IPH response to 'Towards a Childcare Strategy' (Northern Ireland)

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. Giving every child the best start in life is recognised by governments worldwide as the most effective way to improve life chances and health outcomes.  This is one of IPH’s key strategic action areas in our Business Plan and we endorse the need for early intervention, particularly in tackling health inequalities and improving the health and wellbeing of children in the most disadvantaged communities.  International evidence is increasingly pointing towards investment in the early years as a critical component of any sensible approach to improving population health and tackling health inequalities across the life course (WHO, 2008 and Marmot, 2010).  It is also apparent that Northern Ireland public policy is now reorienting towards achieving better and fairer outcomes in the early years, as demonstrated through the recent draft public health strategy (DHSSPS, 2012a) and the draft early years strategy (Department of Education, 2012).

Ambulatory healthcare information system: a conceptual framework

Despite the tremendous amount of data collected in the field of ambulatory care, political authorities still lack synthetic indicators to provide them with a global view of health services utilization and costs related to various types of diseases. Moreover, public health indicators fail to provide useful information for physicians' accountability purposes. The approach is based on the Swiss context, which is characterized by the greatest frequency of medical visits in Europe, the highest rate of growth for care expenditure, poor public information but a lot of structured data (new fee system introduced in 2004). The proposed conceptual framework is universal and based on descriptors of six entities: general population, people with poor health, patients, services, resources and effects. We show that most conceptual shortcomings can be overcome and that the proposed indicators can be achieved without threatening privacy protection, using modern cryptographic techniques. Twelve indicators are suggested for the surveillance of the ambulatory care system, almost all based on routinely available data: morbidity, accessibility, relevancy, adequacy, productivity, efficacy (from the points of view of the population, people with poor health, and patients), effectiveness, efficiency, health services coverage and financing. The additional costs of this surveillance system should not exceed Euro 2 million per year (Euro 0.3 per capita).

Primary care at Swiss universities--current state and perspective.

BACKGROUND: There is increasing evidence that a strong primary care is a cornerstone of an efficient health care system. But Switzerland is facing a shortage of primary care physicians (PCPs). This pushed the Federal Council of Switzerland to introduce a multifaceted political programme to strengthen the position of primary care, including its academic role. The aim of this paper is to provide a comprehensive overview of the situation of academic primary care at the five Swiss universities by the end of year 2012. RESULTS: Although primary care teaching activities have a long tradition at the five Swiss universities with activities starting in the beginning of the 1980ies; the academic institutes of primary care were only established in recent years (2005 - 2009). Only one of them has an established chair. Human and financial resources vary substantially. At all universities a broad variety of courses and lectures are offered, including teaching in private primary care practices with 1331 PCPs involved. Regarding research, differences among the institutes are tremendous, mainly caused by entirely different human resources and skills. CONCLUSION: So far, the activities of the existing institutes at the Swiss Universities are mainly focused on teaching. However, for a complete academic institutionalization as well as an increased acceptance and attractiveness, more research activities are needed. In addition to an adequate basic funding of research positions, competitive research grants have to be created to establish a specialty-specific research culture.

Annual Report of the Chief Medical Officer for the year 1999

The general purpose of the Report is: To make a contribution to the debate on issues relevant to the development of public health policy. To describe aspects of the health status of the Irish people by reference to certain indicators of mortality and lifestyle. To identify particular factors which are relevant to the major disease entities affecting the Irish population. To identify a specific theme of particular contemporary relevance to health in Ireland Download the Report here

Breastfeeding in Ireland. A five-year strategic action plan - National Committee on Breastfeeding 2005

The protection, promotion and support of breastfeeding has been identified in many national policy documents as a major public health issue. Breastfeeding offers mothers and babies significant health advantages both in the short term and throughout their lives.From a health policy point of view, it is generally agreed that the better health afforded by breastfeeding can result in major savings in the provision of health care. Studies have also shown that breastfeeding has a positive effect on the wider economy with fewer days being lost by employed parents of breastfed babies to illness. Although progress is being made in promoting and supporting this health enhancing, environmentally friendly and low-cost feeding option, breastfeeding rates in Ireland continue to be among the lowest in Europe. This Strategic Action Plan has been developed by a Ministerial appointed, multi-disciplinary National Committee on Breastfeeding, in consultation with relevant stakeholders, to further promote breastfeeding among all sectors of the population and particularly among those currently least likely to breastfeed. Its goal is the achievement of optimum health and well-being for children, their mothers, families and communities. Click here to download PDF

Reducing the Risk: A Strategic Approach - The Report of the Task Force on Sudden Cardiac Death

The Minister for Health and Children established the Task Force on Sudden Cardiac Death (SCD) in the Autumn of 2004, with the following terms of reference:1) Define SCD and describe its incidence and underlying causes in Ireland.2) Advise on the detection and assessment of those at high risk of SCD and their relatives.3) Advise on the systematic assessment of those engaged in sports and exercise for risk of SCD.4) Advise on maximizing access to basic life support (BLS) and automated external defibrillators (AEDs) and on:- appropriate levels of training in BLS and use of AEDs, and on the maintenance of that training- priority individuals and priority groups for such training- geographic areas and functional locations of greatest need- best practice models of first responder scheme and public access defibrillation, and- integration of such training services.5) Advise on the establishment and maintenance of surveillance systems, including a registry of SCD and information systems to monitor risk assessment, and training and equipment programmes.6) Advise and make recommendations on other priority issues relevant to SCD in Ireland.7) Outline a plan for implementation and advise on monitoring the implementation of recommendations made in the Task Force’s report. In undertaking its work the Task Force was mindful of national health policy, relevant national strategies and of the recently reformed structures for health service delivery in Ireland. Read the Report (PDF, 1.66mb)

Annual Report of the Elder Abuse National Implementation Group, 2006

Annual Report of the Elder Abuse National Implementation Group, 2006 The specific function of the Elder Abuse National Implementation Group (EANIG) is to overview the implementation of Protecting Our Future (Department of Health and Children, 2002) by various government agencies and other bodies. Protecting our Future became official health policy in November 2002. The group met on four occasions during 2006. I would like to thank the following members who retired from the Group for their hard work and contribution to the elder abuse programme: Ms Mary McDermott, Cllr Eibhlin Byrne, Mr Shay Costello, Ms Anne-Marie Ross and Mr Tom Leonard. A full list of current members is provided at Appendix A. Click here to download PDF 157kb

First Annual Report of the Independent Monitoring Group on "A Vision for Change"

First Annual Report of the Independent Monitoring Group on “A Vision for Change” In January 2006, the Government adopted the Report of the Expert Group on Mental Health Policy "A Vision for Change"Âù as the basis for the future development of mental health services. In March 2006, the Minister of State at the Department of Health and Children, Mr Tim Oâ?TMalley, T.D., with special responsibility for mental health services, established the independent Monitoring Group to monitor progress on the implementation of the report recommendations. Click here to download PDF 255kb

2nd Report of the Independent Monitoring Group on A Vision For Change

This is the Second Annual Report of the Independent Monitoring Group for A Vision for Change the Report of the Expert Group on Mental Health Policy. The Monitoring Group was established in March 2006 to monitor and assess progress on the implementation of A Vision for Change. In this Second Report, the Monitoring Group has found that by and large the recommendations in its first report were not addressed in 2007, although some have been prioritised for implementation in 2008. Download document here

Standard of Healthy Living on the Island of Ireland

Pre-requisites for health are equity, minimum income, nutrition, peace, water, sanitation, housing, education, work, political will and public support (WHO, 1986). It has long been known that social disadvantage harms health (Black, 1980, Ettner, 1996). Many researchers have documented that those in lower socio-economic groups are more at risk of developing major chronic diseases such as cardiovascular diseases (Beaglehole and Yach, 2003, WHO, 2003a), diabetes (Wilder et al., 2005), and some cancers (Brunner et al., 1993, Strong et al., 2005), and are at a higher risk of having multiple risk factors associated with these diseases (Lynch et al., 1997). The living standards that many people enjoy and the behavioural choices they make are heavily determined by their access to resources such as income, wealth, goods and services (O’Flynn and Murphy, 2001). The most prominent explanation between disadvantage and health is that lack of resources restricts access to the fundamental conditions of health such as adequate housing (Macintyre et al., 2003, Macintyre et al., 2005), good nutrition (Nelson et al., 2002) and opportunities to participate in society (McDonough et al., 2005). Each of these issues are very much influenced by material and structural factors inherent to and determined by fiscal, social and health policy (Graham and Kelly, 2004, Milio, 1986).

Forecasting nano law: defining nano

Law and science have partnered together in the recent past to solve major public health issues, ranging from asbestos to averting the threat of a nuclear holocaust. This paper travels to a legal and health policy frontier where no one has gone before, examining the role of precautionary principles under international law as a matter of codified international jurisprudence by examining draft terminology from prominent sources including the Royal Commission on Environmental Pollution (UK), the Swiss Confederation, the USA (NIOSH) and the OECD. The research questions addressed are how can the benefits of nanotechnology be realized, while minimizing the risk of harm? What law, if any, applies to protect consumers (who comprise the general public, nanotechnology workers and their corporate social partners) and other stakeholders within civil society from liability? What law, if any, applies to prevent harm?

Smoking in prisons: the need for effective and acceptable interventions.

Tobacco-smoking prevalence has been decreasing in many high-income countries, but not in prison. We provide a summary of recent data on smoking in prison (United States, Australia, and Europe), and discuss examples of implemented policies for responding to environmental tobacco smoke (ETS), their health, humanitarian, and ethical aspects. We gathered data through a systematic literature review, and added the authors' ongoing experience in the implementation of smoking policies outside and inside prisons in Australia and Europe. Detainees' smoking prevalence varies between 64 per cent and 91.8 per cent, and can be more than three times as high as in the general population. Few data are available on the prevalence of smoking in women detainees and staff. Policies vary greatly. Bans may either be 'total' or 'partial' (smoking allowed in cells or designated places). A comprehensive policy strategy to reduce ETS needs a harm minimization philosophy, and should include environmental restrictions, information, and support to detainees and staff for smoking cessation, and health staff training in smoking cessation.