Budget 2022 presents an opportunity to tackle the effects of COVID-19 on cardiovascular health: in the short-term by fixing deficits in vital hospital and other health and care services; and through longer term solutions that will reduce chronic disease and build resilience in the population to create a healthier Ireland and to minimise the impact of this and future pandemics on public health and the economy.

We urge that Budget 2022 address these four priorities:

Priority 1: Protecting Children’s Health – Tackling Childhood Obesity

Shortly before the pandemic, the Irish Heart Foundation published its Childhood Obesity Manifesto, setting out actions that the country’s leading obesity experts agreed could cut the rate of childhood obesity by 50% by 2030.

To finance the fight against childhood obesity, it is critical that a Children’s Future Fund is established. Good nutrition is central to the health, wellbeing, and development of children and young people.

Without it, children’s health outcomes worsen. Ringfenced funding must be made available to develop new programmes, projects and initiatives that can support children’s health in the post COVID-19 public health era.

Budget 2022 should:

• 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.
• Lower the Band 1 threshold of the levy. Many soft drinks are currently sitting just under the lower threshold 5g per 100ml. This is a great first step – but given that they were able to reformulate very quickly, we think they can go even further.
• Develop healthy food subsidies targeting disadvantaged communities. These subsidies should be funded by the Children’s Future Fund.

Priority 2: Supporting Services and Patients Post COVID-19

Cardiovascular disease, which includes heart disease and stroke, is one of the most common causes of death in Ireland.

At the Irish Heart Foundation, we are fighting to improve services that will contribute to a 25% reduction in premature deaths from cardiovascular disease by 2025.

We are calling for budget 2022 to:

• Reduce the Burden of Chronic Disease: Blood pressure Awareness
• Improve Stroke and Heart Services for patients
• Fund and Maintain a Comprehensive AED Register
• Invest in Cardiac Rehabilitation Services
• Reduce the Cost Burden of Cardiovascular Disease

Priority 3: Prevention and Future Proofing

Almost 6,000 people die each year in Ireland from the effects of smoking and thousands more suffer from smoking-related diseases. Although the Tobacco Free Ireland program set an ambitious target of having a smoking prevalence rate of 5% or less by 2025, the 2020 half year smoking rate stood at 15.7%. Evidently further measures are needed.

Budget 2022 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 €1.93 on a pack in Budget 2022.
• 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 €13 million to €50 million annually.
• Accelerate and pass the Public Health (Tobacco and Nicotine Inhaling Products) Bill to ban the sale of e-cigarettes to, or by, young people under the age of 18.

Priority 4: 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 Programme for Government has committed to extending the smoky coal ban to new towns and eventually nationwide as part of a clean air strategy, individual local authorities are primarily responsible for enforcing air quality legislation and currently, there is no dedicated funding to undertake such functions.

Budget 2022 should:

• Allocate significant funding to local authorities to monitor and enforce air quality legislation and double the maximum fine amount for breaches of regulation from €5,000 to €10,000.
• Introduce a Green Transition Fuel Allowance to facilitate the move away from burning of the worst health affecting solid fuels such as smoky coal, wet wood, and sod turf.
• Double the current NOX levy rate and apply to both category A and B vehicles, to yield an estimated extra €120 million.
• Increase the diesel tax rate to match the petrol tax rate. Phase-out the price cap for diesel used by road hauliers.