Dr. Sheila Gilheany:

The Commission on Taxation and Welfare, which reported last year, was tasked with examining how effectively good health is promoted in Ireland. It was asked to present relevant reforms to advance and incentivise that goal. It came back with a very clear message - health taxes on unhealthy products were recommended.

I will take that back to the issue of alcohol because that is the issue I know most about. Excise duties on alcohol have not changed in the past ten years. They have remained the same, which effectively means that their value is now 15% lower than they were when they were last changed. There is no mechanism I can detect by which the Department of Health inputs into Department of Finance thinking on excise duties. We see a mechanism around tobacco for public health purposes. A clear goal has been set by Tobacco Free Ireland, which reports proudly that the Minister for Finance increased taxation on a packet of cigarettes by a certain amount in each budget. That has been done every year but there is no pressure from the Department of Health or, as far as I can see, a mechanism by which this would be influenced.

We see many examples of this policy incoherence, where multiple other Departments bring forward legislation or policies that have a direct impact on the Department of Health and health budgets, and alcohol takes up 11% of our healthcare budget, yet those other Departments are doing things that do not allow for good health in their policymaking. The Minister previously referred to the Public Health (Alcohol) Act, which is very welcome. It passed in 2018 but is still not fully implemented. In fact, it is a long way off being implemented with regard to restrictions on advertising and the content of that. These are modest measures but at the same time the Department of Justice is seeking to increase alcohol availability by increasing licensing trading hours. That is a complete policy mismatch. It makes no sense whatsoever. When we talk to the Department of Health about that, the response is that it is a matter for the Department of Justice, but it is not. It is a matter for the whole of the Government. We are calling on the committee to take note of this, ask how we can change the paradigm and make it that it is not just about what the Department of Health does but what the whole of the Government does.