Cardiovascular disease (CVD) incorporating heart disease, stroke and blood vessel disease kills around 9,000 people in Ireland each year – that’s a death toll of over 25 people a day. Meanwhile, more than half a million people are living with CVD, and an estimated one and a half million are affected by its biggest risk factor, high blood pressure.

The Irish Heart Foundation is urging the government to act under five priorities.

Priority 1: Protect Children’s Health

Improving our health, and the health of our children, will require long-term political commitment and a wide range of interventions. Amongst the most important is taking action to rebalance the price of healthier and less healthy foods. Currently, many of the unhealthiest foods are not required to pay additional taxes for excess use of fat, sugar and salt. The Irish Heart Foundation believes that new fiscal incentives are a foundational part of building a food system which works for health. This is supported by the recent Commission on Taxation and Welfare report which proposed the Government “develop fiscal measures which could be introduced to encourage a reduction in the consumption of ultra-processed foods, to support reformulation measures to reduce the harm of such foods and promote healthier eating”.

Budget 2024 should:

• Introduce a timetable for new taxes incentivising the reformulation of unhealthy products, beginning with a new tax on high-sugar food products.
• Carry out more extensive scoping work on other taxes to incentivise reformulation of high-fat, sugar, and salt products, such as salty snacks and fast food.
• Extend the Sugar-Sweetened Drink (SSD) Tax to make it even more effective.
• Establish a Children’s Future Fund to reinvest the proceeds of sugar-sweetened drinks tax and other levies on unhealthy foods into a major national programme to improve children’s health.

Priority 2: Enhance heart and stroke services and supports

People affected by cardiovascular disease are often burdened by the high costs arising from their condition. However, there has never been a full assessment of the economic impact of CVD. Moreover, there is little statutory provision for practical, social and emotional supports vital to patients’ quality of life in Ireland despite the huge burden of CVD. The support services that do exist are delivered virtually exclusively by voluntary organisations, in particular national services delivered by the Irish Heart Foundation from its own resources.

Budget 2024 should:

• Provide funding totalling €599,692 to cover 40% of the cost of delivering Irish Heart Foundation national stroke and heart failure community support programmes.
• Develop a new national policy and establish a Cardiovascular Health Unit in the Department of Health.
• Increase Blood Pressure Awareness in the Population.
• Commit to implementing the National Stroke Strategy and provide adequate annual resourcing.
• Make clinical psychology available to all heart failure patients requiring a service.

Priority 3: Ensure the VAT system supports communities

Budget 2024 should:

• Retain the VAT Compensation Scheme and increase it to €20m annually to reflect a 50%

rebate on the overall claims from the sector.

Priority 4: Prevention and Future Proofing

In Ireland, 4,500 people die each year from the effects of smoking, and thousands more suffer from smoking-related diseases. With 18% of the adult population still smoking and youth vaping increasing, more robust measures are needed to achieve a tobacco-free future and protect our children and young people.

Budget 2024 should:

• Increase tobacco taxation annually on a pro-rata basis so that all packs of 20 cigarettes cost at least €20 by 2025. This would require an increase of €2.10 in budget 2023.
• Introduce an equivalent annual tobacco tax increase on Roll Your Own tobacco and the adoption of a taxation policy that acknowledges the substitution impact and adjusts tax rates accordingly to remove incentives to switch to a cheaper alternative.
• Increase the level of funding for tobacco cessation services from the current €15.7 million to €50 million annually.
• Apply an excise tax of €0.10 per ml/ mg of e-cigarette liquid to deter young people and non-smokers from using e-cigarettes.

Priority 5: Improving Environmental Health and the World we live in

An estimated 1,300 premature deaths are caused each year in Ireland by the most health-harming air pollutant, particulate matter, from the burning of solid fuel such as peat, wet wood, and smoky coal. While the new Solid Fuel Regulations have effectively banned smoky coal and wet wood nationwide and restricted the burning of sod turf, local authorities require much more resources to enforce this legislation to the benefit of public health.

Budget 2024 should:

• Allocate significant funding to local authorities to monitor and enforce air quality legislation.
• Double maximum fine amount for breaches of air quality regulation from €5,000 to €10,000.
• Introduce a Green Transition Fuel Allowance to facilitate the move away from burning the worst health-affecting solid fuels.
• Allocate annual funding to the NTA to guarantee the 20% reduction on all public transport fares, and the 50% young adult card discount is made permanent.