Speech by Minister Pat the Cope Gallagher at the launch of the INHALE Report – 2nd Edition

Tuesday 26th February, 2008 at the Royal College of Physicians of Ireland

Ladies and Gentlemen,


First of all I would like to thank Suzanne McCormack, Chief Executive Officer of the Irish Thoracic Society for inviting me to speak at the launch of the INHALE Report which has been compiled by Suzanne herself, Dr Neil Brennan and Dr. Terry O’Connor.

This is the second INHALE report compiling data on the scale, complexity and cost of respiratory diseases and the authors intend it to provide a benchmark for tracking changes and assessing trends in the mortality, morbidity and treatment of respiratory disease against the first report published in 2003 as well as future reports. I hope that, the report will help to highlight and improve awareness and understanding of the extent of lung disease in Ireland.

Particular concerns in relation to diseases of the respiratory system are highlighted. The report found that these diseases are the cause of one in five deaths in Ireland. In 2004, respiratory disease caused over 6,000 deaths, approx. 3,100 men and 2,900 women. Deaths from respiratory disease exceeded those from coronary heart disease in 2004, while cancers of the respiratory system were the second largest cause of respiratory death after pneumonia and ahead of chronic obstructive pulmonary disease (COPD). Lung cancer resulted in the death of more Irish people than any other form of cancer.

Cancer Issues

The delivery of cancer services, targeted in such a way as to ensure equity of access and equality of patient outcome is a priority for the Government. The recent appointment of a National Cancer Control Director to the Health Service Executive (HSE) is being supported by an additional allocation of funding this year for cancer control to the tune of €35m. As we seek to move from the present fragmented system of care to one which is consistent with international best practise it is important that the transitionary period is properly resourced to facilitate its successful completion.

The development of strategies and the provision of investment in other areas of respiratory disease has also been recognised by the Government and in turn by the HSE.

Cystic Fibrosis

The report also highlighted the need for improvement in the provision of services to persons with cystic fibrosis. The need to improve services in this area has been widely acknowledged and the negative experience recounted recently by some patients is a matter of much concern. Arising from the Pollock Report and the work of the HSE Working Group, my colleague, the Minister for Health and Children, identified the development of cystic fibrosis services as a policy priority in 2006 and 2007. Additional revenue funding of €6.78 million was provided to the HSE to develop services over a two year period. The Department is advised by the HSE that 44 additional staff dealing with cystic fibrosis have been appointed to date across a number of hospitals. The necessary funding is available to facilitate the recruitment of a further 37 staff nationally.

The HSE was asked by the Minister to place a particular focus on the development of services at the National Adult Tertiary Referral Centre at St. Vincent’s Hospital. I know that the HSE is working closely with the hospital and the Cystic Fibrosis Association of Ireland with a view to putting in place significantly improved facilities at the hospital for cystic fibrosis patients.

In addition, an independent registry for cystic fibrosis has been established. As yet, the data is not available to fully inform analysis relating to median survival in this country. When it is available, the data from the Registry will allow for accurate benchmarking of our performance against comparable countries around the world in this area.

Lung Transplant Programme

Since the publication of the first INHALE Report the Government’s commitment to establish a National Heart and Lung Transplant Programme has been realised at the Mater Hospital with the first lung transplant performed in May 2005. To date the total number of lung transplants carried out by the Irish team is 16 and this includes four double lung transplants.

HSE’s National COPD Strategy

A common and often undiagnosed condition which exerts a significant health burden is chronic obstructive pulmonary disease (COPD) and which the report states is the third largest cause of respiratory death. An objective of the HSE Transformation Programme is to develop and implement a chronic illness strategy for COPD and with a multidisciplinary group established, the HSE aims to develop a national strategy in that regard.

Tobacco Control

Tobacco smoke is the leading preventable cause of many lung diseases and Ireland has led the way in Europe and beyond in implementing legislation to address the tobacco epidemic. There is widespread agreement that the smoke-free at work legislation has been hugely successful since its introduction four years ago.

This is a positive, progressive health and safety measure, which brings immediate and long-term positive benefits to workers and the general public alike.

But this is not a time to be complacent. Smoking prevalence has been monitored on a monthly basis since mid 2002 by the Office of Tobacco Control. While smoking rates have declined over the last decade, smoking prevalence at the end of 2007 stands at 24%, with 17% of our 15-18 year olds smoking.

Reducing the numbers of smokers and the incidence of smoking related diseases is a continuing policy objective of the Government with legislation to ban the sale of 10 packs of cigarettes along with further increases in tax on cigarettes recently introduced.

Health Information

An important point which this report also raises is the fact that quality information is fundamental to all good decisions regarding health, ranging from health policy development through to the planning and delivery of services in addition to ongoing monitoring and evaluation of services.

The importance of good health information as a basic building block to supporting evidence-based approaches to health care with a view to achieving improved health outcomes is acknowledged and having information that lends itself to international comparison provides an added value dimension that enhances the quality of information.

Leading and driving the development of quality health information are key functions of the Health Information and Quality Authority (HIQA) which was recently established by my colleague, the Minister for Health and Children.

Specifically, HIQA has responsibility for evaluating existing health information, identifying gaps and deficiencies in that data and setting standards for health information. It also has a monitoring role in relation to compliance with standards set. To further support the better use of information in the interests of quality patient care, the Department is working on proposals for health information legislation with a wide-ranging public consultation exercise planned for late March.


Finally, I would like to pay tribute to the efforts of Suzanne McCormack and Doctors Brennan and O’Connor for the trojan work they have done to compile this report which, I am sure, will continue to inform future discussion on many aspects of respiratory disease in Ireland.

I note that the report will also be published by the Irish Medical Journal in an upcoming edition and I trust that its publication will have the outcome the authors’ desire, that is, the highlighting of the damage caused by lung disease and the direction of attention towards the provision of policies and services that will reduce that damage.

Thank you.