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Painting a healthier picture

The possibility of non-Governmental sources of funding for the Healthy Ireland Fund has been discussed at an inter-departmental level, this newspaper understands.

The sources of funding for the Healthy Ireland Fund were discussed at Healthy Ireland Cross-Sectoral Group meetings in September.

That is according to minutes from the 1 September meeting of the Group, which have been seen by the Medical Independent (MI) following a Freedom of Information request. 

The Cross-Sectoral Group comprises high-level representatives from Government departments and key State agencies, including the HSE. It was established to support the implementation of Healthy Ireland.

Healthy Ireland is the Government’s flagship public health initiative, “which aims to create an Irish society where everyone can enjoy physical and mental health, and where wellbeing is valued and supported at every level of society”.

Both the Healthy Ireland Fund and the planned tax on sugar-sweetened drinks (see panel) are key planks in the Government’s Healthy Ireland policy. While both initiatives have been recently announced with great fanfare, the exact details of how either will function have not been released yet.

Dublin City Council’s ‘Dublin bikes’ scheme, often lauded as a leading public health initiative, has received criticism over accepting sponsorship from one of the biggest soft drinks manufacturers in the world, Coca-Cola, which has also sponsored a number of other public health initiatives

This newspaper has also learned that the Department of Health has been liaising with the Department of Public Expenditure and Reform on the mechanism through which the Fund will be administered. 

The minutes from the Healthy Ireland Cross-Sectoral Group’s meeting on 1 September noted that the “initial discussion is around creating a Healthy Ireland Fund to receive Government allocations, but funding could be attracted from other sources over time.”

Funding

These non-Government sources are not specified, however other aspects of Governmental public health policy, such as the National Dementia Strategy, have received funding from NGOs like Atlantic Philanthropies.

However, Dublin City Council’s ‘Dublin bikes’ scheme, often lauded as a leading public health initiative, has received criticism over accepting sponsorship from one of the biggest soft drinks manufacturers in the world, Coca-Cola, which has also sponsored a number of other public health initiatives.

Prof Donal O’Shea, Chair of the RCPI Policy Group on Obesity, told MI last year that there is a “very strong view” from a public health perspective that the company should not be sponsoring such schemes. He said it is part of brand management that promotes “overall” sales, to include sugar-sweetened products contributing to the obesity problem.

Similarly, there has been criticism of McDonald’s funding parent accommodation for children’s hospitals in Ireland and other health-related charity activities.

Last week, a spokesperson for the Department of Health would not provide any more information on any possible private or NGO contributions to the Fund. The spokesperson reiterated that “there is no private funding involved at this initial stage”.

At last month’s Budget 2017 launch, the Government announced that an initial allocation of “€5 million will kick-start the establishment” of the Fund “to support the implementation of Healthy Ireland programmes and projects in a variety of settings, including education, local authorities, workplaces and communities”.

At both the launch of the Government’s new Obesity Strategy in September and the Budget 2017 announcement, there were no details provided on how the Fund will be administered and what projects will be supported.

Last week, a spokesperson for the Department confirmed that the details of how the Fund is to function have yet to be finalised.

“The Healthy Ireland Fund has an initial allocation for 2017 of €5 million, as was announced in the Budget,” the spokesperson told MI.

“The details of the administration of the Fund are currently under consideration.”

In October, Taoiseach Enda Kenny told the Dáil that “Minister of State [for Health Promotion] Deputy Corcoran Kennedy, is responsible” for the Fund.

However while there has been no official announcement on how exactly the Fund will work, minutes from the recent meetings of the Healthy Ireland Cross Sectoral Group that MI has seen give some indication as to how the Fund may function.

Local

At the 1 September meeting, it was clarified that the Fund is not dependent on the introduction of the SSD tax receipts.

The meeting also noted the need “that the Fund does not replace core Departmental funding”.

A discussion over how the money would be transferred from the Fund to projects led to the meeting noting “existing structures [such] as POBAL, Local Community Development Committees (LCDC)” could be utilised.

The members of the Group also noted “the importance of ensuring that research is included from the start of projects to ensure that they can be evaluated. In some cases, surveillance may be appropriate”.

Feedback from other departments on potential projects for the Fund included areas of “deprivation, social inclusion and community developments”.

The Council has 35 members from a wide range of areas including health, academia, older people, sport, non- Government organisations, media and youth and diversity groups

“The LCDCs and Children and Young People’s Service Committee (CYPSC) were suggested as potential partners.

“It was suggested that funding could be used to support and align the work of local authorities in the health and wellbeing area through the Healthy Cities and Counties Network.”

At the subsequent meeting of the Group on 15 September, the Fund was again the most prominent point of discussion.

Absorbed

Once again, representatives from various departments emphasised that it should be ensured that the Fund “does not get absorbed into general actions” and “the need to ensure that the Fund does not replace core departmental funding was stressed”.

“The Fund provides an opportunity to initiate projects which will not only last one or two years, but which have the potential to become core projects once their value has been proven.”

Discussions among departmental representatives also pointed to the localised possibility of how the Fund may be distributed.

“The possibility of using the Fund to encourage implementation of Healthy Ireland at local level” was noted as important, according to the minutes. 

“In this regard, the discussion focused on the LCDCs and the recently-published Local Economic and Community Plans (LECPs). The importance of making links and encouraging co-ordination of local initiatives was emphasised, to enhance connectivity in meeting local needs.”

Unsurprisingly, in recent weeks the Government has heralded the new Fund as an important part of the Healthy Ireland Strategy, even though the budget for now is merely €5 million.

Speaking following the presentation of Budget 2017, Minister Corcoran Kennedy said: “The establishment of the Healthy Ireland Fund will allow Government to support innovative, cross-sectoral, evidence-based projects, programmes and initiatives that support the implementation of the key national policies in areas such as obesity, smoking, alcohol, physical activity and sexual health.”

In September at the launch of A Healthy Weight for Ireland: Obesity Policy and Action Plan 2016-2025, Minister for Health Simon Harris promised that the Fund would allow for “joined-up working” between Government departments on evidence-based projects, programmes and initiatives that support the implementation of Healthy Ireland. 

“This will embed and implement Healthy Ireland programmes and projects in a variety of settings, including education, local authorities, workplaces and communities. The details in relation to the Fund will be announced at a future date.”

Last month, MI reported that the process of how to select a new Healthy Ireland Council has yet to be decided.

The Council has 35 members from a wide range of areas including health, academia, older people, sport, non-Government organisations, media and youth and diversity groups.

It is currently chaired by ex-Irish Rugby star Keith Wood. The role of the Healthy Ireland Council “is to connect and mobilise communities, families and individuals into a national movement, with a common aim to support everyone to enjoy the best possible health and wellbeing”.

The current Healthy Ireland Council is due to remain in position until May 2017.

Earlier this month, MI reported that the new National Clinical Lead on Obesity job description is currently being finalised by the HSE and it is expected the new post will be advertised before the end of the year.

A spoonful of sugar tax

Officials in the Department of Health and the Department of Finance have been in discussions since late May regarding the details of introducing a new tax on sugar-sweetened drinks (SSD tax).

That is according to correspondence between the two Departments that MI has seen following a Freedom of Information request.

Officials from both Departments discussed by email the example of Belgium, which earlier this year introduced a variation of an SSD tax.

The Department of Health sent a draft of a working paper on SSD tax to the Department of Finance in late June. A final edition of the paper Introducing a Tax on Sugar Sweetened Drinks was later published on the Department’s website. The Department of Health was invited to nominate a member to join the Tax Strategy Group (TSG), according to an email from the Department of Finance dated 15 July.

Budget 2017 included a commitment that an SSD tax is to be introduced from 2018, to coincide with the introduction of the soft drinks industry levy in the UK.

A public consultation process was launched on Budget day, seeking input from relevant stakeholders on how the tax will operate in practice.

“The consultation seeks to ensure that the new tax meets the public health objectives as outlined by the Department of Health in its A Healthy Weight for Ireland policy, that Revenue is enabled to collect it efficiently, fairly and effectively, and that compliance with the tax is not overly onerous on producers,” a spokesperson for the Department of Finance told MI.

“The tax must also be designed so that it is compliant with EU State aid rules. Finally, the design of the tax must take into account cross-border issues.

“Contributions to the consultation should be sent to the Department of Finance by Tuesday, 3 January 2017.”

However, the failure to introduce the SSD tax sooner was criticised by the RCPI, which had called for a sugar tax in its pre-Budget submission. 

“Our policy group has called for a sugar tax in this year’s Budget and believe waiting for another year is a lost opportunity,” said Prof Donal O’Shea, Chair, RCPI Policy Group on Obesity, last month.

“On its own, this measure will not reduce obesity but, together with other actions outlined in this plan, we have an opportunity to literally save lives and prevent devastating illnesses for so many people.”

Prof O’Shea warned that “waiting another year to introduce such an important, evidence-based measure to prevent obesity, particularly in children, is a grave mistake”.

“There is broad political consensus and a majority of public opinion that a tax on sugar-sweetened drinks is worth pursuing. The view of the medical community is unanimous. There is no sense whatsoever in postponing it. It is weak leadership and a victory for powerful industry lobbying yet again.”

Minister for Finance Michael Noonan recently defended in the Dáil the decision to delay the introduction of the tax.

“SSD taxes have been introduced in a number of European countries in recent years,” said Minister Noonan.

“The UK is due to introduce a soft-drinks industry levy from April 2018. On Budget day, I said that given the highly-integrated production and supply chains which exist in the soft drinks industry between Ireland and the United Kingdom, it would be prudent to align the Irish SSD tax with the UK’s tax proposal, in terms of time frame and structure.”

Minister Noonan has not indicated how much the new tax will raise. “The estimated yield from the tax on SSDs will depend on the eventual design,” Minister Noonan told the Dáil earlier this year.

British newspaper The Guardian reported earlier this month that Tesco has escaped the UK government’s planned SSD tax by cutting the amount of sugar that its own-label soft drinks contain to below  the 5 grams per 100ml at which the levy is supposed to come in.

“We have worked to make sure our soft drinks still taste great, just with less sugar. Tesco customers are now consuming on average over 20 per cent less sugar from our soft drinks than in 2011. We’re hoping this initiative will help make it a little easier for our customers to live more healthily,” Mr Matt Davies, Tesco’s Chief Executive for the UK and Republic of Ireland, was quoted as saying.

The UK government has expressed satisfaction that its planned SSD tax is exerting pressure on the soft drinks industry to encourage manufacturers to cut sugar from their products before the levy comes into force in 2018.

Will Irish drinks manufacturers now follow suit?

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