The healthcare system could be much more proactive and effective in promoting good health, according to Dr Cecily Kelleher, professor of health promotion at NUI, Galway.
Speaking at a seminar entitled "General Practice for Health - Shifting the Emphasis", at the annual general meeting of the Irish College of General Practitioners yesterday, Prof Kelleher told doctors that all health professionals had a health promoting role. Calling for broader patient advocacy by doctors, she said "they must speak up for patients at a policy and organisational level".
The Centre for Health Promotion Studies at Galway has produced a series of general practice-based research, covering men, women and children, according to Prof Kelleher.
She described the Galway health project, which looked at health promotion for schoolchildren. Participation rates were greatest among children whose parents were in higher socio-economic groups. Attendance by medical card patients was lower, which meant that those with greatest need had least access to the initiative.
In the "wisdom" study, 50 per cent of eligible women expressed an interest in participating in a health-promotion programme. However, only one-third actually turned up, a majority of whom were housewives.
Prof Kelleher also outlined the results of the Men's Health Promotion Project carried out in conjunction with the Western Health Board. It has demonstrated that men are no worse than women in their attendance for lifestyle intervention programmes.
A major finding from this study was that the logistics of a project can be a problem and that resources and type of intervention directly influence the outcome.
Prof Kelleher concluded: "It is accepted that health promotion in primary care has only a partial contribution to make because there are many other factors which influence health. But its contribution is real and acceptable to patients and it can make a difference for those at a greater-than-average risk. This is why, in the case of cardiovascular disease, it is worth investing resources in general practice to make that difference."
Dr Cormac O Dubhghaill, a GP in Spiddal, told the conference of his practice's experience in running a cardiovascular risk assessment (CRA) programme. "The advantages of CRA are its ability to link the various risk factors to the desired outcome in a quantifiable way," he said. However, patient selection was a problem as there was no universal registration system in the State. This excluded people who did not attend family practices frequently or at all, he added.
Dr Andrew Murphy, professor of general practice at NUI Galway, welcomed the national cardiovascular strategy in an address which looked at the opportunities and challenges it offered. Referring to ongoing discussions on the strategy's implementation, he said: "I have no doubt that a compromise will be reached between the various agencies and I strongly urge all those involved to reach this as soon as possible."
The official launch of a joint IMO-ICGP document, "A Vision of General Practice 20012005", will take place today. This collective vision from both organisations is a recognition that a partnership approach, involving general practice, the Department of Health and Children and the health boards, offers the best method of delivering the quality of service demanded by patients.
Full coverage of the conference of the ICGP will be given in The Irish Times on Monday next.