The Institute of Public Health in Ireland welcomes the opportunity to comment on the consultation paper on the New Strategic Direction for Alcohol and Drugs 2006-2011 (NSD). We particularly welcome the approach taken in the strategy, which, from the conceptual base of the Programme Logic Approach, is firmly based on desired outcomes and the pathways leading to them. The Institute aims to improve health in Ireland, North and South by working to combat health inequalities and influence public policies in favour of health.
The Institute applies a holistic model of health which emphasises a wide range of social determinants, including economic, environmental, social and biological factors, as well as the health and social services. The Institute’s work is based on the premise that improving health and reducing health inequalities can only be achieved through addressing these broader determinants of health.
Given this perspective, we particularly welcome the recognition of the wider determinants of health that is implicit in many of the desired outcomes and proposed solutions. In our view, the topics of alcohol and drugs are often treated as a matter of individual choice or a lifestyle issue, when, in fact, they are intimately intertwined with the structure of society, social inequalities, fiscal policy and other legislative issues. We believe approaches to tackling alcohol and drugs misuse must take into account societal as well as individual factors, utilising the potential and powers of the statutory, community and voluntary sectors.
A wider range of agencies and sectors have a contribution to make within their own areas of responsibility, and it is essential that cross-departmental and cross-sectoral co-operation is achieved. We are pleased that NSD recognise the need for this type of work. It would have been helpful if the envisaged role of the community and voluntary sectors in particular had been made more explicit throughout the document, and in particular in Chapter 15. Furthermore, wider use of fiscal policy and legislative measures to reach the desired outcomes, such as those underway in terms of smoking in workplaces and public spaces, could have been explored further.