Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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I welcome from safefood Mr. Ray Dolan, chief executive, Dr. Cliodhna Foley-Nolan, director of human health and nutrition, Dr. Gary Kearney, director of food science, and Ms Fiona Gilligan, director of marketing and communications. The representatives of safefood are here to discuss North-South co-operation in food safety and initiatives to promote healthy eating and to combat obesity. safefood Ireland is involved in a range of cross-Border initiatives involving schools and community groups, such as the community food initiative, and to educate and promote healthy eating with a focus on disadvantaged communities. I invite Mr. Dolan to make his opening statement. Following the presentations, committee members will pose questions.

Mr. Ray Dolan:

I thank the Chairman for his invitation to appear before the committee. In 2012, we appeared before the committee when the Chairman was a member of it. We had a useful conversation and debate that day.

safefood was set up as the Food Safety Promotion Board under the terms of the Good Friday Agreement as one of six implementation bodies established under the Belfast agreement in December 1999. safefood implements, on an all-island and cross-Border basis, policies agreed in the North-South Ministerial Council, the most recent of which was held in Derry last Wednesday. Departmental responsibility rests with the Department of Health, Social Services and Public Safety in Belfast and the Department of Health in Dublin.

Our budget for 2015 is €7.8 million, roughly £6.3 million sterling. Funding is provided by the Oireachtas and by the Northern Ireland Assembly. The Oireachtas provides 70% of the funding, with 30% coming from the Northern Ireland Assembly. safefood does not have a direct involvement in public communications relating to food safety incidents and alerts as these responsibilities are assigned to the Food Safety Authority of Ireland in the South and the Food Standards Agency in Northern Ireland. Our headquarters is in Little Island in Cork, with a sub-office in Dublin that houses our marketing and communications people. This leaves us with four directorates reporting to the chief executive.

safefood’s strategy links economic, social, and cultural factors that continue to change over time, influencing consumer concerns and their perceptions of behaviour in regard to food. The food industry continues to grow globally and, from time to time, there are outbreaks of food-borne illness or incidents that will further alter consumer perceptions and occasionally dent confidence. safefood monitors these concerns and utilises its resources to appropriately inform and, where necessary, reassure consumers so that they may continue to make healthy and safe food choices. We also use targeted consumer messages to further inform, support and motivate consumers to put food safety and healthy eating at the centre stage of their lifestyle choice.

Our focus has evolved from individual food poisoning crises and pathogens to an emphasis on the four c’s, cook, clean, chill and cross-contamination; from limited individual nutrient information to a holistic approach to the obesity epidemic; from bench research to applied and behavioural research; from mass media campaigns to multi-component integrated campaigns; and from print and traditional media to social media. We are aware of the wider public health context in which we operate and we work in partnership with Governments and professional partners across the island of Ireland to inform consumers of positive lifestyle choices to improve their health, particularly nutritional advice and good food safety practice.

Our most recent campaign was on childhood obesity, the aim of which was to communicate practical solutions that parents can adopt to help them tackle the everyday habits associated with excess weight in childhood. To date, six television ads have been developed covering the topics of portion size, treats, fizzy drinks, physical activity and sleep. Some members may have noted that our sleep television ad went out this week.

These messages have been augmented with radio and outdoor advertising as well as considerable digital and social media activity. We have partnered with the HSE and Healthy Ireland in the South and the Public Health Agency in Northern Ireland. Resources have been disseminated through Early Childhood Ireland in the South and Early Years in Northern Ireland. All GP surgeries have been circulated with leaflets detailing practical tips for parents and we have also partnered with the Irish College of General Practitioners in the development of a resource to help general practice tackle this important and sensitive issue.

Our most recent food safety campaign related to chicken and campylobacter. With eight out of ten adults eating chicken every week, consumers need to be reminded to ensure that chicken is cooked and handled properly to avoid food-borne illnesses. In November 2014, we launched a food safety awareness campaign in partnership with the Food Standards Agency in Northern Ireland with the theme, Don't Wash Raw Chicken. Campylobacter is one of the most common causes of bacterial food poisoning on the island of Ireland.

I would like to mention another strong piece of consumer communication in the area of obesity on which safefood is delighted to have worked, that is, the RTE programme "Operation Transformation". On review of one of the earlier programmes in the series, we spotted the opportunity to get involved in the programme and have worked closely for the past five years with the programme makers in the development and roll-out of the series. The show and its format have been a phenomenal success across the island and is being applauded around the world. It has been adopted in Belgium, France and the USA. It has not only worked on an individual level in helping people to lose weight but also on a community level, managing to get hundreds of communities engaged, motivated and moving.

The 2015 programme ran for six weeks in January and February to an audience of just under 500,000, and 314 communities across the island started weight loss groups. Some 20% of those who watched the show claimed to have lost weight, with 46% of those claiming to have lost between 0 lbs and 6 lbs. Some 23% of those who watched the show have claimed that, since the show ended, they are being more active and 21% are now eating healthier food.

I refer to our education initiatives. With up to one in five teenagers leaving school early, this can impact negatively on their longer-term health, as limited knowledge about healthy eating and physical activity is a contributory factor to the growing problem of obesity on the island. In partnership with Youthreach and the Northern Ireland NEET forum for those not in education, employment or training, we developed www.eatright.euand launched it in 2014 to help inform these early school leavers about nutrition and general cooking skills. One of our successful programmes mentioned by the Chairman in his introduction was the community food initiatives.

We are in our second tranche of ten projects, which we fund for the years 2013, 2014 and 2015. These are collaborative, community projects that cover areas from Antrim to Cork. They are targeted at a low-income audience and the emphasis is on cooking skills, growing food, nutrition and food education and food supply. It has proved to be successful.

safefood has promoted food safety and hygiene across the food chain through the establishment of all-island food safety networks. These collaborative arrangements, called knowledge networks, create and augment linkages across the island between food safety professionals. Many food professionals, not only North-South but also east-west, do not get the opportunity to meet and share the issues that arise. This has been a great success over the years.

With regard to research, we have continued to undertake appropriate research and knowledge-gathering in order to address gaps in scientific knowledge related to our core areas of food safety, hygiene and healthy eating. This builds the evidence base that facilitates safefood’s communications to consumers and food safety professionals across the food chain. Our aim is always to provide messages that are supported by science and that are clear, concise, authoritative, relevant and independent. Our information must be accessible, accurate, and supportive of public policy. I, and my colleagues, will be delighted to take any questions that members have.

Brendan Smith (Cavan-Monaghan, Fianna Fail)
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I welcome Mr. Dolan and his colleagues. The importance of the body is evident from the fact that it was one of the six of implementation bodies established following the signing of the Good Friday Agreement. The last point concerned research. Does safefood collaborate with institutes of technology and universities throughout the island of Ireland on research? One of my bugbears is the amount of duplication in this country. Representing two southern Ulster counties, I see too much duplication and not enough collaboration at public service level in general. There is plenty of potential for consolidating research in one university, institute of technology or research institute instead of everyone doing a little bit of this and that. It is not putting public money to best use or getting the best outcomes from research. I have noticed, over the past few years, more third level institutions developing food programmes and it concerns me. It is always better to have specialist centres. We know about the value of specialist centres in the delivery in health services. It is similar in research and innovation.

We have expertise in and a focus on particular areas. Does safefood collaborate with third level institutes throughout the island of Ireland? I presume there is room for improvement with regard to co-operation and eliminating duplication.

On food poisoning caused by chicken, the delegates have noted that they launched the food safety awareness campaign in partnership with the Food Standards Agency in Northern Ireland. There was no mention of the Food Safety Authority of Ireland in that context. Was it because of fiefdom building or defence that it was not involved?

In regard to childhood obesity and awareness campaigns, the delegates mentioned fizzy drinks. Sports sponsorship is a related and contentious issue, particularly alcohol companies sponsoring sports programmes. What non-alcoholic drinks pose particular dangers?

People sometimes confuse safefood and the Food Safety Authority of Ireland, although I know that they have separate remits. safefood's role is the promotion of good health and lifestyle standards. Advertising and marketing programmes are often the only way to get the message out, but perhaps it would also be useful to go into the marketplace to meet potential consumers. Ten years ago I was involved in the roll-out of the Food Dude programme which aimed to persuade children to eat more fruit and vegetables. The outcome of the programme was very satisfactory. Children were provided with various fruits and vegetables at school and by this means they often educated their own parents on the importance of consuming fruit and vegetables. It is welcome that safefood is working with Youthreach and its counterpart north of the Border. Have the delegates thought about working at primary school level? I recognise that the question arises of finding resources to reach the 3,000 primary schools in the State. However, in working with children, they will bring the message to their parents.

Mr. Ray Dolan:

I will begin by addressing the question on the Food Safety Authority of Ireland, FSAI, because I am familiar with that organisation having previously worked for it. It had responsibility for communicating with consumers when it was established under legislation introduced in 1997. When safefood subsequently came on board as a result of the Belfast Agreement, the authority lost its remit of communicating with the consumer. As the Food Standards Agency in Northern Ireland has the remit of communicating with consumers, we partner it in that context. It was not a case of fiefdom building. This arrangement works well and the FSAI is happy with it.

All of our research is put out to tender and we have a good relationship with the various academic institutions. Certain institutions have strong expertise in different areas of food science. UCC, UCD, Queens University Belfast and the University of Ulster all have strong faculties in food sciences, but we often find that the specific areas of expertise differ. This becomes clear when they bid for research contracts because we have an open tendering process. Where commonalities are identified, institutions often collaborate to bid for a project, which also works well for us.

I agree with Deputy Brendan Smith that Food Dudes which was developed by Bord Bia was a great success. Educating children offers a route to reaching their parents. We are closely involved in developing the curriculum in this area and enjoy strong relationships with the teacher associations. We attend their AGMs and other meetings to make presentations. We take advantage of every opportunity to get into schools, both North and South. We are also trying to work with creches.

Dr. Gary Kearney:

We use research to build an evidence base for our communications, whether directly with consumers or in other areas of the food supply chain. When we commission research, we use our network of other food safety agencies to investigate whether similar work has been carried out in centres of excellence on this island and in the United Kingdom to ensure we do not duplicate research. Approximately 96% to 98% of our more than 100 research projects involve partners from both Northern Ireland and the Republic. Mr. Dolan referred to several institutions which are particularly strong in food safety research. They tend to carry out many of the projects in this area because they have the necessary capacity to do so. We also have a scientific advisory committee which advises us on research we might pursue and developments elsewhere in the world, as a way of ensuring taxpayers' money is put to good use and that we maximise the potential of research projects. The committee also helps us to identify gaps in food safety along the food chain from producer to the consumer and to find ways of harnessing research in consumer communications.

Ms Fiona Gilligan:

We have prepared resources for primary schools, including the Eat, Taste and Grow programme in the North and the Tastebuds programme in the South. Children learn about where food comes from and how their diet affects their health. I agree with Deputy Brendan Smith on the importance of children bringing the message home to their parents and this is something we strive to achieve. We have worked with crèches to introduce educational resources on hand-washing sin order that children learn this message at a very early stage. We created a rhyme about hand-washing which children can learn with their carers and teachers in the crèche. We have also worked with Agri Aware to grow food in schools.

On fizzy drinks and sponsorship, we carry out tracking research on an annual basis to identify consumer concerns about food. This year we asked a number of questions about sponsorship. One in four respondents would ban sponsorship of sport by alcohol and food companies, while one in three linked the food sold or advertised at sports events with obesity.

Dr. Cliodhna Foley-Nolan:

The potential for duplication is not a major issue for us.

An issue with which we are all grappling and which can be further improved upon is setting priorities as regards research. Everything is interesting but we cannot afford everything. A number of Government Departments and agencies fund food-related research, including the Department of Agriculture, Food and the Marine, the Department of the Environment, Community and Local Government and the Department of Health. The idea of Healthy Ireland is relevant in terms of pulling those potentially disparate groups together to prioritise areas of research. Even the balance between bench research, which is important in the long term, and things like behavioural research that give more immediate feedback is significant.

One area we have tackled that is a good example from the North-South perspective is dietary surveillance - getting frequent, ongoing and quite detailed information about what people are actually eating. We now have a group of all the relevant funders, as distinct from recipients of funding. They are the groups that are using and want to use public money as effectively as possible. We are agreeing a formula and have six meetings organised with the Departments North and South and the relevant funders, in which we will get together and work out a system avoiding duplication and gaps. That is one example, but there is plenty of scope for developing even further in other areas of research.

Sports drinks sponsorship is an issue involving not just fizzy drinks but all confectionery. Sometimes it is giving the message to children that they can walk from one side of a room to another and then get a bar that contains 300 or 400 calories - it does not make any sense. It is a funding issue for these groups, but very mixed messages are being given. From a policy perspective, we are involved in the special advisory group on obesity in the South and the steering group on obesity prevention in the North. We are influencing policy as much as we can. The alcohol issue is going to come first, but this is also a genuine issue.

I echo what Ms Gilligan was saying about listening to both families and children. Any initiative we have in schools is founded on what children and parents want, or what will target them and impact on them. The resources she was talking about have as major aspects homework and exercise. It might be a nursery rhyme or everybody might have to bring in an apple the next day or bring in an unusual fruit or vegetable. It is all games-oriented rather than what we could call didactic, boring old stuff. Off the top of my head, my recollection is that with Tastebuds - a primary school project which is also running in the North under the name Eat, Taste and Grow - our most recent evaluation shows that 70% of primary schools are taking it up, which is a very high rate.

Seán Crowe (Dublin South West, Sinn Fein)
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Maidin mhaith agus cuirim fáilte don cruinniú. I apologise to the friends and family I have poisoned over the years with chicken and turkey - I am one of those individuals who has been guilty of that, so the witnesses' information is welcome, although I do not want any claims coming in.

As committee members, we do not have many powers but we can make recommendations. What is safefood's view on setting up an all-Ireland body that would deal with emerging food and safety issues? The horsemeat scandal showed us that the island's food chain is complex. An oversupply of horsemeat was combined with pressure from large retailers and their suppliers to cut costs, creating the perfect set of circumstances for fraud and all the difficulties that occurred. Would it make sense to have some sort of neutral space where stakeholders and individuals working in this field could flag up issues of concern, or even to have some sort of whistleblower mechanism for the food industry? If such a body had existed, the problem might have been picked up far quicker. Would safefood, in its non-regulatory, all-island capacity, be well placed to facilitate such a body?

What happened to the plans for the enteric reference centre for the island of Ireland? As far as I can remember, they were shelved by Mary Harney when she was Minister. It was part of the safefood remit at the time and would have allowed food samples to be tested for harmful bacteria. I imagine it would have saved Irish taxpayers a small fortune. Under the current system, we send the samples to Colindale in England, which is a costly process. Could the witnesses let me know the cost? Do they know whether it can result in delays? If there was an outbreak, the Government might wait for a number of samples to save on shipping costs. I think they get it free in the North, but there is pecking order in which the North is placed just above the Republic of Ireland in the prioritisation of tests.

The childhood obesity campaign was mentioned and we all welcome that. Obesity is a problem in both Britain and Ireland. What is the attitude of safefood, if the witnesses can comment, on the question of a sugar tax? A tax on products that contain a high quantity of sugar has been mooted, as has been mentioned already in the context of energy drinks, soft drinks and sweets. We have heard that the money raised in this way could be put back, for example, into the health budget. It could also be put into promoting vegetables and fruit.

Is any work being undertaken with parents and guardians around how to eat healthily on a budget? A lot of the shops in what are officially described as deprived areas stock their shelves with two-for-one offers, doughnuts, all the high-sugar foods, pizzas and so on.

It is almost impossible to get them to bring in fresh vegetables.

How many parents does safefood work with? Cooking is important. I am involved in a not-for-profit company in Fettercairn in Tallaght whose aim was to try to provide a healthy food option every day, but coming up with the calorie count for a particular meal was beyond their capability. Does safefood know of supports for such small community enterprises? I have worked with several groups of lone parents who were naive and did not have a clue how to cook basic foods. There are several of those organisations on the island of Ireland. Does safefood tie in with them? I congratulate it on the work it does.

Cooking for teenagers is another problem. I spoke to some students recently who said even those who are going to university and are highly intelligent do not have a clue how to make the most basic meal. I know there are several programmes on television on that topic, but how do we popularise the culture of people cooking for themselves?

Mr. Ray Dolan:

The Deputy asked some very good questions. We are involved in a very useful project in Fettercairn, a community food initiative, which helps people learn about food and nutrition. It extends to providing facilities to mind children while their parents go to the classes. It is halfway through its three-year cycle and I understand it is a great success, which is a great credit to the people doing it. Often these communities are not ready for the bureaucracy needed to be accountable for State money, or to meet all our requirements for sending in forms and mini-accounts. We have 20 projects, ten of which finished in 2013 and ten which began in 2013. They all run on three-year cycles and focus on people who need that kind of basic education.

In one case a community had put in a request to rent a bus to bring people to the local town and go to the supermarket. I wondered why they were doing that, but it was to educate people about what is on the supermarket shelves, what is worth taking down and what they should not eat, and to explain fruit or vegetables they had never heard of. That campaign has been a great success, so much so that we hope after a three-year cycle they will be able to run themselves or find financing somewhere else. They will often set up market gardens and sell the produce, and open a coffee shop, and that money keeps them going. Many of the first tranche of initiatives, 2010-13, are still going as a result of the kick start we gave them.

The food chain has been very topical since the horsemeat scandal. Last week, a North-South Ministerial Council meeting took place with both Ministers in Derry, and safefood brought in Professor Chris Elliott, an eminent professor of food science from Queen’s University Belfast. He made the Deputy's point to the Ministers that it is not too soon to consider what we could do on the island of Ireland to put a policy in place to address that, whether for whistleblowers or something else. It has been done in other countries, so there is a model. That is topical and I hope we can move on it.

The enteric reference laboratory is one of our functions. A lot of early work was done on it. The present system whereby we send samples to Colindale does not cost us money and it works very well, but an enteric reference laboratory on the island of Ireland would be an even better solution. Resources are an issue. Getting all the key players together is a difficult project and we have not managed to get it across the line. From time to time we revisit it and it is probably time to do it again. Dr. Kearney has been very much involved in this for the past 15 years and can give a front-line view of it.

Dr. Gary Kearney:

In respect of horsemeat, we are all aware that the agrifood business is the biggest indigenous industry on the island, employing just under 275,000 people. Food safety is a key factor underpinning the reputation and sustainability of the industry. Since the horsemeat scandal broke, many people have done a lot of work to introduce new checks and balances. The regulatory agencies in both jurisdictions have put in place systems, committees and groupings to study and trying to scan the horizon and come up with a plan for potential issues in the food chain or food commodities. The Food Standards Agency, for example, has set up a crime unit, which is quite heavily staffed, to reassure consumers that everything is being done and that a dishonest approach within the food chain will not be accepted.

The European Food Safety Authority has pulled all 28 member states together in a major grouping as an initiative to examine what they can do collectively in addition to what they are doing individually to ensure that traceability along the food chain can be optimised. The food chain is extremely complex. The horsemeat scandal showed that. It takes quite a long time to break down what each member state is doing by way of systems, controls, approaches and resources applied. The scandal showed that potential vulnerabilities need to be shored up. It may not have been a food safety, food quality or consumer issue, but it showed us that maybe not everything is right. Food safety is a 24-hour-a-day, seven-days-a-week, forever-and-ever concern. People need to consume food and food is always produced, and we need to be on top of the game all the time. It is not a question of putting a control in place and assuming everything will go correctly. A great deal of effort has been put into that. We have discussed with various stakeholders, including regulators, how safefood can assist in that type of approach. Someone mentioned a neutral space, but we have to be careful because we are not a regulator; we promote food safety across the food chain. It is not our role to audit traceability. We already have very good regulatory agencies to do that.

Professor Elliott has outlined an informal approach in which industry players can come together and share information and pick up trends before they become a problem in terms of food safety further down the food chain. Over the past few years we have established an initiative called knowledge networks. These are collaborative frameworks linking those who work in food safety, or have a responsibility in that area, in academia, including universities and institutes of technology, in industry and in food or food-related agencies, including regulators, across the island. The role of those networks is to identify new risks, especially emerging challenges - to gaze into a crystal ball and examine various areas and try to ask the hard questions such as what happens if the controls do not work in one place or we do not have enough information in another.

We have seven networks. They are built around scientific issues of particular interest - for example, campylobacter in chicken - and we have more than 2,700 members. These are food safety professionals, with 20% coming from industry. We have held approximately 38 events and conferences over the last three to four years and had attendances of 2,200 people within the food chain. People are coming together and identifying issues, especially new risks, that are coming down the track.

We held a very good function at the end of last year with Teagasc. One of our facilitators who runs the campylobacter network, Dr. Declan Bolton from Teagasc, brought in the experts from those countries in Scandinavia that have resolved the campylobacter issue to greater effect than most of the rest of Europe, to learn the tips and tricks they used and how best we can apply what they applied to our situation on the island. We use forums such as those. It is quite robust. There are newsletters and other support mechanisms to try to get people to talk and exchange information on a North-South basis. The industry is an all-island endeavour. It is about building relationships and trust so that information can be shared formally and informally.

The last issue the Deputy mentioned was the enteric reference service. As Mr. Dolan mentioned, I was at the coalface on that. It is in our legislation and we have made a number of efforts to get it over the line. It is a very complex issue. It is not that we are losing money by not having such a service, but the key problem for us, and the reason it was put into our legislation, is the "what if" issue. If there was an outbreak of a major food problem in the Republic of Ireland, how would we get on? There are two centres in the Republic, in Galway and Dublin, that carry out enteric services to a very high standard. The funding streams are not always guaranteed. Even though they do fantastic work, they need a greater guarantee or reassurance regarding funding and resources. In Northern Ireland, the first call is to Colindale. If there was a serious outbreak that swamped us in the Republic, we would use Colindale, but if it affected Northern Ireland there might be a delay in that respect.

As I said, it has been a very complex situation with many stakeholders and many priorities. We had taken the process to a costing stage, where we identified a number of solutions. At that point, two or three years ago, economic circumstances were unfavourable and we were asked to hold off until they were more favourable. We are going to take a fresh look at it. We know the issues and the people. They have not changed. The solutions we had in mind that we intended to cost have not changed. We had a very good consultation with stakeholders across the island, so we have a good understanding of what people think and of what will work. It is a case of moving onward on that process. We hope that over the next year we will have fresh progress in that area.

Ms Fiona Gilligan:

The cookery aspect pulls together two areas of our brief, food safety and healthy eating. It is a critical area and there is an increasing skills deficit, particularly among the lower socioeconomic groups. The two things we have done recently were in television, because the lower socioeconomic groups watch television to a huge extent. The audience figures are huge. Celebrity chefs have been tried and tested, but we have found in the research that people are watching them for entertainment. In one programme we did, called "Take on the Takeaway", we challenged people to cook their normal takeaway - for example, a Chinese meal - at home. They did it with a chef helping them, but they had to do it at a cheaper price and to a quicker time so that it would be ready just as quickly. Obviously, that is what people want when they order a takeaway. Also, the taste would be as good as what they might get from the takeaway. In 80% of cases, people were delighted with what they found. There were eight programmes broadcast throughout the country and the viewership was very high. It was broadcast twice on RTE.

Building on that, last year we did a programme called "Angeline's Home Cooks" in conjunction with Tesco. Angeline Ball fronted the programme. Previously she could not cook - she was a singer but she could not cook well - but she married a Frenchman and ended up learning to cook quite well. It featured items such as Granny's stew, with Granny showing up to teach three contestants how to cook it. Again, this was not a celebrity type of meal. It was a simple, recipe-based piece. For example, when contestants were asked to sauté the onions, some of them did not know what that was. There were many technical things that people who cook regularly will know, but basics such as sautéing, simmering, grilling and so forth were explained. The contestants were also brought to the supermarket and shown the shelves and where to find the food. They were quite surprised that they did not have to go down some of the aisles that stocked the packaged items they were used to buying. Again, there was good viewership. TV3 broadcast it in conjunction with Tesco; the products could be found in Tesco.

On the education perspective, fortunately in Northern Ireland it is mandatory for all secondary school children to take cookery. We would love that to happen in the South. To fill that gap we have worked with St. Angela's College in rolling out a competition along the lines of "Take on the Takeaway". That has run for a number of years. We are reviewing it at present to see how we can alter it and, perhaps, get more people on board. There would have been more than 1,000 students involved each year, not just students doing home economics but others as well.

Dr. Cliodhna Foley-Nolan:

The Deputy mentioned the issue of a sugar tax. What is being proposed at present is a sugar-sweetened beverage tax. The reason is that honey, jam and numerous other products contain sugar and can be nutritious, whereas sugar-sweetened drinks are not. Officially we can say that we would support it. It is one of a suite of measures that has been shown to have some merit, in the same way as calorie posting. However, it brings into focus the bigger issue of fiscal measures in general. The Deputy mentioned fruit and vegetables. It would be the carrot-and-stick approach of subsidising fruit and vegetable availability and cost.

Much has happened in recent times with regard to cost in some of the low-price multiples. It is interesting what is happening there with the supermarkets. It is an example of how we work with our colleagues in the North. Members will be familiar with the offers of five products for a very reasonable price, or variations thereof, that all the supermarkets in the South are advertising on a weekly basis. The same supermarkets had not been doing that in the North. We have linked up with our colleagues who are now putting pressure on the same multiples in the North. It seems crazy.

The evidence is that fiscal measures work. That is the reason we have been talking about them and working with them for years in respect of tobacco and, more recently, alcohol. Food is next. We must be careful that we pick good examples for fiscal measures, but there is no doubt that it works. It is another example of the different Departments in the Government joining up to prioritise health.

The Deputy also mentioned food poverty. Among other things, we work with the Money Advice and Budgeting Service and its counterpart in the North. For example, we have produced a resource called 101 Square Meals which is nutritionally sound, financially okay but also acceptable. It is a critical issue which we have found-----

Seán Crowe (Dublin South West, Sinn Fein)
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Edible.

Dr. Cliodhna Foley-Nolan:

More than that, it must be desirable. That brings to mind a project for which we held a soft launch on Tuesday because it is a time of purdah in Northern Ireland, during which anything that might influence policy may not be dealt with. It involves consensual budget standards. We were doing this work, both North and South, in the context of the issue of food baskets. It is not just about what is nutritionally and financially sound but also what is acceptable. It includes limited treats, as well as a small amount of alcohol and some tips on catering for guests. It is about what is reasonable socially and psychologically, as well as nutritionally. That is the philosophy with which we are working, whether in community food initiatives or different resources. We have an all-island food poverty network involving the key NGOs and Departments, North and South. Our philosophy focuses on acceptability, as well as financial and nutritional considerations.

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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I thank the delegates for their presentation and the thorough answers they have provided to the questions posed.

Dr. Foley-Nolan touched on the food poverty aspect of childhood obesity in low income areas. Has there been any discernible improvement in that regard? As a public representative, I represent socio-economically disadvantaged housing estates, lone parents, unemployed persons and so on. When they come to my constituency services, it is striking how many of their children are obese. Everything seems to be from a fast food outlet. There does not seem to have been any decline in my area; therefore, I do not think the message is getting home. That is not the fault of the delegates, but perhaps we need a more co-operative approach across the board between those involved in politics; education through schools, local authorities, NGOs and so forth.

Dr. Foley-Nolan mentioned "Operation Transformation". I watch television very little, but I have seen a few episodes of this programme. One in particular sticks out for me as a Kerry footballer was involved. Kids are the ones whom we need to target. Has anything like this been done with children as distinct from adults? It is when children are starting in secondary school that it is probably more obvious to an individual and more hurtful to him or her. Has any effort been made to produce something similar to "Operation Transformation" involving young people who have a tendency to look to their peers rather than adults? They expect adults to be fat or obese, which is accepted.

Have the delegates seen any improvement as a result of the school PE and exercise programme? What more could be done in that regard? Many schools, especially in more rural areas, are contending with a reduction in the number of teachers and one of the first things to fall by the wayside is the PE programme. Class sizes are continuing to go up and if teacher numbers are to be cut, they will be cut for what is perceived to be the least important subject, even though it may, in fact, be the most important.

Dr. Cliodhna Foley-Nolan:

I thank the Deputy for his remarks and his support is appreciated. We know that people who are less advantaged do not eat as well. They are not as active and we know that children in less advantaged families sleep for shorter periods of time. All of these factors are relevant.

The Deputy mentioned teenagers and younger children. We now know that children as young as three years are overweight and obese. Their risk of being overweight as adults is huge. We are not talking about the middle-aged spread but about decades of serious illnesses. The evidence shows that what is the norm at home is the issue. Tackling teenagers is certainly not the priority, although this must be done. That is where the childhood obesity campaign comes from.

The Deputy asked if there was any evidence of improvement. There are some indications. Some of the work done as part of the childhood obesity surveillance initiative, COSI, a World Health Organization surveillance initiative, shows a levelling off in some age groups among children. However, it is an unacceptably high level. One in four children is overweight or obese. I am sure Ms Gilligan will be able to provide figures for indications of positivity in our childhood obesity campaign.

The Deputy mentioned his familiarity with the estates in the area in which he works. The challenge is dealing with the stigma attached to not having enough money or not being as well off as we perceive others to be. We have a dilemma in which we are inclined not to emphasise the social inequalities so as not to further stigmatise people. It is a difficult issue. If we say people who are less advantaged are more likely to be overweight, it is just another negative from their perspective.

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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Is it not true?

Dr. Cliodhna Foley-Nolan:

It is true, but it depends on where one says it. As we cannot change people's incomes, to be supportive, one must ask what people can do in their own homes. The issue of fast food outlets is significant. I do not know if the Deputy is aware, but there have been a number of examples in the past year or two of the major chains actually targeting schools. There are three examples where outlets have been built across the road from schools in deprived areas, including one in Cork and one in Bray.

There are some minor positive signs. It took two or three decades to get garage forecourts where one can hardly buy petrol without being tempted to buy two-for-one or three-for-two sweets and whatever else. It will take time and we do not expect improvements immediately, but there are some positive signs.

Ms Fiona Gilligan:

As Dr. Foley-Nolan has said, we did some research at an early stage of the campaign, so while we have at this stage only rolled out this campaign for a little over a year, at the beginning we did a piece of benchmark research with Millward Brown to see what people's behaviours and attitudes were towards the particular messages that we are giving out. Initially, we wondered whether we might be telling parents that their children are overweight and telling them what overweight looks like. However, when we researched the topic with parents, they said they knew that but they needed to know what to do. They wanted practical messages.

The campaign has very practical messages, such as one needs to reduce one's portion size. A five year old child needs half of what an adult needs. People need to drink more water rather than fizzy drinks and cordials which often contain unnecessary amounts of sugar. Physical activity must be increased and a child needs 60 minutes of physical activity a day, which is a very practical message and which has rolled out well. Treats need to be reduced. We found from those messages regarding portion sizes, for example, that one in five had thought about making changes and one in three had made changes and had stopped the child from eating everything on the plate, which is a start, because we are coming from that mentality.

Consumption of water at mealtimes has increased considerably, by 10% in the Republic and 15% in Northern Ireland. These are all claimed behaviours but they are a start. The proportion of people who say treats are being given once a day has dropped by 8%, from 40% to 32%, and one in three have tried to increase their physical activity. We have also found an increase in the comfort factor, with an increase of 7% in the percentage of people now able to discuss the fact that their child may be overweight.

The level of acknowledgement that health risks may present at a later age has also increased by 6%. That is a considerable change because we know that people have a disconnect regarding health risk. Illnesses like diabetes, heart disease and cancers, which are the three pieces we have added to the communication as risk factors for later in life, are now being considered. It is a slow burn, but that is where we are at the moment and there are positive signs.

Regarding the C2DE grouping, our buying for this campaign is heavily weighted towards what people in this group are watching and where they are. For example, our CEO said that he had not seen the sleep ad yet, and I told him he would not have unless he had been watching "Keeping Up With the Kardashians". The television ads are on particular stations at particular times, when we know that our audience is watching. Social media also plays an important role in their lives, particularly YouTube and Facebook, so we have advertising across those platforms. Our Twitter channel and, in particular, our Facebook channel are reaching numbers of about 600,000 on an average three-week period in the campaign. We are also in places like MummyPages.ie, eumom.ie, and NI4Kids.com, which are where these people are having conversations with one another about their children.

Martin Ferris (Kerry North-West Limerick, Sinn Fein)
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There is a way of dealing with the issue of fast food outlets targeting children, but it means involving local authorities. If local authorities state in their development plan that no fast food outlet may be located close to schools, that can be done. It is about getting the relevant councillors in the local authorities across the State and beyond to put that into their county development plans. It would be a very good idea. Fast food provides cheap quantity and is almost instant. For low income families, who may not have education regarding diet and so forth, all those factors contribute to making it attractive.

Another problem with young kids who become obese is that their bodies become dependent. I was reading an article recently that stated that once the body has that dependency, while one might lose weight temporarily, it comes back almost instantly unless one defeats it at an early age. That comes back to education of the parent by the GP and getting that message across. I have 12 grandchildren. One of them is a little obese, but the rest are grand. We are lucky because we do not live near a fast food outlet and we live in a country area. It starts with the relationship between the GP and the parents and the responsibility the parents must take for the child's development.

Ms Fiona Gilligan:

We are working with the HSE in this campaign and part of what it is doing is a pilot that is currently being rolled out, under which the child will be weighed at school, those messages will be sent home to the parent to let them know what weight the child is, and if there is a problem, there may be a need to go on one of the programmes. The W82GO programme has been developed by Temple Street Children's Hospital and is being rolled out in these pilot schools. To return to the question on "Operation Transformation", that is how we are handling the children's aspect of that. It is much more sensitive, so it needs to be done in that contained environment, as opposed to on a television programme where people choose to put themselves forward.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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I applaud safefood Ireland on its education initiatives. "Operation Transformation" has been a huge success.

Have the witnesses done any research on the impact of ICT, especially gaming, on young people at home? It has obviously helped fuel the obesity crisis we have compared with a decade or so ago.

The quality of food in many canteens can be lacking. Have the witnesses any research on the impact of this? Many schools are now very aware and we have made huge inroads in ensuring the food is healthy. We have talked about the sugar tax, which is an issue, but where do we stand with vending machines in schools? We have heard many anecdotes about people being against them. It is a bit like Deputy Ferris's issue regarding fast food outlets near schools.

I lost about two stone myself and, from a community point of view, I spent about six months explaining to people that I was not sick. There was huge peer pressure. I know one lady whose goal in life is to put on an extra two stone. I feel much better. I went down two clothes sizes and one incentive for me was buying new suits and so on. We have this conservation grant and everything comes back to pounds, shillings and pence. Is there any incentive we can give, such as a voucher system such that if someone loses two or three pounds, they could get a One4All voucher or some other kind of voucher? I know it is very controversial, but could any incentive be offered?

A lot of good work has been done, but unfortunately we are failing. More young people are becoming obese. In the past ten to 15 years we increased by ten pounds on average. It will put major pressure on our health system from the point of view of finances and resources. People ask whether we are mad. There is no silver bullet, but there needs to be some incentive. I look forward to hearing the views of the witnesses.

I refer to the recommendations from members. We would welcome the witnesses coming back with recommendations for the committee which we could pass up the line. I look forward to the responses.

Mr. Ray Dolan:

I thank the Chair. We would be delighted to come back with recommendations from our discussions today. Last year we were in the throes of putting together our corporate plan and great pressure was put on us to include targets. In terms of obesity targets, we were told by the clinical experts that if we maintained the same level of obesity in 2016 as we had in 2014 or 2015, we would have done a great job. I found it very sad that one would get plaudits for maintaining the same level of obesity. I will ask Dr. Foley-Nolan to discuss schools, sleep in regard to screen time and that kind of thing.

Dr. Clíodhna Foley-Nolan:

I congratulate the Chairman, who looks healthy. The gaming issue is related to marketing, which is being extended. The very innocent adverts from Cadbury 30 years ago have changed and companies now use ICT and television in participative things like gaming. We have done research on the area. The project was called Candy-coated Marketing and examined the level of exposure of preschool children to unhealthy products. Needless to say, there is very little advertising for apples or grapes. Keeping children sedentary, decreasing their activity levels and what they are exposed to in gaming are all relevant in terms of childhood obesity.

The Government's plan is at an advanced stage and I am a member of an obesity strategy group. Consultation will take place in the next few weeks. Vending machines and what is happening in schools is very much to the fore and is being actively debated. I am afraid that the idea of a financial incentive has not been on the agenda. I appreciate the logic. Plateauing can been seen in a negative way. During my career I have been involved in tobacco and HIV, and now the obesity issue. If one wanted to get depressed, it would be easy to do so.

The temporal trends are very nice. There are slideshows of the different states in the United States that show the level of obesity growing over the past ten years. To stop that is a start. Although it seems somewhat negative, one has to have a level of optimism as well as realism. The temporal trends are an increasing graph upwards. The first thing we have to do is halt the increase and get the green shoots.

Ms Fiona Gilligan:

On gaming, part of the research we found in the development of the sleep message was that almost 50% of nine year old children have a television, tablet or some form of game in their bedrooms. The message we are currently playing shows a child who goes to bed at night but has a game in his or her hand. His or her shadow is thrown onto the wall and one can see his or her girth increasing as he or she increases in age and continues to play a Nintendo or watch television. We are suggesting that parents make the bedroom a game-free zone and charge all screens in another room. It is quite a critical message and some of the pieces we have heard to date indicate that people are delighted to have this evidence because they need it to tell their children to get screens out of the room. Parents are quite happy to have a strong message.

On the incentive end of things, I have heard that insurance companies are starting to consider that. It would be a positive way of doing it.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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On behalf of the committee, I thank the witnesses for coming before the committee and for all the work they are doing. I thank the committee members for posing some pertinent questions. The witnesses were able to educate us on many issues. It is an issue on which we can all work together. I look forward to the recommendations. As a cross-Border body, we are only too delighted to help if we can. It is of fundamental importance that the island as a whole tackles obesity. I wish the witnesses well in the work they do.