Government Policy: Government policy in relation to older people is to support people to live in dignity and independence in their own homes and communities for as long as possible and, where this is not possible, to support access to quality long-term residential care. This policy approach is renewed and developed in the latest partnership agreement, Towards 2016.
Services for Older People are a priority for the Government. This is reflected in the funding committed to services for older people in Budgets 2006 and 2007. In 2006, the Government funded the largest ever expansion in services for older people with a full year cost of €150m. In 2007 a full year package of €255m has been allocated for services for older people. This gives a total of over €400m added to services for older people over two years.
Significant new community-based initiatives have been provided in recent times to support older people. In 2006 a total of 2,000 extra Home Care Packages were provided at a full year cost of €55m (prior to this date only 1,100 packages had been in operation on a pilot basis). A further €55m made available in 2007 will allow new packages to benefit some 4,000 people.
In relation to the Home-Help service, an extra €18m was provided in Budget 2007 to enable the HSE fund some 780,000 additional home helps hours this year.
Additional funding provided by the Government this year will also allow for a further 1,100 day places per week in Day Care centres around the country, and enhancement of the Meals-on Wheels services.
The Fair Deal: The new nursing home care support scheme a Fair Deal starts in January 2008. It will provide uniform financial support for individuals in private and public nursing home beds. The new scheme involves a co-payment arrangement between the individual and the State. At the time of receipt of care, the individual will contribute 80% of disposable income towards the cost of care. In addition, a capped contribution towards care costs based on an individual's asset wealth will be payable at the time of settlement of the individual's estate. The Heads of a Bill are currently being drafted and will be brought before Government in the coming weeks.
Standards: The Health Act, 2007 provides for the registration and inspection of all nursing homes — public, private and voluntary. Inspections will be carried out by the Social Services Inspectorate, part of Health Information and Quality Authority (HIQA). The existing inspection and registration systems for residential services will be replaced by a strengthened and expanded system and the Act strengthens and modernises the registration and de-registration process.
Statutory responsibility is given to the Chief Inspector of Social Services for inspecting and registering children's residential centres, residential centres for people with disabilities and residential centres for older people, including private nursing homes. Residential Centres will be inspected against standards set by HIQA.
Improvements to Subvention: From 1st January 2007 there are no longer three separate rates for subvention. Persons who apply may receive any amount up to a maximum of €300 per week. Additional funding of €55 million was provided for this purpose in Budget 2007.
In addition to the increased rate of basic subvention, additional funding of €30 million has been made available in 2007 for enhanced subvention. This is a supplementary subvention, paid by the HSE, to a person in or entering private long-term care. The amount of enhanced subvention paid is at the discretion of the HSE and varies according to the cost of care.
The additional enhanced subvention funding will be used (i) to develop a consistency between the payment of subvention during 2007 and the new nursing home support scheme for 2008, and (ii) to work towards equalisation of the level of support paid to people in different areas (taking local prices and a person's means into account).
Palliative Care: The provision of a world class palliative care service, remains a priority of this Government and is reflected in the significant development in services and policy in recent years. As outlined in Towards 2016, the Government is committed to further developing palliative care throughout Ireland with particular reference to the 2001 Report of the National Advisory Committee on Palliative Care.
Funding of €18 million has been provided in 2006 and 2007 to develop palliative care services. This funding is being used to improve services in consultation with the newly established Regional Development Committees and in line with the recommendations made in the report of the National Advisory Committee.
The Department of Health and Children has convened a working group to develop a policy for children's palliative care, and a draft policy will be ready by the end of 2007.
Dementia: The Action Plan for Dementia, published in 1999, describes a model of best practice for the provision and planning of dementia care in Ireland. There is a complementary link between Government policy in the area of the care of older people and care for people with dementia. Both policies stress the need to provide support in dignity and independence, through the provision of appropriate services to the people concerned and their carers. The Government is fully committed to providing such support and service improvement, including the expansion of community and residential care services for people with dementia.
Elder Abuse: The Government continues to attach priority to combating elder abuse, and the HSE has recruited 26 of the 32 senior case workers needed to give effect to policy in this area. Elder abuse officers have been appointed in two of the four HSE regions and elder abuse steering groups have also been set up in each of the regions.
Programme for Government: The Government's commitment to older people is set out in the new Programme for Government. A new National Positive Ageing Strategy will be developed in conjunction with the recognised voluntary groups in this area and will include:
The development of operational plans by Government Departments clearly setting out objectives relating to older people.
Joined up thinking on initiatives serving older people.
Ongoing mechanisms to monitor progress and identify challenges.
Liaising with recognised voluntary groups in the area.
And giving consideration to the appointment of an Ombudsman for Older People.
The Department of Health and Children is currently considering the mechanisms to develop the new Strategy for Positive Ageing and details will be announced when this work is finalised.