James Reilly (Dublin North, Fine Gael) | Oireachtas source

Deputy Ó Caoláin raised a number of issues around the dementia strategy and the carer's strategy and I will defer to the Minister of State, Deputy Kathleen Lynch, in regard to them. He mentioned rehabilitation and we are very fortunate to have Dr. Áine Carroll here from the National Rehabilitation Hospital, so she might address that.

The Deputy also mentioned the meningitis B vaccine. All these vaccines must be properly assessed and the Irish Medicines Board is a very competent authority and is recognised in Europe as such. It will do its own assessment and will act accordingly. We all know vaccines can occasionally have a down-side, so we need to be careful. When we offer vaccines, it is important to remember we are proactively encouraging people to protect themselves or their children. We must ensure that protection is real and that the risks are very low. We know there is a small but vocal group in this country which is anti-vaccine. While many of the great health gains we have had in this country, in terms of longevity, have been due to better social conditions, such as housing, clean water and a proper sewerage system, at least 50% is down to vaccination and it is critically important to remember that. However, we will take our time and will take care, but it will be done.

Senator Jillian van Turnhout spoke about a pledge or a code on meeting various interest groups, in particular the tobacco groups. She is right in that there is a WHO convention on this, to which we have signed up. I am very happy to confirm that I will never meet them, although, as a politician, I am acutely aware of the danger of the words "never" and "always". I hold very strong views about this industry which is mounting a campaign. There is a battle ahead. Later today I will meet interest groups, including the Irish Heart Foundation, the Irish Cancer Society, Barnardos, the ISPCC and Cystic Fibrosis Ireland, which I imagine feel very strongly about this issue too and which understand the dreadful damage smoking does. It is the only product I know which is legally and freely available that will kill one if one uses it according to the manufacturers' instructions. It is a fight from which we cannot run away and which we cannot afford to lose. It is a battle that will continue until it is won, and it will be won. I am very pleased to say the Government has passed a document entitled, Tobacco Free Ireland. By 2025, we hope to have a tobacco-free country and by that we mean less than 5% prevalence of smoking in this country.

The Senator asked about the timeline in regard to smoking in cars. Much work has been done on this. The heads of the Bill are with the Attorney General. We do not have an indication as to when they will be ready. A huge amount of legislation is going through the Dáil but this is a priority for me, as is plain packaging. I am sure the Senator read in The Irish Times that the tobacco industry in America is becoming heavily involved with some very powerful individuals who seek to influence our determination to protect our children from this dreadful killer product.

The Senator mentioned Health Ireland: A Framework for Improved Health and Wellbeing 2013-2025 and the reduction in the number of hours spend on physical education. I am in full agreement with her. Exercise is critically important. Forming a habit of exercise early in life stays with one throughout one's life. We want people to have a qualify of life. There is not much point living to 99 years of age if one spends the last 20 years in a wheelchair on an oxygen cylinder. We know from excellent work done in Trinity College Dublin that the last ten days of one's life are the most expensive ten days on the State. If one dies in one's 40s or 50s, it is three times more expensive on the State than if one dies in one's 70s, 80s or 90s. There has been a huge improvement in longevity in this country, which is most welcome. The Senator also mentioned issues around mental health and I will defer to the Minister of State, Deputy Kathleen Lynch, on that.

I refer to Senator Colm Burke's comments on non-consultant hospital doctors. I consider this to be one of the most serious problems we have. It is immoral. These are the brightest and the best. They study extraordinarily hard in school to achieve 580 points - a margin of error of 3%. They study for five years in college and then they come out to a wilderness with no mentoring, no advice on what career path to take within medicine and no idea of the areas which hold best potential in terms of a future career. They have no clear career path. This is our problem and our fault but it is also the fault of the medical profession and the leaders in the medical profession who have allowed this to evolve and who continue to preside over it.

I have already had a meeting with some NCHDs and further meetings are planned. I want to create a safe place for non-consultant hospital doctors, many of whom do not like that term, which is fair enough, where they can devise and think through a new way and a new career path for themselves without being intimidated by the people who are at the top or by anybody in the HSE or the Department of Health, and I mean no disrespect to them. When they formulate those thoughts, let them come to us with them and then let us look at them with the likes of Mr. Barry O'Brien, Mr. Tony O'Brien and others to see how workable they are.

We are presiding over a perversity where our brightest and best are trained by us to go away while we scour the Third World and rob it and deprive it of its doctors. It is immoral and wrong and it must be addressed.