Dr. Nazih Eldin:

On the last point, we already have a surveillance initiative with the World Health Organisation. We have strict guidelines on weighing children, and they are adhered to.

I will make two points in answer to Senator Crown. Where do I start?

I agree with all Senator Crown said. There are two further points to be made, however. The first concerns chronic disease management. The HSE already has chronic disease management programmes. We have added another one specifically for the area in question. My colleague, Dr. Fenton Howell, leads on chronic disease prevention. We actually recognise what the Senator says and we will be addressing the matter very shortly. We have already produced a paper on the matter and I am willing to share it with the committee, if it wishes.

On the statement that we require education and legislation, I contend we also need engineering. My colleague, Dr. Woods, has alluded to the fact that we have engineered physical activity out of our lives. We need it everywhere in life, including work and leisure, as it is very important.

My last point to Senator Crown is on education and training. This was one of the 24 recommendations in the task force report and it has now been actualised. We have a training programme - it is only in its infancy – and we are training general practitioners. The focus is almost entirely on postgraduates, rather than undergraduates, because it is much more difficult to get to universities. We hope that in the next stage, the period 2013 to 2014, the programme will be part of undergraduate education.

Deputy Naughten asked a question on breast-feeding. I just published a paper on the obstacles to breast-feeding faced by professionals and will send it to the committee. The paper has three objectives, the first of which is to promote breast-feeding among the general population, including the young population. This is very important because there is no culture of promoting breast-feeding in Ireland, be it because of the Famine, religiosity or concepts of decency and covering up. There are obstacles to breast-feeding enshrined in Irish culture and we must overcome them. We must better promote breast-feeding.

The second objective is to support those who wish to breast-feed. I alluded to one or two examples, on which I am willing to expand further.

The last objective pertains to protection. The Government and the HSE must adopt the World Health Organization's international code of practice on breast-feeding substitutes. We are not adhering to it. I am not against formula because it is needed, but it is used in hospitals unnecessarily when babies are born. We spend €500,000 on it but we could reduce this expenditure to €50,000. There are children who need substitutes but most do not. We really need to be stricter on adherence to the guidelines. I am willing to work to this end.

I have already stated my interest. As I said, I am not a politician so I ask the members to forgive me. Everywhere I go as a health promotion officer, I say the most important thing anyone can do to promote and improve his or her health is vote. Owing to this, I believe the members are the most important people because they have a considerable responsibility. Bearing in mind that one in four children is obese, we must not continue to do what we are now doing because we will get the same results. We must be very progressive and active. No country in the world could treat so many people; it is impossible. No country could afford it, nor could industry. Therefore, the only approach is to be absolutely progressive and harsh on all the causes of obesity.