Consideration should be given to providing free access to family doctors for all children in the State, the Department of Health's chief medical officer has said.
Dr Jim Kiely said the health of Irish children lagged behind that of children in other jurisdictions. The reasons included poverty, the most important social factor associated with ill-health in children. One Irish child in four children under 14 in Ireland is poor, he said.
To ensure financial reasons did not result in children being denied healthcare, he said, "free access to primary care for all children should be considered".
Dr Kiely made the proposal in his second annual report on The Health of Our Children published yesterday. He said there was an urgent need for a systematic review of primary care and hospital services for children.
The development of acute hospital services for children must be accelerated, he added, "with the promotion of optimal care for sick children as the primary focus, untrammelled by geographic, disciplinary or institutional considerations".
Dr Kiely said the needs of children were becoming more complex and the response needed to be holistic and child-centred. This necessitated "fundamental organisational and behavioural changes within our health system". His report notes that preventable accidents are a significant cause of morbidity and mortality in children and said "an inter-sectoral strategy" for injury prevention, treatment and rehabilitation was necessary. Between 14,000 and 15,000 children are admitted to Irish hospitals with injuries each year.
"Whilst there have been overall improvements in the health of children in Ireland, inequalities in children's health persist," Dr Kiely said.
The report noted that the number of births to teenage mothers in the Republic was increasing again after dipping in the 1980s-1990s. While the incidence of cot death has fallen, it still accounts for four in every 10 deaths in the one month to one year age group.
Injuries are the main cause of death in children over the age of one year and accounted for 170 deaths in the 0-19 age group in 1999. The major cause of deaths was road traffic accidents.