David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I welcome all our witnesses. We have very limited time, so I just want to put a number of questions first to Dr. Campbell and then Dr. Gilheany. I am not looking for everybody to answer them and I will not get through some of the questions I have.

My first observation on the opening statements is that we obviously need to simplify this message as best we can for people. We need a layperson's understanding of what we mean by the commercial determinants to health. Some of it has been laid out. My take away from what has been said in all of the opening statements is that we are putting too much focus on education and too much focus on individual responsibility but not enough focus on what we call the structural changes, which are those power imbalances and so on. Dr. Campbell gave a number of examples of physical change, pricing change, and distribution change. I have two questions on that. Will Dr. Campbell give us very practical examples of what more can be done in those areas that would make a difference?

My second question is about something Dr. Gilheany mentioned, but I will also put this question to Dr. Campbell first for her view. Does Dr. Campbell believe there are sufficient mechanisms or metrics within the Department of Health and Healthy Ireland to measure a lot of the structural interventions that are necessary? Some of them may not even be happening but some, such as the sugar tax, are examples of positive interventions. Is enough of that measurement being done? These are my two questions: the layperson's understanding of what is meant by the commercial detriments of health, and advice Dr. Campbell would give around practical measures that can be taken right now that would tackle some of those power imbalances. I will then come back to Dr. Gilheany.