Dáil Éireann debate -
Thursday, 12 Jul 2012

Vol. 772 No. 3

Topical Issue Debate

Suicide Prevention

Deputy Dan Neville

I will begin my contribution with the following quote from an editorial in the Irish Independent of today:

Suicide remains the great unmentionable in Irish life... The biggest obstacle to reducing the number of deaths from suicide is the taboo most of us still have about discussing our mental health.

We should be extremely concerned about the figures published yesterday by the CSO which reveal an increase of 7% in the rate of suicide. The figures show that 525 people died by suicide in 2011, of whom 439 were men and 86 were women. Some 193 of those who died were under 35 years of age. There were also 65 undetermined deaths in 2011. Combining this figure with the fact that many suicides go unidentified because, for example, they involve single occupancy road crashes suggests that more than 600 people died by suicide last year.

This should be a matter of concern for anybody who values life and understands the trauma experienced by those who feel there is no way out of their crisis other than taking their own lives. They did not wish to die but they did not know how else to deal with their difficulties. The question of what people are thinking when they take their lives deserves much longer debate than is possible in this context. Extensive research is required to understand why suicide rates are so high but we can easily identify two contributory social factors, namely, the neglect of mental health services over many decades and the lack of suicide prevention programmes. Bearing in mind that up to 80% of those who died by suicide suffered from mental health difficulties, the neglect of mental health services is nothing short of scandalous.

The link between suicide and economic recession has also been well-established. Unemployment and the threat of unemployment are the leading predictors of suicide, especially among men. Those who are unemployed are between two and three times more likely to take their lives than those who are in employment. Being out of work has an especially profound effect on the young and the middle-aged.

In the budget, €35 million was allocated to develop mental health services. It is vital that the money is spent as intended because, as the Minister will be aware, in 2006 and 2007 moneys intended for mental health services were spent elsewhere by the HSE. The first step in developing mental health services is establishing community-based multidisciplinary psychiatric services. Recruitment is ongoing for 150 posts in child and adolescent psychiatry. Perhaps the Minister can inform the House when it is planned to have the 150 posts in place. A further 254 new posts are due to be created for adult psychiatry. What is the position on recruitment for these posts, when will they be in place and what is the breakdown between psychiatrists, psychotherapists, psychologists, occupational therapists, family therapists and psychiatric nurses? Perhaps the Department of Health can supply that information. How much progress has been made on the 90 community-based multidisciplinary psychiatric teams promised across the four regions and which areas are being covered? I understand that considerable planning was carried out earlier in the year in regard to how the €35 million will be spent. I am sure these plans are available for discussion.

Minister for Health (Deputy James Reilly)

I thank Deputy Neville for raising this important issue. The Deputy is known to be a great champion of the cause of suicide prevention.

The suicide rate in Ireland gradually declined between 2003 and 2007 from 497 to 458. However, this trend has reversed and evidence supports a link between the economic downturn and the increase in the rate of suicide. A recent CSO report indicates an increase of 7% in the number of suicides. Some 525 suicides were registered in 2011, compared with 490 in 2010. The figures also revealed a rise in male suicides, which accounted for 84% of all suicide deaths in 2011. These latest figures for the numbers of people who died by suicide last year are truly disturbing. Suicide is a tragedy that we are constantly working to prevent. We are also working to give more support to the families affected.

Reach Out, our national strategy for action on suicide prevention, sets out a series of specific actions and calls for a multi-sectoral approach to the prevention of suicidal behaviour in order to foster co-operation between health, education, community, voluntary and private sector agencies. Up to 20 voluntary organisations are part funded by the HSE to provide excellent support services, including telephone and web based helplines. The National Office for Suicide Prevention, NOSP, has implemented most of the Reach Out recommendations in a four way strategy of delivering a general population approach to mental health promotion and suicide prevention, using targeted programmes for people at high risk of suicide, delivering services to individuals who have engaged in deliberate self-harm and providing support to families and communities bereaved by suicide. A wide range of awareness and training programmes is also available, including safeTALK and ASIST, which trains participants to become more alert to the possibility of suicide in their communities. The NOSP has also piloted a system of suicide crisis assessment nurses working with emergency departments and GPs which will be rolled out nationally this year.

The special allocation of €35 million for mental health which was announced in budget 2012 will be used primarily to further strengthen community mental health teams in adult and children's mental health services and initiate the provision of psychological and counselling services in primary care specifically for people with mental health problems. I am pleased to announce that Dr. Stephanie O'Keeffe, former head of the Crisis Pregnancy Agency, has recently been appointed as permanent director of the NOSP. Dealing with the current levels of suicide and deliberate self-harm is a priority for this Government. I am continuing to monitor NOSP initiatives and the activities of voluntary agencies, as well as funding by the HSE and, in particular, progress on our special €35 million package of measures for mental health.

The challenge of suicide prevention is one of the most urgent issues facing society but I am confident that by working collectively policy makers, service providers and service users can and will respond to this challenge. I assure the House of the Government's unwavering commitment to addressing this issue.

Deputy Dan Neville

I welcome the appointment of Dr. Stephanie O'Keeffe as director of the National Office for Suicide Prevention. The permanent position was vacant since last October. I wish her well in the task ahead of her.

I am glad that the Minister recognises this is one of the most urgent issues facing society. He has promised to appoint a director of mental health services. What progress has been made on this vital appointment? Heretofore there has only been an assistant director of mental health services. Mr. Martin Rogan is doing a great job in that position but we need a senior person who will report to the chief executive of the HSE. The Minister has identified the people who collectively should work in this area, but this is a societal issue involving various bodies. Leadership should emanate from Government and those mentioned by the Minister, but the broader society should also take an active part as it has in other countries through various sporting and community organisations as well as clergy and gardaí. In addition, it should be recognised that general practitioners have a role to play.

We wish to promote the rolling out of the applied suicide intervention skills training or ASIST programme and the SafeTALK programme. Last year, the Irish Association of Suicidology provided a short course to over 700 members of the Society of St. Vincent de Paul. In addition, almost 500 gardaí in the Limerick area have been trained by the National Office for Suicide Prevention in a programme, similar to ASIST, under the auspices of the European Union.

A lot of leadership, understanding and discussion are required in dealing with this matter. Until we remove the taboo, people will not seek help in time. The biggest challenge in the area of mental health and suicide is to break down the stigma surrounding it. In that way, people will feel comfortable speaking about their difficulties and will be able to seek assistance without feeling that they are being labelled in any way, as they feel at present.

Amnesty International recently published an excellent survey on mental health, including patients and service users. It outlined the stigma they feel and have experienced as people suffering from a mental health condition. The survey is very revealing although we do not have time to go into it now.

Deputy James Reilly

I thank Deputy Neville for raising this important issue. I recognise, as he does, that the figures we have for suicide could in fact be an awful lot higher if single vehicle accidents were considered. We have seen some tragedies, including one more recently in a foreign clime involving an Irish couple who ended up losing children as a consequence of a man with suicidal intent. I would like to take this opportunity to convey our deepest sympathies to the family concerned.

I agree with Deputy Neville that the response needs to be community-wide and involve the sort of people to whom he has alluded who reach deep into the community at many different levels, including gardaí and clergy. The business community is particularly vulnerable in a recession and there is a role for chambers of commerce, parish councils and other community groups. We need to harness all these groups to try to tackle this problem which is of a very serious nature and a real priority for the Government.

I commend the National Office for Suicide Prevention on the ASIST and SafeTALK programmes. I agree with Deputy Neville that we need to destigmatise mental health issues, which are the same as any other health issues. That is why we want all primary care centres to have a mental health facility. People with mental health issues should attend their local primary care centre in the same way as if they had a sore throat or a chest pain.

We must recognise that not just for the last couple of decades, but also for centuries, psychiatry and mental health issues have been the Cinderella of our health services. They do require particular attention and will receive that from this Government.

Acute Hospital Services

Deputy Michelle Mulherin

The acute services at Mayo General Hospital are under considerable pressure and that is why I am bringing the matter to the Minister's attention. I am asking him to intervene to change the situation. In the past year, there has been an increase of nearly 28% of people presenting to the accident and emergency department in that hospital. As a result, there has been an increase of almost 9% in admissions. The Minister might ask whether they are striving for efficiencies to do their business in the way he and the HSE have outlined for hospitals to conduct themselves. I fully support that but this hospital, its management and the HSE team in the area are very much tuned into the Minister's policy and philosophy. In fact, these statistics are no reflection on the hospital's management because last year it boasted health figures placing it as one of the best performing hospitals in the country. The performance included a 64% reduction in people waiting on trolleys, which compared to a national average of 20%. Therefore the hospital management has been listening and has been trying to implement the Minister's guidelines.

Mayo General Hospital has been assessed by the Minister's special delivery unit and was found to be running efficiently, which is a reflection on the sort of work being undertaken there. However, major pressure is being placed on the hospital as a result of the closure of the accident and emergency department at Roscommon Hospital. Following an examination of relevant data, it has been found that many people presenting to Mayo General Hospital have addresses in County Roscommon.

I have cited figures for presentations and admissions at the accident and emergency department in Mayo General Hospital, but figures for the same period in University College Hospital, Galway, showed a 10% reduction in presentations to the accident and emergency department and a reduction of 5% in admissions.

It is significant that another tranche of people presenting to the accident and emergency department in Mayo General Hospital have addresses in north Galway. Anecdotal evidence points to the fact that people from Roscommon are either going to Mayo General Hospital or Sligo Hospital, and are not going to UCHG. Having visited UCHG's accident and emergency department on a number of occasions, I understand there is a problem in accessing it and it is already under pressure. This situation concerns people in counties Galway, Roscommon and Mayo.

When the accident and emergency department was closed in Roscommon Hospital there was no transfer of resources to Mayo General Hospital, notwithstanding the fact that fewer people were presenting or being admitted in Roscommon. As far as I understand it, the same teams are still there, although dealing with fewer people. That matter needs to be addressed.

Funding from the Minister's special delivery unit should be given to two intermediate care teams, which would take people out of hospital. It would also provide nursing staff, physiotherapy, occupational therapy and health care assistants in order to provide emergency interventions in people's own homes so they would not occupy hospital beds. This in turn would avoid unnecessary admissions to Mayo General Hospital or long-stay residential care, as well as allowing for an earlier discharge of patients from the acute sector.

It would naturally be a better use of the hospital's resources in addition to providing 24-hour nursing care with therapy interventions in the home. Over a maximum 12-week rehabilitation period, that should see patients referring to normal community services afterwards. In the interim, it would keep them well away from Mayo General Hospital, which has an average length of stay of 6.2 days for patients. That compares favourably with other statistics.

The Minister has set aside €28 million to address this issue so that people will not be on trolleys and to target acute services where they are needed. It is an expensive process and costs approximately €1,000 per day to keep someone in Mayo General Hospital. The cost for a step-down facility comes to about €400 or €500 per week. It makes financial sense to keep people out of acute hospital services. Mayo General Hospital is carrying an extra burden and I hope the Minister recognises that. The facts and figures are there to back it up. I am asking the Minister to make an allocation from that fund to the acute services.

Deputy James Reilly

I thank the Deputy for raising this issue.

The Government is committed to ensuring that patients receive the highest standard of care in the appropriate settings be they acute, community or residential. The traditional focus on the institution rather than the patient must be changed. To this end, we support older people to live at home and in their communities for as long as possible. This is realised through a range of community-based services, including mainstream home help, enhanced home care packages, meals-on-wheels and respite or day care. These services are designed to be as flexible as possible to best meet the needs of individual recipients and their families.

In tangible terms, the investment dedicated to services for older people is significant by any standard with, for example, just over €1.4 billion being provided this year for the health sector alone, of which approximately €350 million is for HSE home supports. These services are often delivered on a partnership basis with the not-for-profit and private sectors. We also provide a number of short term care beds nationally, including convalescence, respite, rehabilitation and palliative care beds. In total, there are just under 2,000 short term care beds currently available nationally. Intermediate care is a key component in delivering a continuum of services and particularly in delivering the appropriate care at the lowest level of complexity.

There are currently 160 short term or intermediate care beds available in Mayo General Hospital. I am aware that the hospital made a submission for inclusion in a pilot project on intermediate care being undertaken in my Department by the special delivery unit. The business case suggested the development of two intermediate care teams in Mayo, one in the south of the county and another in the north. The aim of these teams is to avoid unnecessary admissions to hospital or long stay care units, enable a more efficient hospital discharge, provide home care services for those who need help to recover from an illness or injury and to bridge the gap between primary and secondary care. The criteria for admission to this home based service is as follows: clients should be over 65 years of age, clients should have had a recent episode which resulted in a deterioration in their condition, clients have the potential for improvement-rehabilitation within a 12 month period and that the client reside in a catchment area. The cost associated with the development of the two teams is estimated to be €907,000.

The special delivery unit is still considering all of the submissions received regarding this initiative. No final decision has been made concerning the areas to be covered or the extent of these initiatives. However, the submission from HSE west in respect of Mayo General Hospital will be considered with all of the other submissions.

Deputy Michelle Mulherin

I thank the Minister for his response. I would welcome a comment from the Minister on the requirement on Mayo General Hospital to cope, without additional resources, with patients who previously would have gone to the accident and emergency department at Roscommon General Hospital.

I understand that €18 million of the €28 million has been allocated to the Dublin and mid-Leinster regions. Can I take it from the Minister's response that the provision of additional funding for Mayo General Hospital is still under consideration by the special delivery unit and that notwithstanding the recent announcement in regard to the €18 million there is more funding in the pipeline for worthy proposals such as this?

Deputy James Reilly

There is no question or doubt but that patients from Roscommon have been for a long time opting to go to Mayo General Hospital, Sligo General Hospital, Portiuncula Hospital and Galway University Hospital. A survey taken a couple of years ago indicated that only 9% of people with an address in Roscommon were attending the hospital in Roscommon, with the remainder attending other hospitals. It is our intention to reverse this trend by ensuring the provision of more safe services at Roscommon General Hospital so that more people from Roscommon and beyond can be treated there.

On the matter of additional funding for Mayo General Hospital, I must advise the Deputy that Portiuncula Hospital, Galway University Hospital and Sligo General Hospital have not received additional funding. The reality is that we are on an extremely tight budget, with the troika in town every three months examining all budgets. We do not, therefore, have the latitude we had in previous years. As I stated, the provision of additional funding remains under consideration. No final decision has yet been made.

Hospital Services

Deputy Éamon Ó Cuív

I thank the Minister for taking this matter, which I accept is at this stage only speculation. However, I believe it is speculation with a basis.

There is speculation that a recommendation will shortly be submitted to the Minister in regard to the withdrawal of oesophageal and stomach cancer services from Galway University Hospital, leaving only two centres in the country providing these services. I understand this arises out of a plan under consideration by the national cancer control programme. If this were to happen, patients from the west of Ireland would be required to travel to Dublin for treatment. I often think people believe everybody in the west of Ireland lives in Galway city. There are people for whom travelling to Galway takes half the time it would take to travel to Dublin. We are speaking, therefore, of many people for whom Dublin is more than four hours away.

Currently, there are four regional units providing this service. I accept that it is not possible to provide every service everywhere. I agree that we need to decide the appropriate level of service for each particular speciality. I have always accepted that. I believe that, as pointed out by the Minister in response to the previous matter, services currently provided centrally will be provided closer to people's homes while other services will be provided in one particular centre. However, I am concerned that despite the intention to provide regional centres of excellence, taking geography into account, the system - I accept this proposal has not yet come before the Minister - will try to recentralise everything. In terms of the medical issues that arise, there is a need to look beyond medical speciality and to ensure that if all services are to be provided centrally all other back up services will be available, including beds, car parking spaces and so on.

I am asking the Minister to consider this proposal, which no doubt will come before him, in the context of whether it is the right decision taking into account quality of life issues and the fact that it is possible to ensure there is peer review when the service is being provided by only four centres in the country. I hope the Minister can confirm to me today that regardless of what recommendation is made to him he will not be inclined in that way. I hope also that he will take into account that the services in Galway also provide investigative services for non-cancerous conditions such as stomach ulcers and so on.

I hope the Minister's vision of the health service will dictate that where there are good quality regional services available, as in this case, he will resist any proposal to centralise those services at huge inconvenience on a human level for people. I am not a doctor. I do not believe there is any overriding medical reason this should be done. Any case put forward on that basis would have to be considered alongside the case that people have a right to the provision of a top class service within reasonable distance in their region.

Deputy James Reilly

I thank the Deputy for raising this important issue.

The Strategy for Cancer Control in Ireland 2006 recommends that all major cancers, including oesophageal and stomach cancers, be treated in designated centres where patients are managed by multidisciplinary teams, in accordance with the best standards of cancer diagnosis, treatment and care.

The HSE's national cancer control programme, NCCP, recently undertook a quality review of oesophageal cancer surgery in the period 2008 to 2010. This involved an examination of services at four designated cancer centres - St. James's Hospital, Galway University Hospital, University Hospital Cork and Beaumont Hospital. The review examined quality of services against a range of standards of best practice. The outcome of the review was that the overall quality of oesophageal and upper gastrointestinal cancer surgery in Ireland in the four designated centres is within an internationally acceptable range for quality of the procedures, morbidity, mortality and post-operative complications, compatible with the volumes of patients treated in each centre.

In assessing the situation the national cancer control programme was mindful that evidence in international publications indicates that long-term outcomes have been demonstrated to be significantly better in high-volume centres. This necessitates that the programme for managing stomach and oesophageal cancer ensures that it harnesses the strengths of the entire national team of experts in co-ordinating services and monitoring quality in Ireland.

Following the review it has been decided that St. James's Hospital will be designated the national centre for oesophageal and gastric cancer. The national cancer control programme has appointed a clinical lead for upper gastrointestinal cancer. University Hospital Galway, together with Beaumont Hospital and Cork University Hospital will be designated as the three satellite centres for oesophageal and gastric cancer care including radical surgery, radiation therapy and chemotherapy.

The new programme will ensure there is integration within a multidisciplinary service based in each designated cancer centre with access to medical oncology, radiation oncology and specialised upper gastrointestinal surgical expertise; sustainable expert surgical services supported by specialised surgeons, inpatient beds, theatre access and an intensive care unit; sustainable volumes of procedures compatible with maintenance of surgical and nursing skills; implementation of video-conferenced national multidisciplinary team meetings to ensure optimal treatment decisions for selected complex patient management; collaboration with the national cancer control programme's national gastrointestinal tumour group in the development and implementation of national clinical practice guidelines; development and regular reporting of key performance indicators which build on the elements of this recent review; and planning of resources to ensure that money follows the patient.

I am confident the arrangements put in place by the NCCP will help to ensure best outcomes for patients.

Deputy Éamon Ó Cuív

The answer is comprehensive and I am very pleased with it. Can I take it that these are the decisions for the medium to long term? Will this be the arrangement to be in place? If it is, it is a very satisfactory outcome, which will give the perfect balance between having all the co-ordination, each one working in tandem with the other. I have no difficulty with one having a lead role in a speciality, which makes sense. If this is as it will be and if this is the decision from the national cancer control programme, it is a very satisfactory answer to the question I raised and it should allay the fears of many people. The surgery, radiation therapy and chemotherapy will be available locally while on the other hand every piece of national information, skill etc. will be available through a linked-up system between the four centres. I ask the Minister to confirm that my reading of the situation is correct.

Deputy James Reilly

The arrangements are as I have stated. That is the plan and those are the arrangements that have been put in place. I welcome the Deputy's comments. We want all citizens with oesophageal cancer and upper gastrointestinal cancer to get the best treatment. Like the Deputy, I believe that where possible we must have the volume of patients going through to maintain the expertise. Transposition of excellence will occur more quickly with IT link up and regular multidisciplinary team meetings in individual hospitals and also in conjunction with the main centre through IT linkage and video-conferencing, which is something we are developing. We acknowledge that for some parts of the country because of our geography and the population spread long distances are involved for people. I am pretty familiar with the road from Clifden and beyond coming into Galway city, which is a considerable journey in itself.

I am pleased the Deputy has accepted the answer that it will allow for the best of both worlds with a spread of the service in the country and yet have the volumes and expertise to keep us at the top of international best practice.

Employment Rights

Deputy Catherine Murphy

I am sure the Minister is delighted with this one.

Deputy Éamon Ó Cuív

He is multitasking tonight.

Deputy Catherine Murphy

I thank the Ceann Comhairle for selecting this matter which straddles a number of Departments. I am particularly interested in the area of employment rights. With the scrapping of the transition pension from January 2014, in effect the pension age is being standardised at 66. Even though we do not have any default age for pensions, many contracts of employment specify 65. Citizens Information states there is no single retirement age for employees, but that very much depends on the person's ability to sustain himself or herself.

The retirement age is usually set in a contract of employment. Some contracts have a mandatory retirement age and where there is a mandatory age it is usually 65. Recently the Employment Appeals Tribunal ruled on a case in which a person was being forced to retire at 65. She was challenging it under the Minimum Notice and Terms of Employment Act because nothing in her contract stipulated that the age was 65. However, the Employment Appeals Tribunal ruled against her on the basis that it was custom and practice in the company to retire at 65. From 1 January 2014 people who are required to retire at 65 on the basis of their contract will find there will be no transition arrangement until the age of 66, requiring them to apply for a jobseeker's payment. However, this infringes on their rights as employees because they are either being made redundant or let go and they will be required to apply for jobseeker's benefit. While they may have the requisite number of contributions, there is a difficulty with them being required to be available for work to get this payment, which is actually approximately €40 less than the transition payment.

Does this mean the people working in semi-State organisations will be able to work up to 66? Will there be a change in the redundancy arrangement so that somebody being let go at 65 will be able to apply for redundancy? If a person voluntarily leaves work will he or she be entitled to jobseeker's payment? Many anomalies are being thrown up here and while people are starting to ask questions about the changes to pension entitlements, there are knock-on effects on employment rights. Employment rights are the same as property rights or any other kinds of rights. I do not believe the Department of Jobs, Enterprise and Innovation is picking up on that aspect of change that has been made in the Department of Social Protection.

Deputy James Reilly

I am taking this on behalf of the Minister for Social Protection, who is on EU business in Cyprus. Legislation governing employment rights is primarily a matter for the Minister for Jobs, Enterprise and Innovation who advises that in general, the employment rights legislation administered by the Department of Jobs, Enterprise and Innovation does not contain an upper age limit. In particular, no legislation imposes a particular retirement age in the private sector. The upper age limit for bringing claims under the Unfair Dismissals Acts 1977-2007 was removed by a provision in the Equality Act 2004. The effect of that amendment was that a person, aged over 66 when dismissed, may now take a case under the Unfair Dismissals Acts unless he or she has already reached the normal retiring age for employees of the same employer in similar employment, if one exists.

Apart from being included in a contract of employment between an employer and employee, the normal retirement age may be a matter of custom and practice that has developed in a particular sector or workplace. Additionally, the upper age limit of 66 years for receipt of statutory redundancy payments was removed by the Protection of Employment (Exceptional Collective Redundancies and Related Matters) Act 2007. The Employment Equality Acts 1998 to 2008, which are administered by my colleague, the Minister for Justice and Equality, aim to protect against discrimination in regard to access to employment on a number of grounds, including age.

The Employment Equality Acts contain a provision permitting the inclusion a specific retirement age in a contract of employment. However, it is noted that rulings of the European Court of Justice under EU employment equality directives in regard to the issue of compulsory retirement ages may have implications in this regard and these will need to be examined. In the absence of a compulsory retirement age being specified in legislation, there is no current impediment from an employment rights legislation perspective to an agreement being reached in the workplace between an employer and an employee to a person continuing on in employment.

In regard to pension reform, I want to take this opportunity to again explain why we are making changes to State pension provision. As Irish society has changed, pensions policy has evolved to reflect these changes. A key focus of the Minister has been to ensure the State pension is sustainable in light of demographic changes and the associated increases in pension costs. This is compounded by the wider need for sustainable public finances. Our primary consideration in making the changes we have made to reform pensions has been to ensure the system is on a financially sound and sustainable footing. Ireland is not alone in this; all ageing western societies face a similar challenge.

An Leas-Cheann Comhairle

The Minister has one minute remaining.

Deputy James Reilly

The underlying and fundamental issue is demographic. The OECD put this conundrum well when it stated, "Policy makers are facing the challenge of providing a short-term response to the crisis without losing sight of the longer-term structural reforms needed to put pension on a solid footing in light of population ageing." Addressing this demographic problem is what lies behind the changes to the age at which people qualify for the state pension. It is also why the Government has asked the OECD to examine current pension policy in light of the economic downturn and to ensure it meets the needs of future generations. The central objective is to reform the system of social protection in order that it is viable into the future.

The pension reform measures under way, including the raising of State pension age which has been already provided for in primary legislation, address some of these issues. While the current State pension age of 66 remains, the State pension which applies for one year for persons aged 65 will cease from 2014. Thereafter, State pension age will increase to 67 in 2021 and 68 in 2028. There is considerably more in the reply, which I will pass on to the Deputy.

An Leas-Cheann Comhairle

It will be circulated.

Deputy Catherine Murphy

The essential point I am making relates to the gap of a year in provision in the case of an employee who has a contract of employment up to the age of 65 . I cited a ruling of the Employment Appeals Tribunal which provided that because it was custom and practice to retire at age 65, the person concerned had to retire at that age. A problem will arise in the gap year when no transition pension will be provided.

I understand the provisions of the framework on equality and the European Court of Justice in regard to discrimination on age grounds. It seems the onus is being put on individual employers to renegotiate contracts of employment for employees up to the age of 66, yet the custom and practice in those companies can be challenged at the Employment Appeals Tribunal, although such a challenge would probably not be successful as the tribunal has already ruled against such a challenge. In 2014 employees aged 65 will be let go, they will have to wait a year before they can get their pensions and in that period they will be in receipt of jobseeker's benefit but they will not be genuinely seeking work. This area needs to be examined in terms of people's rights to ensure it will not be left to individual employers to arbitrarily decide an employee can remain at work until they reach the age of 66 because it is custom and practice, while at the same time a person who must retire at the age of 65 will have no means while waiting a year to get his or pension at the age of 66.

Deputy James Reilly

I hear what the Deputy is saying. The core principle of sustainable social protection systems in advanced economies is that citizens receive benefits in proportion to their contributions. This has been always part of our pension system and changes to State pension provision which were announced recently put an increased emphasis on this as the system had not maintained a sufficient link between contributions and payments. We will always continue to provide the normal supports to those who cannot, for whatever reason, continue working or find themselves in financial difficulty. In this regard, the Deputy may wish to note that in 2011, almost half of those who received the contributory State pension were already on a social welfare payment before they reached pension age. For those with an income need, social welfare schemes will continue to be available for those who fulfil the eligibility criteria. The Government and the Minister for Social Protection are determined to defend and protect our State pension as the cornerstone of a secure and comfortable old age and the changes to State pension provision will go a long way towards this goal.