Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1027. To ask the Minister for Health if she will commission a comprehensive national report on the prevalence and projected trends of obesity in Ireland, with particular reference to the growing strain it places on the healthcare system and its wider economic impact; if she will undertake a review of international best practices, including the recently proposed NHS model in the United Kingdom, which seeks to allow structured pharmacist-led prescribing of clinically approved weight-loss medications-such as semaglutide (Wegovy) and tirzepatide (Mounjaro)-outside of traditional hospital-based specialist clinics; if she will consider the feasibility of introducing a similar model, enabling responsible access to such medications through community pharmacies or regulated digital platforms under clinical oversight; if she will address the serious public health concern that individuals are increasingly sourcing unregulated or potentially counterfeit versions of these drugs online without medical consultation, leading to significant risks including overdose, misuse, and exposure to unsafe or fraudulent substances; and if she will make a statement on the matter. [23434/25]

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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A Healthy Weight for Ireland, the Obesity Policy and Action Plan (OPAP), was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025). OPAP covers a 10-year period up to 2025 and aims to reverse obesity trends, prevent associated health risks, and reduce the overall burden for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted challenge and needs a multi-pronged response, with every sector of society playing its part.

Since the implementation of OPAP, levels of obesity and overweight have stabilised.

According to the Healthy Ireland Survey 2024, the rate of obesity (for all ages from 15 years old) is at 21% and the rate of overweight at 35%. This data is collected every second year of the Healthy Ireland survey and overweight and obesity rates have been just under 60% for a number of years. There has been little change in our rates since OPAP was launched.

Data for children is collected separately through the WHO Childhood Obesity Surveillance Initiative (COSI) – the latest round, published last year shows that overall, one in five primary school children are now living with overweight or obesity, a small overall improvement over the lifetime of the OPAP. However, this figure remains at one in four for children in DEIS schools.

It is welcome that obesity rates are not rising. However, given the projected increase to the overall population and in particular the aging profile of our population, with greater numbers of older adults living with the health impacts of overweight and obesity in the coming decades, it is key that we seek to reduce the prevalence of overweight and obesity to reduce associated risks and costs.

There are a number of reports for Ireland which calculate the overall cost of obesity. A 2012 study by University College Cork for Safefood entitled " The Cost of Overweight and Obesity on the Island of Ireland” estimated that adult overweight and obesity cost the healthcare services in Ireland just under €400 million every year. Overweight and obesity combined accounted for an estimated 2.7% of total health expenditure in the Ireland (2.8% in Northern Ireland). Total annual costs were estimated at €1.13 billion – the majority attributed to loss of productivity and absenteeism.

A further study in 2017 for Safefood, entitled “Lifetime Costs of Childhood Overweight and Obesity” put the total lifetime cost of childhood overweight and obesity in Ireland at almost €5 billion - €1 billion in direct healthcare costs and €4 billion in indirect costs including productivity losses, increased morbidity and premature mortality.

There are also international studies into the cost of obesity. In 2019, the Organisation for Economic Co-operation and Development (OECD) published a report entitled "The Heavy Burden of Obesity”, which examined the effect of obesity from a number of different perspectives, including economic, social and healthcare costs across OECD, European Union and Group 20 countries. The report found that treating diseases caused by overweight and obesity will cost USD 425 billion a year, and that “treating high BMI and associated conditions will cost more than USD 200 per person per year, on average, across the OECD” (OECD (2019), The Heavy Burden of Obesity: The Economics of Prevention, OECD Health Policy Studies, OECD Publishing, Paris, doi.org/10.1787/67450d67-en.). The OECD is currently examining the economic and policy implications of breakthrough obesity treatments and expects to publish a report in due course.

Work has already begun on the drafting of a successor to OPAP and we hope to finalise development of a new obesity policy by the end of the year. The new strategy will aim to capture all aspects relating to supporting a healthier weight for everyone in Ireland, including, but not limited to, education, health promotion, obesity prevention, with a particular focus on enabling measures for a healthier food environment and continuing the work done on both treatment and management of obesity under the HSE Model of Care for the Management and Treatment of Overweight & Obesity. As a new policy is developed over the course of this year, research gaps and evidence-needs will be reviewed and will be taken into consideration in the next obesity policy to ensure all initiatives are evidence-based. Two workshops with stakeholders have been held to date and a public consultation is expected to be run in the coming months.

With regard to weight-loss medication, patients should only buy medicines from a trusted source - see online-medicine-safety.hpra.ie/#buying-safely - such as a local pharmacy. Pharmacies are regulated by the Pharmaceutical Society of Ireland (PSI) and the medicines sold within them have been authorised and the safety and quality of the medicine is monitored by the medicines regulator, the Health Products Regulatory Authority (HPRA) - see www.hpra.ie/about-us.

When prescription medicines are bought on-line in Ireland there is no way of knowing for certain if the product is genuine, if it contains the right active ingredient or if it has been tested and approved for human use. The HPRA states that the supply of online prescription medicines into and within Ireland is illegal and that consumers are taking a risk with their health if they seek to buy outside of the regulated pharmacy setting or via the internet.

As part of its enforcement remit, the HPRA conducts ongoing monitoring to identify illegal online activity promoting prescription medicines and other substances to consumers. It routinely intervenes to disrupt online promotions through website closure and social media page removals.

Patients should never purchase or use a prescription medicine that has been sourced online, as this increases the risk that the product is a fake, it contains the wrong ingredient, the packaging is incorrect, the quality standards are poor, there may be toxic components, or there may be unsafe interactions with other medicines.

Pharmacists play a crucial role delivering many important services to support the health of our communities, offering expert advice on illness, ensuring the safe supply of medicines, and delivering vaccines to the public. Pharmacists are trusted and are one of the most accessible healthcare professionals.

Building on these strong foundations, I believe that pharmacists can do more for our health service and I am a huge advocate for the reform and expansion of pharmacy services. My ambition and that of Government’s is reflected in the commitments and priorities set out in the Programme for Government.

The findings and recommendations from the Expert Taskforce to Support the Expansion of the Role of Pharmacy provide an important framework to inform the reforms and developments required to deliver expanded pharmacy services. My vision for the future includes pharmacists playing a much larger role in our health service, and I’m happy to see the progress being made by my Department to facilitate this.

The overarching recommendations from the Taskforce call for independent, autonomous prescriptive authority within and related to the individual pharmacist’s scope of practice and competence, implemented in a stepwise manner, commencing with the introduction of a common conditions service.

In line with the Taskforce's recommendations, the Department is prioritising delivery of all the regulatory enablers to facilitate community pharmacies to establish Common Conditions Services. I want to see this service established in 2025. This priority work is facilitated and supported by a multi-disciplinary group, including pharmacists, clinicians and regulatory experts, supported by pharmacists working in my Department. The work of the group, which meets monthly, includes the development of training and education programme for pharmacists, a package of secondary legislation and importantly the development of clinical protocols, to ensure a robust and safe services, that pharmacists can deliver in confidence.

This service will enable pharmacists to manage common conditions by offering advice, and, when appropriate, prescribing prescription-only medicines through established protocols. The eight conditions to be included in the service are as follows.

1. Allergic Rhinitis (Inflammation of the inside of the nose caused by an allergen)
2. Cold Sores (Tiny, fluid-filled blisters on the face or genitals)
3. Conjunctivitis (An eye condition caused by infection or allergies)
4. Impetigo (A contagious skin infection)
5. Oral Thrush (A fungal infection in the mouth)
6. Shingles (A skin infection caused by the chickenpox virus)
7. Uncomplicated UTI / Cystitis (An infection in the bladder or urethra)
8. Vulvovaginal Thrush (A genital fungal infection)