Martin Daly on alcohol in pregnancy: education, policy and prevention

I suppose around the foetal alcohol syndrome issue, I mean, how aggressive is our education around, and I don't want to, we shouldn't be trying to gaslight women who are pregnant, but how aggressive is our, and this aggressive might be the wrong one, how robust is our education piece around alcohol and the danger to babies? Thank you. So we do have a HSC communications campaign around alcohol in pregnancy. There's been a clear message for a number of years that no amount of alcohol is safe during pregnancy at any stage. We can see, though, from market research that we've done in the HSC that this message isn't necessarily landing with the public, and we do have an issue around social norms around alcohol use in pregnancy. Our rates are considered, are up there in terms of being one of the highest in OECD countries studied. We are seeing some positive shifts though. We most recently did another round of public market research last summer, and we can see that the younger women, so kind of 15 to 34, we're seeing a lowering of rates of alcohol use in pregnancy. Now it's market research, so it's not, it's robust. I know, I accept that. Do you think, though, that it would be a good investment to have addiction counsellors as part of, say, antenatal classes, where you have dedicated part of, I'm sure it's mentioned by midwives who are carrying out these antenatal classes, but some of those specifically, because it's such a big problem. Yeah, so we are working currently on an updated alcohol and pregnancy communications campaign, so we'll be launching that in the new year, using all of our evidence from recent market research and other sources of evidence. We also do have drug and alcohol liaison midwives funded across our maternity services who play a really, really important role. I think though there is, prevention is such a huge piece of this picture because we have quite, you know, about 40% of pregnancies are unplanned, so actually it's really about reducing our per capita alcohol use more generally in the population is going to impact, that's going to have the most significant impact. We also have more work to do, I think, in terms of women getting a consistent message in pregnancy from their healthcare professionals. We can see from our market research as well that they don't always receive consistent messaging around that, so we are working on that. We have done a number of different initiatives trying to reach healthcare professionals around that. We've got a new pack for healthcare professionals coming out again in the new year that we'll be launching along with that public communications campaign update, but I suppose it's really all those broader measures around reducing accessibility, availability, increasing the price. That's, you know, I think going to be a huge factor in terms of reducing prenatal alcohol use. Just one question, I'll keep it short because I know the members want to come back in here. We've had some success in reducing alcohol consumption over the last 20 years in Ireland, so we need to say that also. And the culture has been changed in certain respects around drink driving and a lot of other cultural issues. But just coming back to that piece again about alcohol consumption and education, does our education need to start much earlier in our school system? So I think we'll just talk first about that we are doing that. I mean, I think we'll talk about what we are doing in the school system. Yeah, sure. Thank you. Yeah, so we are doing quite a lot of work with the Department of Education and Youth and with the NCCA, National Council for Curriculum and Assessment and NEPPS around our development of SPHE resources in schools. So we have alcohol and drugs now incorporated across lessons right from first year up to sixth year. We're currently working on the senior cycle resources. I know it was referenced by Ms. Leonard earlier that we now, for the first time, will have a lesson around commercial determinants of health, which I think is really, really positive, looking at not only the marketing and advertising on alcohol, but also tobacco, gambling and a whole range of other topics. We have it integrated as well into our new sexual health education as well. I think there's more work we need to do at the primary school level as well. There is a new wellbeing framework at the primary school level currently in development. So we look forward to working with our education partners around strengthening the work in primary schools as well. Just to say, Deputy, I think we need to acknowledge that as a people, we have a very complex relationship with alcohol. You know, when you survey people, the vast majority of people can consider themselves light or moderate drinkers and the overall consumption wouldn't back that up. We have a huge amount of public health work to do in terms of convincing people to reduce their alcohol intake. I might ask Matthew just to help the Ireland has a huge role to play in that. I understand that. And just finally, there's this conflation between increasing cocaine usage and the pricing of alcohol. That seems to be a drinks industry narrative. Is that true? Is there evidence there to say that, you know, cocaine usage has gone up because alcohol prices have gone up? No, Deputy. I mean, the opposite is the case. The prior price of alcohol, we know, drives, I mean, minimum pricing drives down the level of alcohol intake. I might just ask Matthew to talk briefly about the Healthy Ireland and its role in the public health. Yes, we are currently reviewing the current Healthy Ireland framework. We've been going through the documentary evidence that we've had so far. We're doing a public consultation in the new year, hopefully in the first quarter, probably around February, and we will be inviting submissions for that as well. So we'd be very happy to hear from the members here and from organisations about what they think should be going. Thank you.