Facing the challenge: The impact of the recession and unemployment on men's health in Ireland

The economic recession with its accompanying rise in unemployment rates is linked to extremely adverse effects for men’s mental health. This research report Facing the Challenge – The Impact of the Recession and Unemployment on Men’s Health in Ireland identifies a strong expectation of increased mental health problems for men given the very strong correlation between unemployment and male mental ill health. The report is the result of a research and consultation process carried out, in Northern Ireland and the Republic of Ireland, by Nexus Research Co-operative on behalf of IPH. 93% of frontline organisations, North and South, in contact with unemployed men linked health challenges to unemployment and recession and all organisations surveyed noted adverse health challenges for men they work with. In addition to health challenges being higher for unemployed men, they were also very high for men who saw themselves as being threatened with unemployment. The organisations surveyed and the men who were interviewed identified the challenges to health as:•    High levels of stress or anxiety•    Dependency on or over-use of alcohol/other drugs•    Deterioration in physical health•    Development of conflict in family or close personal relationships•    Isolation (including sharing or communicating problems)•    A reluctance to approach services or seek help

IPH Response to Dept of Justice and Equality Review of the Code of Practice on the Sale and Display of Alcohol in Mixed Trading Premises

IPH responded to the Department of Justice, Equality and Defence review of the voluntary Code of Practice for the display and sale of alcohol in supermarkets, convenience stores and similar mixed trading outlets. The voluntary Code was introduced in 2008 as an alternative to the statutory rules for structural separation of alcohol products in mixed trading outlets which are set out in section 9 of the Intoxicating Liquor Act 2008. Interested bodies and individuals were invited to submit comments on the Compliance Report for 2011 and on the effectiveness of the voluntary approach to structural separation by 20th December 2011. The Minister said he intended to also seek the views of the Minister for Health and the Joint Oireachtas Committee on Justice, Defence and Equality before reaching any decision on whether to bring the statutory rules in the 2008 Act into operation.

IPH response to Health and Social Care Board and Public Health Agency Community Development Strategy

The Health and Social Care Board (HSCB) and the Public Health Agency (PHA) launched a new Community Development Strategy for public consultation.  The HSCB and PHA want to see strong, resilient communities where everyone has good health and wellbeing, places where people look out for each other and have community pride in where they live. The HSCB and PHA seek a number of benefits from implementing this strategy including; a reduction in health and wellbeing inequalities, which also means addressing the social factors that affect health; strengthening partnership working with service users, the community and voluntary sectors and other organisations; strengthening families and communities; supporting volunteering and making best use of our resources. Key points from the IPH summary include IPH welcome the Community Development Strategy as an approach to enhance health and wellbeing and tackle health inequalities in Northern Ireland.   IPH recommend the current three strategy documents (Full and summary versions and the Performance Management Framework) are merged into one document for greater clarity. Reference to the Performance Management Framework is required in the main body of the text is to ensure good practice is implemented. IPH welcome the focus on tackling health inequalities using community development approaches however the contribution of community development approaches needs to be highlighted. HIA is a tool to support community engagement and provides a mechanism for HSCB and PHA to support the implementation of this strategy.

IPH response to the Strategic Review of Health Inequalities in England post 2010

IPH contributed to the Strategic Review of Health Inequalities in England being carried out by Professor Sir Michael Marmot, Chair of the Commission on the Social Determinants of Health.  IPH acknowledges the immense work done by the Review team and welcomes the opportunity to inform its work. We see the review as a vital opportunity to provide a “catalyst for concerted action” not only in England but in its near neighbours in Northern Ireland and Ireland. Health inequalities are rife across the UK and Ireland despite a range of developments in policy and practice designed to create more equal opportunities for health. We commend the approach taken in the Review, which applies scientific rigour and the combined expertise of a number of defined task groups to seek solutions to the vexing challenge of health inequality.

A Health Economics Model. The cost benefits of the Physical Activity Strategy for Northern Ireland - a summary of key findings

This summary report follows on from the publication of the Northern Ireland physical activity strategy in 1996 and the subsequent publication of the strategy action plan in 1998. Within this strategy action plan a recommendation was made for the health sector, that research should be carried out to evaluate and compare the cost of investing in physical activity programmes against the cost of treating preventable illness. To help in the development of this key area, the Department of Health, Social Services and Public Safety's Economics Branch agreed to develop a model that would seek to establish the extent of avoidable deaths from physical inactivity and, as a consequence, the avoidable economic and healthcare costs for Northern Ireland.

Improving Stroke Services in Northern Ireland (PDF 194 KB)

Stroke can strike anyone, any age, anytime. Today in Northern Ireland around 4000 people each year have their lives and the lives of their families dramatically changed by stroke. A significant number of these could be avoided by simple lifestyle changes. More exercise, less alcohol and more attention to diet can make a major difference. Cutting down or cutting out smoking will make the most significant lifestyle contribution to a reduction in stroke and the enormous personal impact that it brings. åÊThese recommendations seek to make improvements in the key areas of prevention; treatment and rehabilitation of stroke patients in a modern health service setting. The accompanying standards outline the levels to which we must aspire, in the delivery of these services. åÊ

Adopting the Future Consultation response document (MS Word 290 KB)

While for most children the best place to grow up is with their birth parents, others are unable to do so. Under the Children (Northern Ireland) Order 1995, the first duty of Health and Social Services Trusts, where children cannot live with their birth parents, is to seek a home for them with their extended famly. Finding a safe and caring new home for children with their wider family or friends allows them to keep important attachments and connections in their lives, and is therefore the preferred choice where it is possible. Where this is not possible, society has a clear responsibility to provide children with stability and permanence in their lives. Some children are placed in alternative forms of care. Adoption is traditionally a means of providing a permanent family for a small, but significant number of children who are unable to return to their birth parents. Adoption is, however, much wider than just the service provided to children. Adoption affects birth parents, prospective adopters, adoptive parents, siblings, grandparents and other relatives. The Department of Health Social Services and Public Safety believes that more can and should be done to reflect the complex needs of those affected by adoption. åÊ

Adopting the Future (PDF 865 KB)

While for most children the best place to grow up is with their birth parents, others are unable to do so. Under the Children (Northern Ireland) Order 1995, the first duty of Health and Social Services Trusts, where children cannot live with their birth parents, is to seek a home for them with their extended famly. Finding a safe and caring new home for children with their wider family or friends allows them to keep important attachments and connections in their lives, and is therefore the preferred choice where it is possible. Where this is not possible, society has a clear responsibility to provide children with stability and permanence in their lives. Some children are placed in alternative forms of care. Adoption is traditionally a means of providing a permanent family for a small, but significant number of children who are unable to return to their birth parents. Adoption is, however, much wider than just the service provided to children. Adoption affects birth parents, prospective adopters, adoptive parents, siblings, grandparents and other relatives. The Department of Health Social Services and Public Safety believes that more can and should be done to reflect the complex needs of those affected by adoption. åÊ

Equality Impact Assessment Guidance Framework (PDF 177 KB)

This document sets out a guidance framework for undertaking an EQIA, and has been approved by the Equality Steering Group and the Regional Equality Liaison Panel. The framework is designed to assist practitioners or managers having to undertake an EQIA for the first time. The framework will: - Introduce policy makers to an effective EQIA approach, setting out a recognised need for specific requirements and guidance on how to fulfil equality requirements; - Steer policy makers to where to seek help, including key documents and additional information sources. åÊ

Report of the National Advisory Committee on Palliative Care

Over thirty years ago, Prof. John Hinton voiced his criticisms of the standard of medical care offered to patients with advanced and life-threatening conditions. In the decades that followed, we have witnessed a remarkable renaissance in terms of our understanding of the needs of patients in the final stages of life. Developments in therapeutics and in our knowledge of pain and symptom management have spearheaded a quiet but very effective revolution. In parallel with developments in medical science, we have developed a much deeper understanding of the complex psychosocial and spiritual needs of patients and their families, as they seek to cope with the pain and suffering associated with progressive and inevitable loss Download the Report here

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.

Call for Submissions: White Paper on Universal Health Insurance - Supporting Documents

  The Department of Health has published a White Paper on Universal Health Insurance. The White Paper sets out in detail the elements of the proposed Universal Health Insurance model for Ireland. As such, it provides detail on the overall design of the model, the proposed system for deciding on the standard package of services and the financing mechanisms for the system. This is a most fundamental reform of the health system and we recognise the importance of consulting extensively and inclusively with all interested parties.  It is important to seek your views on the policy as it is set out in the White Paper, and we view this as a valuable opportunity for citizens to contribute to the development of policy on the future of their health system.  Therefore, we would like to hear from any individual, group, organisation or other body that wishes to contribute to the consultation on the White Paper. In particular, but not limited to, we would welcome your views on the following issues: A consultation document setting out a number of key questions under each of the above headings has been developed and can be downloaded here. There is an opportunity at the end of the document for views or comments on other aspects of the White Paper to be provided. Alternatively, additional views or comments can be sent as an email or hard copy to the addresses below. It is intended to establish a separate independent Expert Commission to examine the issues around the basket of services to be provided under UHI and within the overall health system. The Minister will announce details of the Commission in the near future. Therefore, it would be useful if the submissions on the White Paper refrained from commenting in detail on the services to be provided under UHI. Views on the basket of services will be sought by the Commission when it commences its consultation process. The White Paper can be downloaded here, and two further supporting documents Background Policy Paper on Designing the Future Health Basket and Background Policy Paper on Raising Resources for Universal Health Insurance, which informed the development of the White Paper are also available for download. Links to other supporting documentation that informed the White Paper are also provided below. Submissions can be submitted: By E-mail to: uhiwhitepaper@health.gov.ie By Post to: UHI White Paper UHI UnitDepartment of HealthRoom 7.26Hawkins HouseHawkins StreetDublin 2 The closing date for submissions is close of business 28th May 2014 and will be strictly adhered to. All submissions received will be subject to the Freedom of Information Acts 1997 & 2003 and may be released in response to a Freedom of Information request. Download the consultation document (MS Word) (From the website of the Health Research Board) Integration of health and wellbeing services with general health services The integration of health and social care services

ARC HLC

ARC Healthy Living Centre provides a range of services for a range of groups eg older people, young, unemployed etc. This is their 3rd application and is a Level 3 project. Previous BCPP projects have focussed on for example, peer education programmes for young people, working with Surestart and addiction services. As a result of the project the pharmacist has integrated well into the community. This project will build upon previous work to increase health awareness, promote interagency understanding and deliver a wide range of interactive sessions with groups such as SureStart and alcohol projects. It will also seek to take this out into other areas and encourage other pharmacists to become involved in this way of working.

Rabies - it can be a fatal bite

Rabies is a preventable disease, but it kills up to 55,000 people each year. Therefore on World Rabies Day, 28 September 2011, the Public Health Agency wants to raise awareness and understanding about the importance of seeking medical advice on whether the country or countries people are visiting require vaccination against this serious disease.Rabies is transmitted to humans mainly by the bite of an infected animal (commonly a dog, but can be spread by other mammals including cats and monkeys). It can also be spread through a scratch, or by the animal licking a cut or a wound and saliva from the infected animal getting into the eyes, mouth or nose. It is impossible to tell just by looking at an animal if they are infected, therefore while visiting other countries it is best to avoid touching animals, especially strays.Dr Michael Devine, Consultant in Health Protection, PHA, said: "Rabies is an acute viral infection which is almost certainly fatal. The infection causes inflammation of the brain and symptoms usually start 2-8 weeks after exposure. Early symptoms include headache, fever and anxiety; progressing to acute pain, violent uncontrolled movements, spasms of the swallowing muscles making it impossible to drink and respiratory failure."People may be used to thinking about rabies when they go to more exotic locations like Asia and Africa, but it can also be present closer to home, such as in some eastern European countries. So it is always best to play it safe and avoid animals, especially strays."Dr Devine continued: "If you are bitten by an animal while abroad it is important to clean the wound thoroughly with soap and water and seek medical attention immediately, even if you have been previously immunised, as treatment must be given to attempt to reduce the risk of developing the disease - treatment works best if initiated as soon as possible. Rabies vaccination is very effective - almost 100%. Booster doses may be required after one year and then every 2-5 years for those at continued risk."

Consultation launched on Community Development Strategy - your views matter

Issued jointly by the Health and Social Care Board and Public Health AgencyThe Health and Social Care Board and the Public Health Agency have today launched, for public consultation, a new Community Development Strategy.The consultation period will run for 12 weeks from Friday 10 June until Friday 2 September 2011.The Board and Agency want to see strong, resilient communities where everyone has good health and wellbeing, places where people look out for each other and have community pride in where they live.Residents from deprived areas in Northern Ireland experience;lower life expectancy;higher rates of emergency admission to hospital;higher rates of lung cancer;higher rates of suicide; andhigher rates of smoking and alcohol related deaths.The kinds of health and social care issues which can be improved by community development approaches include depression; isolation; falls amongst elderly people; child protection; teenage pregnancy; childhood asthma; postnatal depression; drug and alcohol abuse; and ultimately also long term conditions such as obesity, diabetes and cancer.The Board and Agency seek a number of benefits from implementing this strategy such as; a reduction in health and wellbeing inequalities, which also means addressing the social factors that affect health; strengthening partnership working with service users, the community and voluntary sectors and other organisations; strengthening families and communities; supporting volunteering and making best use of our resources.John Compton, Chief Executive of the Health and Social Care Board said: "Community development is an important way to improving health and wellbeing - driving a message that 'prevention is better than cure' between different groups and communities, and helping to ensure the most effective use of the health and social care budget."Now more than ever we need to work in partnership with families and communities to achieve better health and wellbeing for those living in Northern Ireland.No one organisation can meet this challenge on its own and strong partnerships are needed. "Chief Executive of the Public Health Agency, Eddie Rooney added: "Every health and social care organisation should incorporate a community development approach into their programmes, and this strategy assists them to do so."The Board and Agency have jointly held pre-consultation workshops over the past few months across Northern Ireland on their Community Development Strategy and have engaged widely with the community and voluntary sectors. We are now keen to receive feedback from individuals, families and the wider community as your views are very important to us - they will help shape the future of community development across the province," he said.The draft Community Development Strategy, as well as information on how you can respond, can be found in the attachments below.