Mr. Tim Collins:

I would call it the tragedy of the horizon in that we tend to address what is in front of us and not what is further out. We have seen inaction on climate change and on a range of social issues that are immediately impacting on us. That is the problem. It is the reason prevention is the poor cousin of acute medicine. I am optimistic. There are things happening. The chronic disease management programme in general practice, which mandates GPs to do annual checks among people of a certain age group, is a good start. There has been a sea change in the attitude and enthusiasm of GPs around the country in regard to prevention, particularly because of that programme, but it is not enough because it is confined to medical card holders.

There are straws in the wind in that the excellent plan which the Deputy shepherded through a number of years ago, that is, Sláintecare, has commenced implementation. Laura Magahy and her team are making inroads and it looks like they are getting some budget. We are in contact with them about hypertension awareness. The response has been slow but positive. I am not pessimistic. We are beginning to make inroads, but we are so far behind in terms of the resources that we put into prevention. One of the things we are asking of the committee today is that it reaches outside of its traditional remit of health and look at the wider determinants of health. Unless this committee takes a lead, there will be no consideration of the health impacts of air pollution and junk food marketing to children. There is no sense in addressing weight management in children unless we shop junk food marketing. That is the first step. Everything else, in terms of the services they need at a health level, must come after that. I am optimist and I think we are beginning to make progress.