Ms Richelle Flanagan:

I thank the committee for inviting us to make a presentation and its very informed questions. I reiterate what Dr. Murphy has said. In respect of the figure of €10 million, that would certainly be a very good start and would allow us to put into action the outcome and evidence based programmes we already have in place. I read in the newspaper on Tuesday that the Minister had talked about moving to an outcome-focused health system. We have programmes that show outcomes; therefore, let us start using them to tackle the obesity epidemic. To put the figure of €10 million in context, it costs approximately €10,000 to see 15 kids; with that money one could have 1,000 programmes and see 15,000 children who were overweight or obese. There is a multiplier effect because this is a family-based programme; therefore, we are not dealing with the child and the parent but extending into the family - two parents and two children, for example - who also benefit. The cost per session in the Up4It! programme is the same as in the weight programmes in communities that do not have a multidisciplinary focus. It is very good value for money, providing outcomes that, as Dr. Murphy has mentioned, have long-term effects. We know that it is much more difficult to keep the weight off adults with obesity. It is better to get in early with children. It would be a very well spent €10 million and most welcome.

For some reason people tend to think obesity is not a disease. It is. If one's child was suffering from any other disease, one would be at the door hollering to have him or her treated. It is scandalous that there is no HSE-funded childhood obesity programme in the acute setting for children who have fractures. It beggars belief.

In reply to the question about whether we have had the opportunity to present to the Department of Health, we have been banging on the door about several initiatives with regard to chronic disease and obesity and consider our call is falling on deaf ears. We want to see some action taken for these children. The talk is all of prevention and we understand prevention is the best approach, but the clinical services to manage children's obesity have been missed out on. That is one of the points we want to get across today: kids who are suffering from adult disease in their childhood need treatment.

On the question of a national post, we agree that there should be a focus on childhood obesity in the paediatric stream. We need an overarching national post to deal with obesity in general for adult and paediatric services. That is part of the problem. We have a very fragmented and small service; in 88% of the country there is no access to childhood obesity treatment programmes; in 73% there is no access to prevention programmes tailored to meet the needs of obese children. Part of the problem is that there is no one driving the agenda.

With regard to referral pathways from GPs, Ms Ball said GPs were referring children to the Up4It! programme, but as Dr. Murphy said, it is not available. If it is not in the mind, there is nothing available to which people can refer to.

In response to Senator John Crown's question about the misguided focus on eating disorders, safefood has compiled reports to show that parents do not recognise obesity in themselves, let alone in their children. That is the problem and we have to help them. This is not blaming people but about putting the supports in place. That is a very important point. Research shows that GPs are unsure about how to have the conversation with parents. We all need to step up to the plate in our clinical services to deal with this issue. We want Deputy Peter Fitzpatrick to recognise in his report that we would like to see the clinical services integrated with prevention programmes. The two have to be part of tackling the problem.

Deputy Caoimhghín Ó Caoláin mentioned the roll-out of the Core programme. It would make sense when there is a programme that costs only €600 per family to roll it out. Similarly, the W82GO! programme is evidence-based and we call on the Government and the HSE to start funding it. Providing €10 million would be a fantastic start.