Dr. Sinead Murphy:

Since Senator John Crown is here but may have to leave, we will start with his questions. He heard it exactly and clearly. There is no funding available. It is entirely from research funding, that is, from a grant given by the Health Research Board to one member of the team. It is funding various parts of the work, including the technology aspect, and trying to bridge the gap. It is excellent research. There is also fundraising by the fundraising body in the hospital at Temple Street.

There are no appointments, medical or otherwise, to this programme. There are no consultants with a special interest in paediatric obesity. I do it as part of my work. As Ms O'Malley said, the allocation is, at most, one day a week. One would need 14 days per week to begin to address this issue at Temple Street hospital alone. We are grossly under-resourced. Traditionally, paediatric endocrinologists would have dealt with this issue, but, as Senator John Crown has pointed out, there are approximately 1 million children and six paediatric endocrinologists in the country. That is the answer. They are dealing with paediatric diabetes, congenital adrenal hyperplasia and all of the thyroid and growth issues. Clearly, paediatric obesity does not get the time it deserves because there are not enough paediatricians appointed to deal with the issue. That is clear.

Senator John Crown referred to cultural effects. There are parents who are fearful of mentioning being overweight in case they might turn their children into children with anorexia. Part of our role as advocates for children and as health advocates is to educate parents in order that they know this is not the case. I have sat in clinics with a child weighing 120 kg while the mother behind the child was signalling to me not to mention the issue of weight. When such children go out to play, everyone they meet calls them fat and does not talk to them. This is not right and it only makes matters worse. Certainly, we need to be able to address this issue properly and educate parents in order that they know that it is an unhealthy lifestyle. We need to move the focus from weight onto health. That is what our programme and the Up4It! programme are about.

That brings me to the need to educate GPs. At Temple Street hospital we run several evening sessions at which we educate GPs and invite them to attend interactive information evenings. We have made a conscious effort at these sessions in recent years to concentrate on this issue and inform them about our service, although now we almost have to keep them a secret because we cannot deal with the influx of referrals. We also talk to them about how to talk to their patients. Should a patient present with something else we would like to be able to encourage GPs to have the time and resources to measure him or her, plot him or her on centile charts and, in a completely non-blaming way, explain to the child and parents that in terms of growth the child is doing well in one direction but in another is not healthy or where we would like him or her to be. However, one must have an option.

Deputy Caoimhghín Ó Caoláin mentioned drawing the attention of GPs to this problem and whether they were aware of the Up4It! programme. They are not because it is not available as the funding is not available any more. It is a difficult issue because, on the one hand, we can educate GPs on how to bring the issue to the attention of parents, but then, on the other, GPs have to explain that the parents and children must go off and deal with it. There is nowhere to send them to and that is the subject of our appeal to the committee today.