Seanad debates

Wednesday, 8 February 2006

Strategy for Men's Health: Statements (Resumed).


12:00 pm

Photo of David NorrisDavid Norris (Independent)
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I welcome the Minister of State back to the House. It is somewhat confusing as I have been spread out like Marmite over the past few days. I was talking about prostate cancer, which is a serious problem accounting for almost 25% of male cancers. There has been an apparent significant increase in the incidence in the past ten or 15 years. That is partly related to higher rates of detection. It is very much to be welcomed, in particular the prostate specific antigen, PSA, test. This is a blood test taken once a year. I do it. It is very useful and all men in my age group, which is 60 plus, should take it because apart from anything else, this cancer has a tendency to increase in manifestation as one gets older. It is clearly age related. Very few cases are registered in men under 50. More than 60% of the cases occur in men over 70 years old and the largest number of cases diagnosed were in the 70 to 74 and the 75 to 79 age groups. Worldwide, 650,000 men are diagnosed with prostate cancer every year. That is an indication of the significance of the problem.

The figures for Ireland are worrying. The latest figures I have show that in the totality of Europe, we are third highest in the mortality league. That is something that should worry all of us, particularly because there have been news reports on the matter and new information appears to be coming in all the time. Since I last spoke I have read newspaper reports which indicate that very little, proportionally, is spent on research into prostate cancer. That is something the Minister could examine profitably.

If we compare the shining example of women, who have had a campaign about breast cancer and research into breast cancer, although the incidence of these two cancers — one related almost entirely to women and the other exclusively to men — is very similar, breast cancer research is given five times the amount of money. I approve of money spent on research into breast cancer but a proportionate amount should also be spent on research into this form of cancer, which affects males only. Since 2000, €1.76 million has been invested in breast cancer research in Ireland while in the same period only €0.35 million was spent on research into prostate cancer. Our medical teaching hospitals and the medical faculties of our universities have had significant success in research into cures for illness. In my university, for example, one of my very distinguished colleagues was involved in the discovery of a cure for leprosy. A significant advance has been made in the treatment of blindness, retinitis pigmentosa. Comparatively small amounts of money spent on this kind of research can yield results that have a significant effect on people's health. In addition to the education campaigns, which I fully support, money must be put into research.

I would like to return to the question of the difference between men and women in terms of the way in which they regard their own health. Women regularly examine themselves; men do not. That is very important, particularly in terms of conditions such as testicular cancer, something about which we have heard virtually nothing. There was a veil of silence over this area and I would like to pay tribute to people like Ferdia MacAnna, who is a very popular figure in the entertainment world. He developed this cancer and wrote about it both in book form in his autobiography and also in mass circulation newspapers. That took a good deal of courage and it is something we should be grateful for because it alerted men to the possibility of this cancer, the need to be aware of changes in that area of the body including lumps and so on and to get early treatment because this form of cancer, like many others, is amenable to treatment if it is found early. Unfortunately, many men who find changes in the testicular area or a lump are embarrassed. They do not want to go to the doctor and ask about it. We ought to maintain an education programme to try to get rid of that false sense of shame because they will be much more worried, shamed and scared if they find themselves in a situation where they have to have radical surgery in that area.

Broadening out the debate on men's health somewhat, there is the question of the alcohol culture. I had a long argument with a friend of mine who is not from Ireland. He maintained that alcohol was part of the Irish culture. That is a very curious definition of "culture", particularly when one considers the way in which we drink. I do not believe in restricting people or playing the old granny in Irish society but young people should be educated about the dangers of alcohol and in that regard we should look at the drinks industry, which has a massive and extremely effective lobby. If we are serious about the health of our population, and specifically young men because they are disproportionately affected — the young are particularly affected — we should examine the way they are targeted by the drinks industry to encourage them to drink, particularly the question of sports sponsorship and so on. The Government had a report which indicated that sponsorship and advertisements for alcohol should be banned, particularly where it related to sport. The Government has not acted on that and if it is serious about health and men's health, that should be examined.

Suicide is a very severe problem in this country. Whereas it is always tragic when somebody takes his or her own life, there is a disproportionate concentration of figures at the lower end of the age spectrum. Once again, if one refines the examination further one will find a disproportionate number of young males commit suicide. We need to examine that and get some facts and figures. We have them, for example, for the United Kingdom and the North but we do not have any detailed figures. It would be useful if the Minister would ask for a report on what lies behind these suicides. I would say part of it is because of the changing role of men in society. Many young men are confused because they are getting conflicting messages. The alpha male syndrome, the idea of the man as a hunter-gatherer and so on, has been changed in a very positive direction but young men do not have the clearly defined role model they had previously and a number of them find that confusing.

Underneath that there is the question of sexuality. Despite the fact that we are bombarded as a society by sexually explicitly advertising and programmes to a degree that I, now that I am in my 60s, find astonishing, the level of intelligent sexual awareness has not increased and the Government has a responsibility in that regard in terms of education.

One of the most significant aspects is that in terms of bullying patterns in schools, for example, a total of 90% of bullying incidents included some degree of anti-gay message. That is an astonishing figure yet almost none of the schools has taken on board a fully comprehensive sexual education programme. I am not suggesting the promotion, for example, of alternative lifestyles or——

Photo of Paddy BurkePaddy Burke (Fine Gael)
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The Senator has one minute remaining.

Photo of David NorrisDavid Norris (Independent)
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I thought I would not need all the time. I am like one of those gases — I expand to fill the space available.

There is a serious point to be made, namely, it would be useful if a mutual information pack about sexuality was available and classes were conducted in this area. That would give some reassurance to the 10% minority of school children who will inevitably turn out to be gay.

I apologise that the Minister of State was kept waiting for such a long time outside the Chamber but it was not just because of the extended Order of Business. It was also because we were paying tribute to a beloved former colleague in this House, the late Senator Ruairí Brugha.

We were talking about road safety on the Order of Business, among other issues. I pointed out, as others have, that there is an opportunity to give young people driving lessons within the school context. Questions have been raised about insurance and responsibility, etc., but I am sure these matters can be sorted out because in Germany this is a compulsory part of the school curriculum. Imagine the impact this might have on the incidence of fatalities. I do not have the exact figures, but a high proportion of the people killed at weekends are young males who sometimes are on their own. There is even the suggestion that in a proportion of these cases, the accidents are not entirely accidental. This is a way some young people have of ending their own lives and it is very tragic.

Photo of Michael KittMichael Kitt (Fianna Fail)
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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.

Photo of Frank FeighanFrank Feighan (Fine Gael)
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I welcome the Minister of State to the House for this discussion on men's health. Over the years the issue has been obscured, so I welcome the fact that it is at last beginning to be put at the top of the agenda and I thank the Minister of State for his co-operation on that.

For years we had a macho society and a drink culture in which a man was not considered a man until he could drink ten pints and a few whiskeys and smoke a few cigarettes. Football matches, weddings, christenings and birthday parties were all occasions during which the drink culture and its associated diet, which was not exactly the best, were evident. Over the years many people died because they just did not know anything different from that culture. Although my father often enjoyed a pint of Guinness, perhaps the main thing that saved him — he lived to an elderly age — was that he did not drink shorts. I worry that shorts are beginning to be accepted by younger people. They are perhaps a modern thing, but whereas a pint of Guinness or a pint or bottle of beer will not do much harm to the liver, half a bottle of whiskey a day will ensure that a man will not survive into a ripe old age unless he is very fortunate. I am worried that we are now moving into a culture of shorts and hard liquor. We need to consider that issue seriously. However, people are now more aware of what happens, whereas the drink culture of previous generations killed off many adult men over the decades — perhaps up until the 1970s — because they simply did not know any better.

Diet is another issue, much of which is centred around the drink culture whereby people eat fast foods, such as the chicken snack box or batter burger, which are not conducive to a healthy lifestyle. I remember a friend telling me of what happened when my grandfather went to the doctor about 40 years ago. At that time the staple diet in every house in the country involved the use of the frying pan for breakfast, dinner and team, where all cooking was done using fat and lard. People were so used to the frying pan that when the doctor told my grandfather, "James, what you need to do now is go home and throw out the frying pan", my grandfather replied, "If we throw out the frying pan, what will we eat?" It is great to see things have changed since then, as we are not now as reliant on the frying pan as we used to be.

One issue that does not revolve around the public house is the breakfast roll. As the celebrated song by the comedian Pat Shortt mentions, the breakfast roll involves "Two eggs, two rashers, two sausages, two puddin'— one black, one white". However, I believe the jumbo breakfast roll will prove to be a serious issue. Although it might be great when people are young and working on a building site — when they drive to work, they just pull into a forecourt — but the body cannot continue to take that. The breakfast roll contains enough fat and calories for the whole day. If we do not stop, we will move much closer to the situation in the United States, where the widespread use of Dunkin' Donuts and McDonald's mean that obesity is a major issue.

Over the past ten years, the average weight of people has increased by 10lbs because of such convenience foods. We are not paying enough attention to the contents of food and to food labelling. Convenience foods may be great when people are young, when their lifestyle allows them to fight off those effects, but when people get to a certain age they cannot continue with such diets. Poor diet can present as serious a health risk as smoking.

Physical activity is excellent and a great help to health, so perhaps more could be done to encourage people to take it up. I have always said that one cannot beat a walk in the morning. Many men have now taken up walking, whereas ten years ago men would have been involved only in football or rugby and, when they retired from that, would have ended all physical activity apart from perhaps a game of golf. I would encourage people to take up walking but the Government could also help by, for example, ensuring that any bypass that is built includes lights and footpaths to allow people to walk in safety. On many country roads with poor lighting some walkers wear fluorescent jackets but some continue to take their lives in their hands. However, the poor unfortunate driver who knocks them down also has cause to worry.

The smoking ban was a welcome move for our pub culture. It actually highlights how many men and women are dying unnecessarily as a result of over-indulgence in tobacco. It was all very fine over the years because when one passed pubs one never saw the people who were dying inside them. Now, one can see them outside smoking. When one passes a pub one will see withered young men who are in their 30s and 40s but who look to be in their 50s and 60s. This is a result of addiction to alcohol and cigarettes. It is a lifestyle about which people should be better informed, although much has been done in this regard. I enjoy that lifestyle myself so I cannot say much more.

We often discuss the incidence of suicide among young men. For too long we did not know what to say about this issue and politicians did not know what to do about it. Young men do not talk to each other if they have a problem. I attended a seminar on depression and asked what one should do about this. In political life one meets many people in our offices and constituencies, especially young men, who are so stressed and depressed that one is often fearful they might commit suicide. One does not know what to do.

There is a family life centre in my constituency which is a great support. I can phone counsellors and arrange to put people in contact with them. It is a great resource for a politician because we do not know what to say. Sometimes, however, when one meets somebody in that condition it can be useful to ask them if they are suicidal. It can help to get through to them. This is an important issue for politicians because we encounter these situations all the time.

There is much talk about the incidence of prostate and testicular cancer. These issues have still not been addressed. Men do not visit the doctor as often as they should. Perhaps it is time to consider a scheme whereby a doctor would visit football clubs, IFA meetings and other venues where men congregate and encourage them to visit the doctor. Men tend to be lazy and not to watch what is happening.

It is good that the incidence of smoking among men has decreased. This will help men's health. There is also the issue of stress. Today I drove to Dublin from Roscommon. I left at 7.50 a.m. and reached Lucan at 9.20 a.m. but did not get into town until 10.50 a.m. I am very stressed. God help anybody who must make that journey every day because I am stressed after doing it this morning. We must do something about our roads network and provide a better transport network so people can get to work on time. I accept that much has been done, as the Minister would say, but there is a great deal more to do.

We are becoming more aware of the issue of men's health. It is no longer a taboo subject. Prevention is always better than cure.

Kate Walsh (Progressive Democrats)
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I am glad to have an opportunity to contribute to the debate. Rather than address the wider issue, I will focus on the specific issue of diabetes. I refer Members to the extensive contribution made by my party colleague two weeks ago for an excellent, wider consideration of men's health.

I have had diabetes for over 30 years and I believe I have managed it well. It is estimated that there are 250,000 diabetics in Ireland, nine out of ten of whom have type 2 diabetes. If current trends continue, it is predicted that by 2015 one third of all men in Ireland will face increased risk of diabetes. Type 2 diabetes must not be considered a future concern but a current problem. It is a critical and growing dilemma which must be addressed. I welcome the strategy for men's health; men with diabetes will benefit from it. However, the Diabetes Federation of Ireland has highlighted the need for a national diabetes strategy.

While approximately 250,000 people in Ireland have diabetes, it should be noted that approximately 100,000 people with diabetes are currently undiagnosed. I have reason to mention undiagnosed diabetes because I sometimes meet people who mention various symptoms, such as that their eyes are giving them trouble. I advise them to get checked for diabetes. A limited amount of knowledge is not ideal but it is a help. I noted with particular interest a recent appearance by Ronan Collins on "The Late Late Show". He revealed that he only discovered he was a diabetic when his general practitioner observed him consuming large quantities of cola when they were out playing golf.

It is agreed that men are poor when it comes to getting themselves checked out for medical problems. Undiagnosed type 2 diabetes is the primary cause of heart disease, kidney disease, lower limb amputations and blindness among people under 65 years of age. We must convey the message to men that they must have their health checked.

Many contributors to the debate two weeks ago referred to the lifestyle issues that are particular to men and the impact they have on their health. Men must check whether there is a family history of diabetes and take note of their levels of physical activity. They must understand that the likelihood of their developing diabetes increases with age. We must ensure that the general population, and men in particular because they are slow to have their health checked, take note of the risk factors. A simple blood test will detect diabetes. The tragedy is that people fail to get that blood test even though it can bring them back to good health when they learn how to manage their diabetes.

A further 100,000 people have pre-diabetes. If this is detected, it can be stabilised to prevent progression to diabetes. Earlier diagnosis of diabetics will mean fewer eye and cardiac problems, fewer limb amputations and less incidence of renal failure. It will also deliver cost savings for the health system.

Not enough credit is given to the Tánaiste and Minister for Health and Children for her work on this issue. She has clearly stated her concern and commitment to dealing with this problem. She has correctly acknowledged that the challenge in health now is to manage chronic illnesses in the community. In 2002, a total of 3,000 people entered the acute hospital system suffering from diabetes; in 2004, it was 4,000, an increase of 33%. The Tánaiste has stated that the most appropriate way to manage illnesses is at community level. This is why a major focus of the negotiations with doctors is on the management of chronic illnesses at primary care level. I congratulate the Tánaiste on her initiative in this regard.

Mary Henry (Independent)
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I am delighted this debate is taking place. In particular, Senator Glynn, who has promoted this debate for some time, should be congratulated. I am pleased that Senator Kate Walsh spoke about diabetes, which has been discussed by other Senators. I am president of the Diabetes Federation of Ireland so I am very concerned about the figures cited by Senator Kate Walsh about the increase in the number of diabetics who have been diagnosed. It is almost impossible to deal with them so I do not know how we would cope if diabetics who are currently undiagnosed were diagnosed with the disease.

It is important to introduce the obesity strategy as quickly as possible because it is very important for men and women. I am disappointed with the rate of progress in this regard. Since the election of the Government in 1997, there has been an incredible increase in the percentage of the adult population who are obese. In 1997, the percentage was 9% but it is now approximately 18%. This represents an increase of approximately 10% per year. I am doubtful if this will go down as one of the achievements of this Government.

It is important to encourage people to take exercise even if they are overweight. Walking keeps blood sugar levels down to a considerable degree, even if one is overweight. Public awareness campaigns of this kind are worthwhile. I recently read a paper about the value of exercise in keeping blood pressure down in men. It revealed that 20 minutes of moderate cycling three times per week was as effective over the course of two weeks as a considerable amount of medication in lowering blood pressure. We must promote these solutions, which are very simple and could make a considerable difference to the nation's health.

I am very fond of advertisements seen in London which use slogans like "Stairs — they are your friends" which encourage people to use stairs instead of lifts. Another advertisement's slogan was "Fear the pie" and featured a picture of a pie that looked as if it would engulf the viewer if he or she ate it. More public awareness measures along these lines would do no harm.

Cancer statistics have not been mentioned and are, unfortunately, associated with obesity. Some of these statistics are worrying because we could do more about detecting such cancers early, particularly colorectal cancer. Colorectal cancer is the most common cancer of the digestive tract and it was thought for many years that if it could be detected earlier, there would be a better outcome in respect of treating it. We have found this to be the case.

Many European countries have pilot screening programmes, if not full screening programmes, for the detection of faecal occult blood. This test is cheap and easy to carry out. The patient is given the papers which with to conduct the test. I will not describe the details of how the patient collects the faeces sample to test it for occult blood. The samples are sent to a laboratory through the patient's doctor over a three-day period. If the test is positive, the patient is offered a sigmoidoscopy. It is frequently possible to detect these cancers at a precancerous stage when they are called adenomas. In many cases, these adenomas can be removed in a sigmoidoscopy or colonoscopy. Early detection is, therefore, extremely important in preventing the development of cancer.

I raised the issue of screening programmes on the Adjournment some years ago and hoped that, at least, a pilot scheme would have been introduced. However, this has not happened. The Minister of State should examine the matter. Unfortunately, it frequently happens that a person with these cancers begins to feel miserable, goes to his or her doctor, is found to have anaemia, the anaemia is investigated and it is discovered that he or she has cancer which must be treated with a major operation. It is also possible that such people would have secondary cancers. It would be a good idea if we tried to introduce such a screening programme because colorectal cancer is one of the worst killers in this country. Given the existence of such a simple test for it, I hope the Minister would promote such a screening programme.

We still do not have a population register, the lack of which makes any screening programme less effective than it should be because an exact age cohort that could be brought forward each time is unavailable. Perhaps work could also be carried out in this area. I have raised the issue ever since I entered the Seanad but there has been no progress on it.

I compliment all the speakers in today's debate because a great deal of sense has been spoken. Those speakers who argued that men are not good at looking after their health are correct. Men are not particularly enthusiastic about visiting their GPs, a situation we wish to change.

1:00 pm

Photo of Seán PowerSeán Power (Minister of State, Department of Health and Children; Kildare South, Fianna Fail)
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I never cease to be amazed at the collective wisdom that exists in this House. I mentioned to a few Senators over the past few days that it is very pleasant to have debates where people feel they are not forced to defend a particular position or promote a particular motion tabled by a party, but can speak from their own experience, research and understanding of life. This debate on men's health has presented such an opportunity. Much of the debate has been very thought-provoking and many constructive proposals have been made. I thank Senators from all sides of the House for the way in which they debated the issue.

Certain issues were raised by a number of Senators. This has been a protracted debate and this is the third day on which we have tried to deal with the issue. Senator Browne argued that policy on men's health should not focus solely on disease but on the wider determinants of health. He called for the introduction of a men's health week in June 2006.

A number of speakers mentioned the high suicide rate in Ireland, which is the second highest among OECD states. However, we now have a dedicated suicide strategy which, when implemented, will address the issue and we will hopefully see a major reduction in the incidence of suicide.

Sudden adult death was also raised during the debate. A report on this issue has been commissioned, which is expected to be published in the near future. Senator Glynn suggested that this debate take place and participated in it. A number of other speakers spoke about the reluctance of men to address their health and their tendency to ignore it. It is sometimes stated that ignorance is bliss but nothing could be further from the truth when it comes to one's health. A small measure of education in this regard would go a long way. It is important that men give their health the attention it deserves.

The emphasis must be on early detection. If a person has a problem, there is no point in him or her ignoring it. Statistics and experience show that there is a far better chance of success and a return to good health and a normal and fulfilling life if problems are identified early and dealt with.

I think today was the third time that Senator Norris attempted to tell us about his experience and it was interesting to hear him share it. He experienced a particular problem during a procedure he was undergoing. As Senator Norris stated, it is a problem that only arises once in every 3,000 cases.

Anybody familiar with Senator Norris would realise that he is not an everyday person and would be regarded by many as one in a million. It is not unusual that he has stood up, produced evidence and shared the experience of his case. He mentioned the necessity for research on prostate health. It is an area that should be considered, and men should be encouraged to check themselves on a more regular basis. Women do so regularly, but men seldom do so. It is important to change this and encourage men to be more aware of their health and the need for regular checks.

Senator Feighan mentioned that prevention is better than cure, and that is true with regard to health. Senator Kate Walsh referred to diabetes and it is important to point out that if people have the courage to go for a simple blood test it can transform their lives. People could then manage the disease reasonably well if they find they have it, and could go on to lead normal lives again. It is important to encourage this.

I appreciate the expertise of Senator Henry in this area and welcome her comments on the matter. With regard to obesity, a task force on the matter has been launched, and a number of recommendations were contained in its report. All of these do not necessarily require large amounts of money to be spent, and many relate to changing lifestyles. We have provided €3 million in the Estimates for this year which will be used to implement a number of the recommendations contained in that report. Senator Minihan discussed a research report entitled Getting Inside Men's Health. It was specifically commissioned to inform the development of men's health policy.

Senators Feeney and Kitt, among others, raised the issue of lifestyle. Lifestyle issues for men, particularly matters such as alcohol, drink-driving, obesity, etc., are important and will be addressed in the men's health policy. We also need to tackle the underlying causes, such as why men continually take risks with their health.

I thank the Members for their very positive and constructive contribution on the issue of men's health. It is reasonable to state that for too long this issue has been confined to the margins. As a result there is much to be done in terms of addressing the grave statistics on men's health that have been put before the House today and on the previous occasions when the issue was discussed. It is readily acknowledged that in the past men's health has not achieved the attention it should have. It is now very much on the agenda of this Government, and the publication of the men's national health policy in the summer with the men's health action plan later this year will represent significant steps in improving men's health.

Many challenges lie ahead in the implementation of the policy, not least the challenge of embracing the diversity within men and that there are many different ways to be a man. It is imperative that men's health is defined outside a narrow biomedical model and embraces a broader social determinants view. This will require a multidisciplinary and multisectoral approach for successful implementation. It is incumbent on this policy not just to promote health-affirming changes to men's attitudes and behaviours but to create a supportive environment and strengthen community action towards men's health.

In this respect, effective men's health policy must draw on multiple strategies that target individual behaviours while considering issues at the macro and environmental level. It is important that the policy has a clear timeframe for implementation and a clearly defined means of evaluating outcomes. A great challenge in the years ahead is perhaps the need to strengthen the evidence base on men's health in Ireland and identify what works best in different contexts.

There are major challenges for the development and implementation of the policy but I am confident there is a willingness and commitment from all involved to deal with the issue and ensure we bring about major improvements in men's health for the years to come.

Sitting suspended at 1.05 p.m. and resumed at 3.15 p.m.