Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the panel here this morning. If the figure is as high as nine out of ten, they would be as well advised that the reasons for opting for gluten free products are not diet related. There are a number of people taking gluten free products who are not coeliacs, and for the wrong reasons. They might be surprised to know that it may not contribute in the way they expect.

I am the father of four children who are coeliac. I have one who is not; I do not know how she escaped. We are very familiar with the condition and dealing with it. It is important to say at the outset that big advances have been made. There have been major developments and improvements in increased awareness, increased choice of foodstuffs and the quality of foodstuffs. I remember the quality of some of the foodstuffs in the early stages of my children's diagnosis was very unattractive but that has changed dramatically. It is important to put out the positive story because huge strides have been made, and the Coeliac Society has contributed enormously to that advance. More restaurant menus are offering clear coeliac choices and the allergen highlights on food products, which is not just about coeliac disease, about the presence of wheat, rye, oats or barley covers a whole spectrum from nuts, dairy product and eggs, depending on the issue the individual may have.

Promotion of awareness is hugely important and I very much welcome the fact that the witnesses are here before the health committee today. I hope that in itself will be a contribution, not only in terms of our being re-briefed but also in terms of public awareness arising out of this engagement. I would like to ask if Ms Denning would mind circulating the members with a copy of the gluten-free booklet, the product listing, after the meeting. She may not have one for everyone in the audience with her but if she does that is even better. It would be helpful because many of the members would not have had sight of the different publications and information the Coeliac Society continues to furnish to those who are registered.

As regards coeliac clinics at hospital sites, Professor Kennedy mentioned the current position in his presentation. What is the current position across hospital sites? My own experience would suggest Crumlin hospital is where the great bulk of final diagnoses - in terms of the biopsy - are made. Professor Billy Bourke and the team there are excellent and I pay tribute to them. Is that the only location at this time? Can Professor Kennedy give us an outline of the network, if one exists, and what he thinks should be the optimum arrangement to work and lobby towards?

It is very important for this committee to be able to reflect patient needs in hospitals, certainly to the HSE. Concerning food provision and preparation, it is very important to highlight preparation as much as the actual food provision itself. That is something the committee can certainly do.

The screening programme mentioned in the presentation is very understandable. Dr. Doorley talked about this as well. It is understandable to target siblings and immediate family, but we all accept that the extent of coeliac disease is much greater than the confirmed statistics suggest. Its presence is much wider than that. How could initial screening programmes be rolled out beyond just that target base? I am firmly of the view that the earliest diagnosis possible is in the interest of the young person and the individual's life path, but it is also cost effective because we are saving people from having to look for other interventions later in life as a result of neglecting the condition.

I noted the list of associated conditions and would like to ask either Professor Kennedy or Dr. Doorley to elaborate a little on EE. We were wrestling earlier with the name of the EU Commissioner for Health and Food Safety and here I go again, I am going to wrestle with this but I will do my best. Eosinophilic oesophagitis, EE, is the effect on the lining of the oesophagus. I have picked up recently that EE is showing itself more and more as an associated condition in those diagnosed with coeliac disease. Can the witnesses comment any further on that?