Luke Flanagan (Roscommon-South Leitrim, Independent)

I hope Members on this side of the House are listened to because we have some good ideas, as I am sure Members opposite have great ideas as well. There is not enough concentration on the prevention of strokes. The Minister for Health no doubt has heard the phrase, "Prevention is better than cure". Apart from causing less pain for patients, from an economic perspective, prevention is also infinitely cheaper. Without decisive action stroke numbers could increase by 50% by 2021 with the bill for this as high as €1.5 billion. Annually, 10,000 people are affected by stroke, of whom 2,000 die while 50,000 live with disabilities caused by stroke. What more incentive does one need to prevent this from happening in the first place? I accept prevention cannot work in all cases as some may be unlucky to have a genetic disposition towards stroke. However, the majority of cases can be prevented.

The other day I read that stroke is the leading cause of disability which I initially did not believe because I thought that would have jumped out at us long ago. When I verified it from other sources, it added to the reasons why we need to tackle strokes.

I was accused by Deputy Buttimer of never agreeing with the Government. Last week, however, I did agree with it. It is not often I will cheer anyone joining Fine Gael but it was an excellent move for the Government to bring Senator Eamon Coghlan on board to promote his points for life fitness programme for schools. He knows what he is talking about when it comes to fitness. His points for life initiative aims to make physical fitness for children and young people a core part of their lives and the school curriculum including bringing in exercise programmes for 15 minutes every day. While I believe it is an excellent idea, I would go further and stretch it to half an hour every day even if means taking five minutes off each class in secondary school or less teaching time in national school.

People take in more information in a much shorter time after exercise. Up until last week I was a runner but now I have had to buy a bike because of a bad hip. From personal experience, I know when I do a radio interview after exercise, I would not like to be the person on the other end. It makes total sense from a mental and physical point to ensure such a fitness programme is introduced. Last week Senator Eamon Coghlan pointed out that even though a new physical education curriculum at primary level has been in place since 1999, unfortunately it has only been fully implemented in 65% of schools. That needs to change.

More importantly, what also needs to change is the idea that when one stops playing for, say, Castlerea St. Kevin's football club or playing sport in school, that is the end of exercise in one's life. The German, French and other European health systems do things differently to here. Their people also do more exercise than us which is one major factor that leads to their people having better health. If one does more exercise, one is less likely to get a stroke or other lifestyle diseases and, accordingly, less likely to put pressure on the health system. That is the road we need to take. Instead of it being the Department of Sickness, it should become the Department of Health.

The amount of good exercise can achieve will be limited if one eats a lot of junk food, however. It has been suggested the Government places a calorie counter on all restaurant menus. While I do not agree it should apply to all restaurants as it does not make sense for some, a point which was teased out very well on RTE's "The Frontline" the other evening, such a regime should be applied to all fast food. Last summer, my family and I had the experience of a calorie counter on a menu in a restaurant near Luton. We were entertained, as well as everything else, by the number of calories contained in a dessert. Skinny as I am, we made our decision on which dessert to have based on the number of calories contained in them. To use the Celtic tiger phrase, we will get more bang for our bucks in the health area by encouraging people to do exercise. As someone connected with cannabis and drug culture, I tell those who are looking for a buzz to go out for a run instead as nothing can beat it.

While I am full of opinions on many matters, I am out of them when it comes to smoking. What does it take to convince people to stop smoking? Someone recently told me that the new advertisements against smoking told them they had a 50% chance of surviving. That is not the Minister's fault, it is something that is very hard to get around. For the past six weeks, five of my immediate family have used plastic inhalers to give up cigarettes. These are people who said they could never give them up. I have never seen them get this far in quitting. The Government is going to get a lot less in terms of tobacco duties from the Kelly and Flanagan families in the future.

Alcohol abuse is a massively contributing factor to stroke occurrence. Having lived in Europe and purchased alcohol on every street corner for low prices, raising the price of alcohol will not solve the problem of alcohol abuse. The approach must be through education. Marketing is the education the alcohol companies - the drugs companies - use. No matter what education the State gives young and old on alcohol abuse, there is no way to keep up with the message sent out by slick alcohol marketing companies. Alcohol advertising and marketing must be banned. On Monday night's "The Frontline", we were told that rather than such a ban coming in, which had been promised, the debate would continue on it.

I understand the downsides of such a ban, how it could hit sporting organisations and the pressure that entails. When I was a councillor, I ran a five-a-side league in my town which comprised 16 teams. Pressure was put on me by local publicans to have the teams go to their pubs after the game on Thursdays for some sandwiches in exchange for having a pub's name on the league. We resisted this, the league happened and we put the matches on later so the teams could not get to the pub. We survived and when the word got out we were not taking money off pubs, we got money from other people.

Unfortunately, prevention is not going to work for everyone and inevitably, some people will need care. The acronym FAST is used in a campaign for identifying stroke. "F" stands for face - has the person's face fallen on one side? "A" is for arms - can the victim raise both arms and keep them there? "S" is for speech - is their speech slurred? "T" is for time - time to call 999. I presume the acronym FAST was chosen because speed is of the essence when dealing with stroke victims. I will be accused of turning into a parish pump politician but then again I have been called worse.

Roscommon hospital has a problem not with expertise in treating stroke victims but with speed of access to stroke care. If a patient in Roscommon hospital has a stroke, he or she will be seen to, given a scan and thrombolysed quickly. However, if a stroke victim happens to be standing outside the hospital walls when he or she has a stroke, he or she will have to get into an ambulance to go to Galway or Ballinasloe. If it is at the wrong time traffic-wise, trying to get through Claregalway could mean the journey to Galway hospital could take up to four hours. Dr. O'Keeffe, clinical director of Galway and Roscommon hospitals, said stroke patients have a window of four and a half hours to get correct care. Not everyone agrees with this, however. Dr. Ronan Collins, director of stroke services at Tallaght hospital, said he would not support that view and did not endorse providing such information to people who may suffer from a stroke in future. That is a good idea because they will probably end up dying. He advised that if a distinction is made between heart attack and stroke it is not accurate to suggest that patients in rural areas have up to 4.5 hours to receive appropriate treatment after suffering from strokes. He also stressed the critical importance of transporting stroke patients to hospital as quickly as possible.

Unfortunately, those who suffer strokes in Roscommon or other areas that were dependent on Roscommon hospital will not be helped by the 90% of hospitals that have stroke units. I support the motion and if the Minister has news on our air ambulance service I would be delighted to hear about it.

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