Paschal Mooney (Fianna Fail)

I welcome the Minister of State. This is an area the Minister comes up against on a regular basis in terms of a policy issue, and it is welcome that there should be a debate on this important issue.

The motion refers specifically to endorsing the efforts being made to highlight the benefits of healthier lifestyle behaviours as a means of preventing this disease. The rolling out of Government policies on healthier lifestyles is as relevant as addressing the lobby groups which have been bombarding us with e-mails in recent weeks about amputations and what could and could not be saved. It is not simply a matter of addressing the consequences of this terrible condition but preventative policies, and in that regard I applaud the Government for the initiatives it has taken.

Notwithstanding the comments and the criticisms being levelled at the podiatry services across the country, I want to put on record that that is not the case in my region of Donegal, Sligo-Leitrim and west Cavan. I will deal with the specifics of that, but in reading some of the documents supplied to Members on all sides of the House about this motion, there is a reference which would support my contention that in our region at least this issue is being addressed effectively and efficiently. It states:

In relation to the quality of treatment available from the HSE and whether it differs from region to region, the short answer is 'Yes - there are differences'. Quality of care is good, where care is available. Across the spectrum of health issues which a person with diabetes may have ... the problems relate to the actual existence, availability, and access to the required services rather than the quality of care. So to answer the question, it's down to waiting lists for existing services on one hand and the need to develop services where none currently exist on the other.

That is a fair assessment.

The north-west HSE region has more podiatrists than any other region in the country. The general service provided is not specific to diabetes but between podiatrists and chiropodists, they visit all of the rural clinics and, in the normal course of events and in association with the diabetic nurses, identify those who are suffering from diabetes and recommend the appropriate facilities into which they should be placed.

There is perhaps a need for a link between those who are operating on the ground and those providing the services at hospital level but on the evidence so far in my region, there is in place a very efficient service. Despite what was said earlier about the numbers of those who, tragically, undergo amputations subsequently, the condition is being picked up because of the intensive nature of the trawl and in the normal service being provided by the podiatrists and the chiropodists, certainly in my area.

I am not an expert in this area but I understand it is only the chronic cases that require amputation and that in some cases, and I do not want to stereotype people who end up with this life-threatening condition, it goes back to prevention and the person's lifestyle. To be frank, for generations those of us in this country have indulged in foods that are not in our best interests. If there is to be a focus on how to address the diabetes, it should not be one-sided. It should not be a question of just providing more podiatrists, more beds or more facilities; it should include the provision of health education. Health policies have been introduced not only by this Government but also by successive Governments over the last quarter of a century, but they have not had the desired impact. I even see it with my children. They are more likely to be stuffing themselves with fast food than eating the required daily intake of fruit and vegetables. This is a complex area. We as parents try to encourage our children to adopt a healthier lifestyle, but when Wi-Fi, the iPhone and the Sky box are competing for a child's interest, it is far easier for him or her to be a couch potato than to go out and exercise. This is coupled with their trips to the local fast food shop, or the greasy spoon as we used to call it, although I know such places have moved on a lot since then. Parents are fighting an uphill battle.

If I were to communicate just one point to the Minister of State it would be this: if we formulate a marketing campaign that is listened to by young people we can encourage this generation, at least, to start thinking about their health. When I talk about a healthier lifestyle, I am not just talking about doing the Dublin city marathon; I am talking about watching one's food intake. People need to be educated at school level. I know it is not as widespread as it used to be, but school tuck shops used to stock crisps and fizzy drinks and this was never questioned. In fact, a Member of this House - I will not name the man - who was involved with teachers argued on one occasion that such a diet was full of protein. I walked away shaking my head in disbelief that he thought that was the sort of diet schoolchildren should have - chips, crisps and soft drinks.

Companies that produce such foods also have a responsibility in this regard. I know they are in the business of making money, but it is not a coincidence that each year, coming up to the beginning of the school year, our children are bombarded daily with printed and broadcast advertisements. The major international retailers start to run promotional weeks in which a number of packets of crisps or fizzy drinks can be obtained for a couple of euro. These are linked, rather cleverly, with some sort of school scheme in which, for example, if children buy crisps or fizzy drinks they get free copybooks. There is a need for joined-up thinking in this regard. We should be addressing the issue of lifestyle as well as filling the gaps that exist in the provision of services.

Health professionals in my region are doing a good job identifying potential candidates for amputation and acting quickly to save them. I commend the HSE north west in this regard and I commend the motion to the House.