD), Regional Transportation Strategy (RTS) Review.

Speech by Mr. Micheál Martin TD – Meeting The Challenges Of Cultural Diversity In The Irish Healthcare Sector

It gives me great pleasure to accept the invitation to address this conference on “Meeting the Challenges of Cultural Diversity in the Irish Healthcare Sector” which is being organised by the Irish Health Services Management Institute in partnership with the National Consultative Committee on Racism and Interculturalism. The conference provides an important opportunity to develop our knowledge and understanding of the issues surrounding cultural diversity in the health sector from the twin perspectives of patients and staff. Cultural diversity has over recent years become an increasingly visible aspect of Irish society bringing with it both opportunities and challenges. It holds out great possibilities for the enrichment of all who live in Ireland but it also challenges us to adapt creatively to the changes required to realise this potential and to ensure that the experience is a positive one for all concerned but particularly for those in the minority ethnic groups. In the last number of years in particular, the focus has tended to be on people coming to this country either as refugees, asylum seekers or economic migrants. Government figures estimate that as many as 340,000 immigrants are expected in the next six years. However ethnic and cultural diversity are not new phenomena in Ireland. Travellers have a long history as an indigenous minority group in Ireland with a strong culture and identity of their own. The changing experience and dynamics of their relationship with the wider society and its institutions over time can, I think, provide some valuable lessons for us as we seek to address the more numerous and complex issues of cultural diversity which have arisen for us in the last decade. Turning more specifically to the health sector which is the focus of this conference, culture and identity have particular relevance to health service policy and provision in that The first requirement is that we in the health service acknowledge cultural diversity and the differences in behaviours and in the less obvious areas of values and beliefs that this often implies. Only by acknowledging these differences in a respectful way and informing ourselves of them can we address them. Our equality legislation – The Employment Equality Act, 1998 and the Equal Status Act, 2000 – prohibits discrimination on nine grounds including race and membership of the Traveller community. The Equal Status Act prohibits discrimination on an individual basis in relation to the nine grounds while for groups it provides for the promotion of equality of opportunity. The Act applies to the provision of services including health services. I will speak first about cultural diversity in relation to the patient. In this respect it is worth mentioning that the recognition of cultural diversity and appropriate responses to it were issues which were strongly emphasised in the public consultation process which we held earlier this year in the context of developing National Anti-Poverty targets for the health sector and also our new national health strategy. Awareness and sensitivity training for staff is a key requirement for adapting to a culturally diverse patient population. The focus of this training should be the development of the knowledge and skills to provide services sensitive to cultural diversity. Such training can often be most effectively delivered in partnership with members of the minority groups themselves. I am aware that the Traveller community, for example, is involved in in-service training for health care workers. I am also aware that the National Consultative Committee on Racism and Interculturalism has been involved in training with the Eastern Regional Health Authority. We need to have more such initiatives. A step beyond the sensitivity training for existing staff is the training of members of the minority communities themselves as workers in our health services. Again the Traveller community has set an example in this area with its Primary Health Care Project for Travellers. The Primary Health Care for Travellers Project was established in 1994 as a joint partnership initiative with the Eastern Health Board and Pavee Point, with ongoing technical assistance being provided from the Department of Community Health and General Practice, Trinity College, Dublin. This project was the first of its kind in the country and has facilitated The project included a training course which concentrated on skills development, capacity building and the empowerment of Travellers. This confidence and skill allowed the Community Health Workers to go out and conduct a baseline survey to identify and articulate Travellers’ health needs. This was the first time that Travellers were involved in this process; in the past their needs were assumed. The results of the survey were fed back to the community and they prioritised their needs and suggested changes to the health services which would facilitate their access and utilisation. Ongoing monitoring and data collection demonstrates a big improvement in levels of satisfaction and uptake and ulitisation of health services by Travellers in the pilot area. This Primary Health Care for Travellers initiative is being replicated in three other areas around the country and funding has been approved for a further 9 new projects. This pilot project was the recipient of a WHO 50th anniversary commemorative award in 1998. The project is developing as a model of good practice which could inspire further initiatives of this type for other minority groups. Access to information has been identified in numerous consultative processes as a key factor in enabling people to take a proactive approach to managing their own health and that of their families and in facilitating their access to health services. Honouring our commitment to equity in these areas requires that information is provided in culturally appropriate formats. The National Health Promotion Strategy 2000-2005, for example, recognises that there exists within our society many groups with different requirements which need to be identified and accommodated when planning and implementing health promotion interventions. These groups include Travellers, refugees and asylum seekers, people with intellectual, physical or sensory disability and the gay and lesbian community. The Strategy acknowledges the challenge involved in being sensitive to the potential differences in patterns of poor health among these different groups. The Strategic aim is to promote the physical, mental and social well-being of individuals from these groups. The objective of the Strategy on these issues are: While our long term aim may be to mainstream responses so that our health services is truly multicultural, we must recognise the need at this point in time for very specific focused responses particularly for groups with poor health status such as Travellers and also for refugees and asylum seekers. In the case of refugees and asylum seekers examples of targeted services are screening for communicable diseases – offered on a voluntary basis – and psychological support services for those who have suffered trauma before coming here. The two approaches of targeting and mainstreaming are not mutually exclusive. A combination of both is required at this point in time but the balance between them must be kept under constant review in the light of changing needs. A major requirement if we are to meet the challenge of cultural diversity is an appropriate data and research base. I think it is important that we build up our information and research data base in partnership with the minority groups themselves. We must establish what the health needs of diverse groups are; we must monitor uptake of services and how well we are responding to needs and we must monitor outcomes and health status. We must also examine the impact of the policies in other sectors on the health of minority groups. The National Health Information Strategy, currently being developed, and the recently published National Strategy for Health Research – Making Knowledge Work for Health provide important frameworks within which we can improve our data and research base. A culturally diverse health sector workforce – challenges and opportunities The Irish health service can benefit greatly from successful international recruitment. There has been a strong non-national representation amongst the medical profession for more than 30 years. More recently there have been significant increases in other categories of health service workers from overseas. The Department recognises the enormous value that overseas recruitment brings over a wide range of services and supports the development of effective and appropriate recruitment strategies in partnership with health service employers. These changes have made cultural diversity an important issue for all health service organisations. Diversity in the workplace is primarily about creating a culture that seeks, respects, values and harnesses difference. This includes all the differences that when added together make each person unique. So instead of the focus being on particular groups, diversity is about all of us. Change is not about helping “them” to join “us” but about critically looking at “us” and rooting out all aspects of our culture that inappropriately exclude people and prevent us from being inclusive in the way we relate to employees, potential employees and clients of the health service. International recruitment benefits consumers, Irish employees and the overseas personnel alike. Regardless of whether they are employed by the health service, members of minority groups will be clients of our service and consequently we need to be flexible in order to accommodate different cultural needs. For staff, we recognise that coming from other cultures can be a difficult transition. Consequently health service employers have made strong efforts to assist them during this period. Many organisations provide induction courses, religious facilities (such as prayer rooms) and help in finding suitable accommodation. The Health Service Employers Agency (HSEA) is developing an equal opportunities/diversity strategy and action plans as well as training programmes to support their implementation, to ensure that all health service employment policies and practices promote the equality/diversity agenda to continue the development of a culturally diverse health service. The management of this new environment is extremely important for the health service as it offers an opportunity to go beyond set legal requirements and to strive for an acceptance and nurturing of cultural differences. Workforce cultural diversity affords us the opportunity to learn from the working practices and perspectives of others by allowing personnel to present their ideas and experience through teamwork, partnership structures and other appropriate fora, leading to further improvement in the services we provide. It is important to ensure that both personnel units and line managers communicate directly with their staff and demonstrate by their actions that they intend to create an inclusive work place which doesn´t demand that minority staff fit. Contented, valued employees who feel that there is a place for them in the organisation will deliver a high quality health service. Your conference here today has two laudable aims – to heighten awareness and assist health care staff to work effectively with their colleagues from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. There is a synergy in these aims and in the tasks to which they give rise in the management of our health service. The creative adaptations required for one have the potential to feed into the other. I would like to commend both organisations which are hosting this conference for their initiative in making this event happen, particularly at this time – Racism in the Workplace Week. I look forward very much to hearing the outcome of your deliberations. Thank you.

IPH response to Department of the Environment, Heritage and Local Government and the Department for Regional Development Spatial Strategies

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. As an all-island body, the Institute of Public Health in Ireland particularly welcomes that the Framework for Collaboration has been co-produced by the Department for Regional Development and the Department of the Environment, Heritage and Local Government. In addition the Institute of Public Health welcomes a more holistic approach to spatial planning that takes into account the environment and sustainable economic development. A clean environment and a more equitable distribution of prosperity have associated health benefits, as outlined in the IPH’s Active travel – healthy lives (2011) and Health impacts of the built environment- a review (2006).

IPH response to the National Transport Authority on the Greater Dublin Area Draft Transport Strategy 2011-2030

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland.IPH has a keen interest in the interactions between transport and health. IPH has produced two papers in the recent past on this topic, the most recent being Active travel – healthy lives published in January 2011 which built on the 2005 publication Health impacts of transport. The IPH welcomes the draft transport strategy in terms of addressing each of the key messages outlined in the Active travel – healthy lives paper.IPH is interested in this area not only in terms of increasing ‘active travel’ for healthier lives, but also in terms of the environmental and social impacts of inequitable access to forms of private and public transport.

IPH response to Department for Regional Development's Regional Development Strategy

Key points from the IPH response include: There is growing recognition that the leading causes of illness and death, including heart disease, cancer, respiratory diseases and injuries, may be exacerbated by elements within the built environment which contribute to sedentary lifestyles and harmful environments.  IPH call for greater recognition of the links between regional development and health.   Health inequalities are the preventable and unjust differences in health status experienced by certain population groups.  The RDS has a role to play in tackling health inequalities experienced in Northern Ireland.   Supporting a modal shift in transport methods can lead to improved health and reduced health inequalities.   The RDS plays an important role in addressing climate change which is identified as a major public health concern for the 21st Century.  Creating healthy sustainable places and communities can go hand in hand with reducing the negative impacts of climate change.   IPH recognise the RDS is an overarching strategic framework which will be implemented by a range of other agencies.  To fully appreciate the potential health impacts of the RDS, IPH call for a Health Impact Assessment to be undertaken to fully determine the links with health and potential impact on health inequalities particularly in relation to the implementation strategy.

IPH response to Road Safety Authority Ireland Road Safety Strategy 2013-2020

The Road Safety Authority has responsibility for co-ordinating the development of Ireland’s Road Safety Strategy.  The Government’s road safety target of no more than 252 deaths per annum by the end of 2012 was achieved in 2009, when the number of road collision deaths in Ireland fell to 239.  The reduction in the number of fatalities was achieved through robust actions in terms of education and awareness, road engineering, and enforcement, including significant legislative milestones.  The challenge is now to ensure that the impact of these measures on collision levels is sustained and enhanced into the future through continuous education, enforcement and road engineering measures and initiatives. IPH welcomes the opportunity to respond to this consultation given the significant burden of injury, disability and mortality associated with road traffic collisions on the island of Ireland.  IPH supports the development of evidence-based strategies and actions which can maintain a transport system, in which the safety of all road users is paramount. 

IPH response to Broadcasting Authority of Ireland (BAI): General and Children's Commercial Communications Codes (June 2012)

IPH submitted their views on the Draft BAI General and Commercial Communications Code. IPH previously submitted views to the BAI in the first phase of consultation (Oct 2011). The final code will regulate the advertising of food and non-alcoholic beverages that are high in fat, salt or sugar on Irish television channels. The submission sets out approaches to appropriate scheduling and content restrictions as well as to possible exemptions.

IPH response to Broadcasting Authority of Ireland Children's Commercial Communications Code

The Broadcasting Authority of Ireland (BAI) is an independent statutory organisation responsible for certain aspects of television and radio services in Ireland, guided by the Broadcasting Act 2009. The BAI are undertaking a review of the Children’s Commercial Communications Code section 11 rules on Diet and Nutrition. This section sets down standards with which commercial communications for food and drink shown during children’s programmes and/or where these communications are for food and drink products or services that are of special interest to children.

IPH response to Draft Regional Planning Guidelines for the Greater Dublin Area 2010-2022

The Regional Planning Guidelines (RPG) for the Greater Dublin Area 2010-2022 (draft) is a policy document which aims to direct the future growth of the Greater Dublin Area over the medium to long term and works to implement the strategic planning framework set out in the National Spatial Strategy (NSS) published in 2002.  A series of recommendations have been made to Local Authorities clearly linked to and supporting the national investment in transport, particularly public transport, under Transport 21.  The draft was prepared and agreed for public consultation. The IPH response  to the consultation reports on how the RPG may impact on health and makes recommendations to maximise opportunities for health gain and minimise health loss.

IPH response to Department for Regional Development public transport reform consultation

This is the IPH response to the Department for Regional Development's public transport reform consultation.

Response to the Health Information and Quality Authority on their Corporate Plan

The Institute of Public Health in Ireland is an all-island body which aims to improve health in Ireland, by working to combat health inequalities and influence public policies in favour of health. The Institute promotes co-operation in research, training, information and policy in order to contribute to policies which tackle inequalities in health. He Institute houses the all-Ireland population health observatory, INIsPHO. The Institute has enjoyed good working relations with HIQA and welcomes the opportunity to submit its views for inclusion in HIQA’s forthcoming Corporate Plan. Our response highlights the inter-relatedness of the four Functions of HIQA. The Institute believes that HIQA’s first Corporate Plan should aim to develop all four Functions in a co-ordinated manner that recognizes and takes advantage of their inter-dependence. For example; the Health Information Function should include a strong focus on, but not be limited to, information requirements to support the delivery of the other three Functions. As well as gathering relevant information in a complementary way, these other Functions can help define priorities for the Health Information Function. This approach will have implications for the organizational structures and processes within HIQA, and the way it conducts its business.

Improving Dementia Services in Northern Ireland - A Regional Strategy - November 2011

Improving Dementia Services in Northern Ireland - A Regional Strategy - November 2011

Regional Eligibility Criteria for the Provision of Wheelchairs Through the Northern Ireland Wheelchair Service (PDF 2.20 MB)

A Guide for wheelchair users on regional eligibility criteria for the provision of wheelchairs through the Northern Ireland Wheelchair Service