Alan Farrell (Dublin North, Fine Gael)
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To ask the Minister for Health if he will provide an update on proposals to reduce the €1.6 billion costs related to obesity to the Exchequer; and if he will make a statement on the matter. [56885/12]

James Reilly (Dublin North, Fine Gael)
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The prevalence of overweight and obesity has risen steadily in recent times, with 61% of Irish adults now overweight or obese. The World Health Organization refers to the alarming speed with which obesity has increased in recent decades as a global epidemic.

The recently published report, The cost of overweight and obesity on the island of Ireland, funded by safefood and conducted by University College Cork, provides reliable figures for the annual economic cost of weight related ill health in Ireland. Initial findings estimate the annual cost of overweight and obesity in the Republic of Ireland to be €1.13 billion. The direct health care costs are €398 million or 35% of total costs. This figure includes hospital, GP and drug costs. In addition, two thirds of the economic costs were indirect costs in reduced or lost productivity and absenteeism, which amounted to €728 million. These figures show that the extent of the problem is greater than previously estimated, as indicated in the extrapolated figure of €400 million in the 2005 National Task Force on Obesity report.

The UCC study shows that almost 10% or 37,341 years of life lost are due to overweight and obesity. The burden of disease from overweight and obesity combined account for an estimated 2.7% of total health expenditure. This Safefood funded study is particularly timely given that obesity is the major health problem in Ireland, of itself, and is contributing to other chronic diseases such as coronary heart disease and type 2 diabetes. Irish studies have shown that two out of every three adults are overweight or obese; one in four primary school children and one in five teenagers are overweight or obese. Of particular concern are the results of the recent Growing Up in Ireland survey which found that in children as young as three years of age, one in four are overweight or obese.

As Minister for Health I have made overweight and obesity a public health priority and have established a special action group on obesity, SAGO, which I meet with regularly to progress the obesity prevention agenda. It is recognised that no single initiative alone will reverse this growing trend, but a combination of measures should make a difference. For this reason, the special action group is concentrating on a range of measures including actions such as calorie posting in restaurants, which I have asked the SAGO to prioritise as one of the key initiatives that will have a positive impact in addressing the problem of our rising levels of overweight and obesity and as a means of educating the general public on the calorie content of food portions.

Additional information not given on the floor of the House

This involved a public consultation process with over 3,130 responses. Top line statistics from that process indicate that 96% of consumers want calorie menu labelling in all or some food outlets with 73% of food businesses indicating that they want calorie menu labelling in all or some food outlets also. This indicates that there is strong support for this initiative among the general public and also, in fact, within much of the food industry itself. Calorie posting has already commenced in a number of establishments and it is envisaged that in the coming months, when the necessary implementation mechanism has been devised, it will be further implemented.

My Department has worked with the Broadcasting Authority of Ireland with regard to the marketing of food and drink to children towards a new children’s code to restrict marketing of high fat, high salt and high sugar foods and drinks up to 7 p.m. My Department, under the auspices of SAGO, has revised the healthy eating guidelines, including the food pyramid, and I launched these on 13 June 2012.

Treatment algorithms inform primary care staff of the steps to be taken with regard to managing obesity. An adult algorithm has been agreed with health care professionals and is now available. It is understood that the treatment algorithm for children is at final stages of agreement. The special action group on obesity has been discussingopportunistic screening and monitoring with the HSE with a view to earlier detection of overweight and obesity in children. This will improve the identification of overweight children at an earlier age and prevent these children from progressing into the obese category. Research is underway in association with the Department of Children and Youth Affairs to establish the use and types of foods and drinks stocked in vending machines in post-primary schools. Both I and SAGO have met with the Food and Drink Industry Ireland, FDII, and its members to discuss my action priorities and they have indicated to me that this is an area they are interested in supporting.

We know that three out of every four Irish adults and four out of five Irish children do not meet the targets set in the national physical activity guidelines developed by the Department of Health and the HSE in June 2009 and are consequently at risk of developing serious health problems due to inactivity. National guidelines alone are insufficient to increase participation levels and so the HSE has also developed a programme entitled A Physical Activity Plan for Ireland to give clear direction for the promotion of physical activity in Ireland and address the risk of developing health problems associated with sustained inactivity. The national physical activity plan which will contribute to addressing this major health issue is currently being considered by SAGO and my Department.

A new health and well-being framework is being developed and will be launched as part of Ireland's Presidency of the EU. This is an overarching strategic framework for sustained action to improve the health and well-being of the nation. It will set out ambitious goals for improved health and well-being among our population. Priority areas being addressed include tobacco, alcohol, food and physical activity. The four goals of the framework are: to increase the number of Irish people who are healthy at all stages of life; to reduce health inequalities; to protect the public from threats to health and well-being and to create an environment where every sector of society can play its part.

Billy Kelleher (Cork North Central, Fianna Fail)
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Certain statistics on this issue were presented to the health committee some time ago. Mr. O'Shea, a consultant with expertise in the area of diabetes and obesity, has said we are now sitting on a time bomb. He went further and said it has exploded and the carnage already surrounds us. He said we must act promptly. We must be forceful in our decision making process. Some of it might be unpopular in terms of policy, because we will have to examine the issue of taxation to discourage consumption of fizzy or high sugar drinks. There are also the issues of exercise, calorie counting and making ourselves aware of health. Other countries such as Australia have tackled this problem head-on. They have become almost obsessed with health but have achieved amazing results in a short period of time.

The Minister said something previously which struck me considerably, that we owe it to the generation following us because ours could be the first generation to be obliged to bury the people born after us. It is incumbent on us not only to extrapolate from the figures but to do something about it. Every possible measure should be taken. The Minister has set up the special task force and the health committee would like to play its part, but society in general must be encouraged and cajoled by policy, some of which might be unpopular as it might require tax hikes. Other aspects of policy will require a change in mindset. However, if we do not do something, we could end up burying our children.

Michael Kitt (Galway East, Fianna Fail)
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There is much interest in this question. I call Deputy Ó Caoláin and I will call the other three Deputies after the Minister.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Last February, the Minister told the Dáil there would be a voluntary code which would be monitored over a period of time. In the event of non-compliance or if it did not bear fruit, the Minister said he would legislate. Much of the focus in this regard has been on restaurant menus. I believe it should be directed at the foodstuffs we buy in supermarkets and the local convenience store and what we buy from fast food outlets. There is a much greater danger across those three areas and certainly a greater lack of awareness of what we are consuming. What is the up-to-date position with the monitoring of compliance with the voluntary code? Is the Minister satisfied that progress is being made? Will he consider expanding it into the other areas I have suggested? At what point will he make the decision as to whether legislation is required?

James Reilly (Dublin North, Fine Gael)
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The Leas-Cheann Comhairle is correct. There is major interest in this because, as Deputy Kelleher correctly points out and as I have mentioned in the past and we all believe it now to be true, ours could be the first generation to bury the generation following us due to the epidemic of obesity and the consequent epidemic of type 2 diabetes, something which I never saw in a person under the age of 30 years old when I was practising 20 years ago. Now, one sees it in teenagers. It is scary. There is no question that it is related. I have had an interest in this for a long time. Every second person who came to my clinic and had obesity was unaware of it. If one is not aware one has a problem, one cannot address it. Awareness is a huge part of it, and I thank Deputy Kelleher for his support in striving to improve awareness.

The issue is multi-factorial, so it does not just involve the Department of Health. It involves the Department of Justice and Equality, in terms of having safe places to exercise at night, the Department of the Environment, Community and Local Government, so there are well-lit pathways that are safe, and the Department of Education and Skills, in getting children to form a good habit of physical exercise. Senator Eamonn Coghlan has been very active in this area and in advising people about the value of fitness for the sake of fitness and how well it makes one feel. There is much medical information and research which shows that muscular activity creates endorphins, which are morphine-like substances that can make one feel well.

Luke Flanagan (Roscommon-South Leitrim, Independent)
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They are great.

James Reilly (Dublin North, Fine Gael)
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This issue requires a cross-departmental approach. This is the first Government to appoint somebody at the level of principal officer across health, education and children to promote this issue and awareness. All help and support is gratefully accepted and we will facilitate the Deputy with any suggestions he might have on how we can progress this.

On Deputy Ó Caoláin's question, we are monitoring the situation. There is an appetite among many of the businesses to become engaged in this. Part of the problem earlier was that they, even the Dáil restaurant, were a little concerned about whether they would be in trouble if there were not exactly 65 calories in the sandwich. That is not what we are trying to achieve. We want people to be aware of the general level of calories in a product. I am aware of an instance of somebody going to a coffee bar, reaching out for a bun but putting it back when they saw that it contained 400 calories. That is what we want. It is not about a nanny state, but we want people to be informed. They have a right to know. What they do with the knowledge thereafter is entirely a matter for themselves.

Luke Flanagan (Roscommon-South Leitrim, Independent)
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One cannot turn on the radio without hearing about how much money we would save if we could do something about the promissory notes. It would not save us as much as some people claim. It is only approximately €1.3 billion, but we hear about it all the time. However, alcohol abuse is costing us €3.7 billion, the Minister says obesity costs us €1.13 billion while not doing enough exercise was estimated to cost us €1.8 billion. Yet, every day of the week we are talking about the promissory notes. The promissory note is very important but it pales into insignificance in comparison with these figures. Is there a figure that takes all three into account? If €3.7 billion is the cost of problems with alcohol abuse, part of that sum would be included in the obesity figure. In a way, they are subsets of each other. Is there information on the exact figure?

The big problem is that for the first time in the history of the human race, with the exception of the landed gentry and royalty in the past, it is easily possible to get enough calories. In my house it was often said that one would not leave many tins of dog food open for the dogs because the dogs are so stupid they would keep eating it until they died. It appears that human beings in certain areas of the world who have unlimited access to food are a little like those dogs and do not know how to stop. It is a big challenge. One issue that is never taken into account is the fact that few of us prepare our food. While perhaps one should not eat a bag of chips because they contain many calories, and ideally one would not, if one at least goes out to buy the spuds, carry them into the house, peel them, make the chips and wash the dishes afterwards-----

James Reilly (Dublin North, Fine Gael)
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One would be too tired to eat the chips.

Luke Flanagan (Roscommon-South Leitrim, Independent)
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-----one is using up some of those calories. The problem nowadays is that there is unlimited access to food and one need not put any energy into getting it.

Billy Kelleher (Cork North Central, Fianna Fail)
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One cannot go to the bog to cut the turf either, which would burn more calories.

Patrick O'Donovan (Limerick, Fine Gael)
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Previously, I have raised the issue of compiling the number of people we know will invariably die as a result of obesity related illnesses in the future, be it cancer, diabetes or heart disease, and comparing that with the manner in which the State has addressed the issue of deaths on our roads through the Road Safety Authority under the stewardship of an independent person such as Mr. Gay Byrne.

Will the Minister consider, as part of the interdisciplinary, inter-departmental approach, appointing an obesity czar? The person could be a figurehead in holding the Government to account but, more importantly, also bringing the public with them and especially younger people. Members are not viewed in the best light on many issues, particularly those that affect society. It is a good idea to put a person in situ, who is respectable to legislators, children and people involved in the matter. The White House and the Obama Administration has done something similar in the United States and there have been tangible results.

Mick Wallace (Wexford, Independent)
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Deputy Luke 'Ming' Flanagan should eat his spuds in their jackets rather than putting them in the deep fat fryer. With regard to the Minister's bun, I have a coffee shop and would rather people did not touch them if they are not going to eat them. Obesity is costing over €1 billion but the last round of sports grants to sports bodies was oversubscribed by ten times. Some €26 million was available at the time. Perhaps the Minister can have a word with the Minister for Transport, Tourism and Sport to say that it would be a great investment if the State was to spend more on sport in order to fight obesity. None of the members of the Wexford Youths under-18 and under-19 teams are obese.

Michael Kitt (Galway East, Fianna Fail)
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We have ranged far and wide in this question. I must ask the Minister to be brief.

James Reilly (Dublin North, Fine Gael)
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That is because the issue ranges far and wide. I will examine the idea proposed by Deputy Patrick O'Donovan. Having a focussed individual such as that has merit. I have made this point about public health to county council health forums. We have a responsibility in the House on the issue. Politically, it is more sexy to open a new wing of a hospital or an MRI scanner than to promote a public health initiative. We have been very poor in supporting these things as politicians. We pay lip-service rather than paying for them. Every euro spent on prevention can save between €12 and €20 on treatment. That is well proven.

I agree with Deputy Luke 'Ming' Flanagan that there is a great amount of money to be saved in prevention. There is a major educational job to be undertaken and there are many vested interests. I would like to see vending machines in schools selling only fruit, apples and water rather than the chocolate and crisps they currently sell. We must make the right thing to do the easy thing to do. If one is hungry and all one can avail of is a vending machine that sells this sort of stuff, that is what someone will do. The issue will occupy minds for a considerable time to come. I am open to initiatives people have to talk to us and to submit to the special action group on obesity. I look forward to the contributions of Deputies.

The Minister of State, Deputy Alex White, is particularly interested in alcohol and is progressing a policy on it. I would like to see not only the unit of alcohol on the side of the container but also the calories.