Tony Killeen (Clare, Fianna Fail)

I thank Senator Keaveney for raising the issue, which I am responding to on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children.

The programme for Government contains a commitment to the development of a freely available and personalised national programme to provide for the prevention and early detection of illnesses for both men and women. The programme intends that guidelines should be developed for the personal health check based on best available national and international evidence of what works well, with structured call and recall arrangements during a person's life and provision for appropriate clinical follow-up where required.

The Department of Health and Children is examining at present a range of issues which need to be addressed to decide how best to proceed on this commitment in the context of international best practice, our own national health policy and the many competing priorities for health service development.

By way of context, it is appropriate to acknowledge that chronic diseases represent a major challenge for the health services and society generally. They represent the major component of service activity and expenditure in the health care system as well as being the major contributor to mortality and ill health in this country. Given projections which predict a doubling of the elderly population over the next 30 years, this will give rise to a significant increase in chronic diseases, which will bring a significant challenge to our society and health care system as well as to individuals and their families.

The main causes of chronic disease are known and largely preventable. Lifestyle factors, including tobacco and alcohol usage, together with physical inactivity, poor diet and obesity are key risk factors along with high blood pressure and cholesterol for chronic disease. Effective interventions are known and it is estimated that 80% of cardiovascular disease and type 2 diabetes as well as 40% of cancer could be avoided if major risk factors were eliminated.

It is also very relevant that the challenge of chronic diseases and the lifestyle factors that contribute to them is especially acute among lower socioeconomic groups. The policy question that arises here, as elsewhere, is to how to use scarce resources to help those who need help the most. The context, therefore, in which the role of a personal health check is being worked on is one in which there will be a strategic and integrated approach to the prevention, detection and effective management of chronic illness. This is an area in which the Department of Health and Children at present is preparing a policy framework which will be completed in the coming months.

Among the issues to be considered for a personal health check programme are whether whole age cohorts of the population should be offered or encouraged to have a periodic health check or whether a more targeted approach is preferable. Also to be considered is the appropriate clinical content of a personal health check and the interval between checks according to individuals' age, gender and relevant risk factors.

The appropriate degree of State involvement in any programme and the organisational issues which would arise will also be considered, along with direct and indirect cost issues. The Department of Health and Children therefore is considering these and other relevant issues to inform the best way to proceed.