Michael Kitt (Fianna Fail)

I welcome the Minister of State to the House. I am very glad to have the opportunity to discuss the issue of men's health. In the executive summary of the report, entitled Getting Inside Men's Health, there is a reference to the fact that the predominant players in decision making are men. However, they do not lobby or campaign or argue on the issue of men's health to the same extent, for example, as women do. It is not always useful to make comparisons between men and women as regards health. It is, however, significant that the figures show Irish men die six years younger on average compared to Irish women. Obviously there are other issues as regards accidents, suicide and the potential for self-harm which reveal pronounced gender differences in mortality trends.

As well as the differences between men and women there are also differing trends among men as regards health. Much of what we see in sport currently indicates that macho characteristics are uppermost, with people taking risks they should not. This is worrying. In the television programme "Jackass", people are dared to become involved in some very risky adventures. This is the type of programme which should come with a health warning, because of its display of macho culture.

The question of the school curriculum is interesting. There is very little in the school curriculum at any level as regards men's health. The general reaction from young people is to say they will worry about such matters in 20 or 30 years. As young people they believe they should not have to worry about an issue such as health. That promotes its own type of culture, with people, for example, opting not to visit a doctor. The reluctance of men to see a doctor is highlighted consistently in all the different reports and reviews I have read. There may be some way to make GP services more male-friendly. In County Galway it has been possible for medical group practices to introduce rotas, for example, where people can have more access to a GP. Men, in particular, do not like sitting in a doctor's waiting room. Without being sexist, they dislike sitting in waiting areas with women and children. There are, perhaps, ways in which this problem can be overcome and many group practices are trying to accommodate easier access to the doctor.

I raised the question of public alcohol centres on the Order of Business this morning. I know the House is discussing mental health tomorrow, but the question of public units is something we should debate. I have made the point that we have excellent private centres, which are, however, very expensive and would require patients to have adequate insurance cover. However, there was a unit in St. Brigid's psychiatric hospital in Ballinasloe which facilitated overnight accommodation, and such a facility is normally required for the treatment of patients suffering from the effects of binge drinking. At a time when we have extra alcohol counsellors, I cannot understand why people cannot be taken out of their normal environment, if only for a short period, and treated in such units. That was the way in the past, and unfortunately, we appear to be going backwards by no longer having such public residential units for the treatment of such cases.

Closely related to this is the question of depression. Not enough is being done to help men, in particular, suffering from depression. Additional counsellors have been appointed to tend to the needs of affected families and there is talk of community counsellors being available. Again, however, people often need to be taken out of their immediate environment, in the same way as those with chronic alcohol problems should be.

A positive aspect to the report is that smoking has reduced by 26%, indicating a downward trend in the consumption of tobacco among Irish men. Smoking is still a considerable health issue, nonetheless, which has a knock-on effect on other areas. However, it is good to see the downward trend.

Another issue in the report relates to sports people and physical activity. It indicates that many people, when ceasing to be active in sports, fail to take up any other physical activities, and this can lead to health problems. It is an issue that should also be addressed.

Senator Norris and others referred to testicular cancer. As we know, this area presents a particular difficulty for men, and more research should be done on it. I sat on the former Western Health Board for five years, where we used to hear a good deal about it. In addition, male doctors on the board would talk about the real problems of men with prostate cancer who experienced a very poor quality of life. The current notion that men should have various blood tests and examinations by doctors in this regard is very welcome, and much progress is being made although there should be more research into this area.

There is also the issue of obesity and people being overweight. This area should be tackled further by the Department of Health and Children. There are figures in this report with which I do not agree, or perhaps I do not understand them, regarding whether married men are healthier than their single counterparts and so on. I agree, however, with its comments as regards fatherhood and the findings that men are, perhaps, more responsible while caring for their children's health. It dawns on them that they have a responsibility towards their children and makes them want to "grow up with them" as opposed to having a poor quality of life as parents. That is an important point. Whereas in the past only mothers brought the children to the doctor, that might change in the future as men take more responsibility for their own and their children's health.

Many men's groups have highlighted the need for time off from employment, given that some fathers — the figure is 90%, according to the report Getting Inside Men's Health — have never availed themselves of parental leave. I welcome the fact that the situation is changing, but it appears that a lot of ground needs to be made up. It is interesting that, following the latest budget, there was a lot more discussion about parental leave for both mothers and fathers.

One simple recommendation in the Getting Inside Men's Health report that interests me is the suggestion of a helpline that men could phone if they have a question about cancer. We already have an international men's health week and a men's cancer week but men have said they would like to be able to get more information. A helpline would be very welcome. I also welcome the report's recommendation that more people should challenge the macho drinking culture and that efforts should be made to encourage people to quit smoking or to reduce the amount they smoke. Other recommendations concern the need to tackle obesity and the culture of taking risks.

Finally, I welcome Senator Norris's suggestion that the number of young men involved in car accidents might be tackled if lessons about driving were provided at second level. As I have mentioned on previous occasions, the suggestion should be considered, especially for the transition year in second level school. The driving programme devised by Rosemary Smith, who we all know was a great rally driver in her day, is already being used in some schools. That is a welcome development. All the shock and horror television advertisements showing the most dreadful accidents seem to have failed, so it is time we taught people the rules of the road, perhaps during the transition year in second level schools. That would lead to a better situation regarding how young men behave on the road.