7th February, 2002
Dr. Henry: I am delighted the Minister of State is here this morning and I compliment her on bringing forward this strategy. She has put a great deal of energy into her job and the commitment she has instilled in her officials shows because this is obviously not a one woman effort. She clearly had a great deal of help and support in bringing forward this strategy. I am concerned that this commitment may not be maintained when she is no longer in this position having gone on to higher office - not just minding children but minding all of us.
I support Senator Cox's point that money should be ring fenced to deal with the issues described in the strategy. If there is one thing that should be done before the election it is the establishment of the children's ombudsman. There is so much in this strategy that the Minister of State will not get it all done but that is one of the most important provisions.
I will address the issue of better co-ordination between Departments which the Minister of State raised. When I was reading the children's strategy, I also looked at the health of our children in the annual report of the Chief Medical Officer for 2000 which has just been published and the health strategy which was published by the Minister for Health and Children. There were serious deficiencies in both documents regarding the health of our children.
The Minister raised the matter of a national longitudinal survey of children which is worthwhile. Some years ago the late Dr. Nessa Joyce carried out such a study of cohorts of children born in the Rotunda Hospital. I am not sure how long they were followed up for but there may be work in the background which can be accessed which would allow comparison between the children of this generation and those of the 1960s and 1970s which is when that study was carried out. There may also be other studies which may be useful to the Minister of State.
I am delighted Senator Fitzpatrick is here because, as a general practitioner, he will have views on this too. All of the relevant documents - the national children's strategy, the health of our children and the health strategy - are missing any reference to eating disorders. This has unfortunately become a serious problem. I will return to the issue of advertising which Senator Cox referred to earlier.
I must declare an interest in that I am president of the Diabetes Federation of Ireland. I was asked to take that position by the federation because in debates in this House I have raised the lack of play and recreation facilities for children, which is emphasised in the Minister of State's report. Senator Fitzpatrick will know this goes hand in hand with a great increase in obesity. When we refer to eating disorders in children, we are inclined to think of the teenage anorexic or bulimic girl and indeed we have a number of boys in that situation.
Obesity in children has become a serious issue. When I was a medical student - and indeed a young doctor - to see type 2 diabetes patients in their teens was most unusual. I do not remember seeing one case and perhaps Senator Fitzpatrick does not either. Tallaght Hospital now has a clinic for type 2 diabetes adolescents. This is the type of diabetes associated with obesity and inactivity. Shortly, we may have more teenagers and children with type 2 diabetes than with type 1, the genetically derived variety we are more used to seeing. This is a part of the Minister of State's survey which has a very practical implication for children and I would like it to be publicised to a greater extent. Children should be asked what we can do about this issue which is a sensible part of the strategy.
Perhaps Members saw a recent television programme called "Fat Club" in which a dozen seriously overweight people banded together and undertook a weight loss regime. None of them seems to be doing frightfully well and I am not surprised because if the sergeant major in charge were dealing with me I would not do too well either. Every so often they report on their progress, but they do not appear to have been asked how they felt they could best lose weight. The Minister of State has suggested that we must ask children more about what we can do for them and that would be useful.
We have done a fair bit of research in this area already. In 1990, a Dr. Watson in Cork documented that Irish children's aerobic fitness level was 80% of that of their European peers. That is very bad. They do less physical education in schools than children in other European countries. There is a considerable amount of literature available to show that the relationships between physical activity and television watching and body weight and fatness in children go hand in hand. Children watch television when there is not much else they can do. I remember when my own children were small that if one suggested any other activity to them, they were much more inclined to take that up.
The issue of the lack of recreational facilities, which has been brought forward in the strategy, is extraordinarily important. It is very serious to hear Senator Ridge saying that a school built 32 years ago is still without a sports hall. The problem is one of departmental co-ordination. Here is the Department of Health and Children trying to do something about recreational facilities for children in what, from Senator Ridge's description, is obviously a deprived area, yet the Department of Education and Science has not built a sports hall at the school. How on earth is one to offer recreational activities, particularly to teenagers, unless there is somewhere for them to take place?
The surveys of what children eat are very important. A survey done by Dr. Broderick and Dr. Shiel at St. Patrick's College, Drumcondra showed that the diet of those in fifth class in primary school was not what one would have hoped. Despite that and the fact that most of the children there were very inactive, 10% to 15% described themselves as being on a diet. We need to do a great deal of research in this area. It will be remembered that last year a major all-island nutritional survey looked at what adults eat. We did not come out of it very well. Very high fat and carbohydrate intakes were indicated. We have relied far too much and for far too long on medical research supported by pharmaceutical companies. They, of course, are not going to undertake research in this area, therefore departmental support must be sought to facilitate research into the nutritional intake of these children, their levels of physical activity and how they think these can be improved.
I spoke to a teacher from the Tallaght area who told me that she has great difficulty in getting teenage girls to become involved in PE. We discussed whether it might be better if they did dancing. One must listen to them and hear what they have to say. Dr. John Nolan in the metabolic research unit in St. James's Hospital recently pointed out to me that when he compares work he did in California with that which he has done here, he finds that our children are nearly in worse circumstances. This is all part of a world-wide plague. The increase in type 2 diabetes is associated with obesity and lack of exercise, but there is no need for us to sink under the waves. We could take the lead in trying to stop what is happening.
What are we going to do about finding a home for the community games? There are refugees in Mosney, but the community games have nowhere to go and they have represented tremendous work over many years. I support the Minister of State's statement that we need far more co-ordination among Departments and I support Senator Cox's comments about advertising. The Nordic countries are much stricter about the advertising they permit on television. The fact that we get British television here is no reason for us not to make an effort in that area. The distorted body image which is described as desirable is no less than an exploitation of children who at the same time are encouraged to eat every sort of fast food available. This is important not just physically, but also psychologically because no child likes to be fat and inactive. They end up being bullied and I congratulate Dr. Mona O'Moore at Trinity College, Dublin on the work she has done regarding bullying, which is an issue we should take up again.
I congratulate the Minister of State on the progress made regarding pornography on the Internet. I am sorry I was not able to attend the briefing on Tuesday morning at which progress on the report was outlined. When people like me began to say that something had to be done about pornography on the Internet, we were told it was impossible. The first meetings I went to in Helsinki and Stockholm were, however, greatly encouraging. Of course it is not impossible to address this issue. Nobody wants their children to look at pornography on the Internet and no server wants to become known as a site of pornography because it is not a good way to attract advertising. In this area, again, there is a need for co-ordination among Departments.
I recently received a complaint about pornography in e-mails. I was very flattered that the person who wrote to me assumed my knowledge of computers and e-mail was as great as his. He spoke a lot about cookies and spam. The European Commission and the European Parliament have had debates on this issue and there was a move at one stage to call for a ban on unsolicited commercial e-mail, commonly known as spam, some of which is very unsuitable. They, unfortunately, failed to get support for an option to be taken up in Europe, whereby one had to opt in to receive these commercial e-mails. Support was eventually garnered for an opt-out, though some countries such as Finland, Denmark, Austria, Germany and Italy have supported an opt-in for such e-mails and have passed opt-in regulations on spam. Unfortunately, the Department of Enterprise, Trade and Employment did not support that option because it said it would interfere with commerce. Germany is a commercial country, as are Finland, Denmark, Austria and Italy. They are very important economies and if they feel they can cope with not getting unsolicited e-mails which may contain unsuitable material, I do not see why we could not. Perhaps that could be addressed.
The Minister of State spoke of the need to take a holistic approach to children, which is absolutely correct. I was particularly concerned last year during the debate on the Mental Health Bill. There is one more thing the Minister should try to do before she moves on to higher places. We did not succeed last year in getting separate mental health facilities for children and adolescents put on a statutory footing. It is one of the most important deficiencies in the Mental Health Bill, not one line of which has yet been brought into play. I ask her to do something about that because fewer than 300 children are admitted as in-patients every year, but they are admitted to adult psychiatric wards.
Young people, who were patients as children or as adolescents, contacted me before that Bill came before the House to see if I could do anything about ensuring there were separate facilities for children. They did not ask for compensation for themselves or anything else. They just wanted separate facilities because they said it was a terrifying experience being in with psychiatrically ill adult patients. I hope the Minister of State applies pressure on the Department of Health and Children, although this also involves another Department. It is difficult for the Minister of State because she must go from one place to another to try to move her strategy forward.
Regarding the Children Bill, as the Minister of State will be aware, I very much regretted that children, who were put into care because they probably were being neglected by their parents, did not have the same statutory safeguards as children who were put into detention. For example, the places for children who were neglected would be inspected periodically, whereas the places of detention would be inspected every six months. Every pressure must be put on all the Departments so they know there are provisions under the children's strategy which the Minister of State expects them to fulfil.
Senator Ridge spoke at some length about teenage sex and pregnancy. Unfortunately, there is a very high rate of teenage pregnancy. There was a tragic case recently where a 15 year old had a concealed pregnancy, delivered unaided in her own bedroom and some days later a stillborn child was found in her wardrobe, but we are not even talking of children from really deprived backgrounds where something like this can happen.
Schools must be investigated to see what they are doing under the sex education programme. One teacher told me that whenever he had to give any sex education programmes, he sent all the boys out to play football. That was not very helpful because boys are involved in teenage pregnancies as well. We want to know what is happening in that regard too and, therefore, it is important that the Minister of State asks the Department of Health and Children to look at this issue.
One other place from which I would like to see children's voices reported is the children and family courts. As the Minister of State will be aware, these children have to be heard in camera. That rule is very strictly enforced - apparently it must be at present. Over a year ago the Courts Service appointed a barrister who was to produce anonymous reports on cases where it was important to read what children said in court. In the family courts, more than just the children would be reported, but the Minister of State should do something about this because we do not know if their voices are heard at all in separation issues or in divorce proceedings. We do not know what is happening in the children's courts at all. Therefore, will the Minister of State also consider if she can bring forward the necessary legislation to allow this anonymous reporting?
The Minister of State said in her report that we must put special emphasis on children with disabilities and she is right. We have a huge responsibility to do something in this area because the number of children with disabilities in this country is high. To my horror, I discovered the other day that our dreadful waste management policy, or our lack of policy, may be important in this regard. There is a pan-European report which showed that mothers who lived within three kilometres of a hazardous waste dump, that is, in the case of this country, most waste dumps, were more likely to have children with disabilities than those who lived between three and seven kilometres from them. Perhaps by our dreadful lack of action over the decades in dealing with waste management we have inadvertently contributed to the number of children being born with disability.
There is a need for a cross-departmental approach and it will not do to leave the Minister of State with the strategy in her hand. Ministers must back her up on this issue. I am sure that any of us who can do anything to help the Minister of State will do so. I will certainly do as much complaining as I can because sitting and looking at the strategy will not achieve anything. The Minister of State must get her colleagues to enforce what she has brought forward.
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