Gabhaim buíochas leat, a Chathaoirligh, agus le gach Seanadóir as ucht an deis seo a thabhairt dom labhairt sa Teach mar gheall ar chúrsaí a bhaineann le daoine níos sine. Tá mé sásta éisteacht leis na cainteoirí ar gach taobh. Tógfaidh mé na pointí éagsúla faoi deara.
I thank the Cathaoirleach and Senators for giving me this opportunity to make a statement on the subject of older people. It is very appropriate to address this important issue, given the potential to bring about change following the establishment of the Office for Older People earlier this year. This move, which was brought into force at the end of January, highlights once more the commitment of the Government to older people.
In recent years there has been a growing realisation of the enormous contribution made by older citizens through all walks of life in both the public and the private arenas. If we look across the Atlantic to the example of the septuagenarian senator, John McCain, we see that age need be no barrier to ambition and achievement. Closer to home, the actor David Kelly, the author Jennifer Johnston, the painter Louis le Brocquy and the historian RB McDowell, are just a few who force us to rethink the supposed limits and boundaries of age. I think also of Paddy Burke of Littleton, Thurles, age 79, who was recently awarded a recognised award for being a cheesemaker, and also Maura Armstrong from Upperchurch, Thurles, again from my constituency, who at the age of 83 completed the women's mini-marathon a couple of weeks ago here in Dublin. They are an inspiration to us all. Older people are living longer, healthier lives and those lives can be filled with purpose and meaning.
In comparison with some European countries, Ireland has a relatively young population. The latest statistics tell us that 11% of people living in Ireland are aged 65 years or over. It has been estimated, however, that this figure will rise to 20% by 2036 and to 29% by 2056. This presents Ireland with both great challenges and great opportunities in the future. It is to be regretted that, all too often, the debate and statistics surrounding older people relate to talk of "problems" or "burdens". While issues such as care or illness are genuine concerns that must be properly addressed, I am happy to use any occasion to stress the wide-ranging possibilities and potential of older people.
For that reason, I am pleased that one of the key functions of my office is to develop a strategy for positive ageing. My goal is to develop a meaningful and innovative strategy that will result in real improvements in the lives of older people. The strategy will involve, for example, the development of operational plans by Departments, clearly setting out objectives relating to older people and joined-up thinking on initiatives serving this community. Other areas for consideration include ongoing mechanisms to monitor progress and identify challenges.
The new strategy will be developed on a cross-departmental basis. To ensure this happens, I also have responsibilities in the Departments of Social and Family Affairs and the Environment, Heritage and Local Government. I am also a member of the Cabinet committee on social inclusion which ensures there is an integrated, coherent approach to issues relating to older people at Government level. This approach is key to delivering the Government's vision of improved integration of services, and thereby further supporting older people into the future.
My office also will continue to develop health policy and will oversee and monitor the delivery of health and personal social services for older people and the running of the long-stay charges scheme. It will, in short, be the focal point for the development of a more comprehensive policy in regard to older people. The remit of the office also will be extended to impact positively on issues in regard to employment rights and opportunities, promote gender equality for older people, and work closely with agencies providing services to older people in rural communities. The resources of my office, which is staffed by officials from the Department of Health and Children, will be strengthened by the addition of staff of the National Council on Ageing and Older People. These new staff will add significantly to the research and overall capacity of my office.
I stress that the voluntary sector in general, and older people in particular, will of course also make a positive and essential contribution to the development of policy in this area. This will be primarily through the establishment of a new national advisory council on older people. One of the main functions of this new council will be to advise me, as Minister of State, on all aspects of the lives of older people. The council also will suggest ways of better co-ordination and delivery of services for this sector of society.
The establishment of the office, the interdepartmental network and the advisory council will bring a greater coherence to policy making for older people. These significant new measures will allow for a much greater degree of cross-cutting and will develop further the partnership approach that has featured so strongly in the planning and development of services for older people in recent years.
The establishment of the Office for Older People is only the most recent manifestation of the Government's long-running commitment to improving the welfare of older people. The Government and the social partners have adopted a life cycle perspective in the current social partnership agreement, Towards 2016, placing the person as the centrepiece of social policy development. The vision for older people, as reinforced in Towards 2016, is to provide the support, where necessary, to enable older people to maintain their health and well-being as well as to live active and full lives in an independent way in their homes and communities for as long as possible. There are specific initiatives for older people in the partnership agreement, such as pensions and income supports, housing and accommodation, community and residential health care, mobility, and promoting education and employment opportunities.
The high level objectives of these initiatives, individually and in combination, are intended to make a real and significant improvement in the quality of the lives of older people. To underpin the objectives in Towards 2016, older people have been highlighted in the social inclusion priority of the National Development Plan 2007-2013. A sum of €9.7 million will be invested under the older people programme, with €4.7 million allocated to the living at home sub-programme and €5 million to be provided for the residential care sub-programme.
The Government is firmly committed to using the national development plan as a vehicle to translate policy into reality over period of the plan. Our objective of continued development of community based services for older persons is reflected in the unprecedented level of funding invested in the system in recent years. In the past three years, this Government has funded the largest ever expansion in services for older people to ensure they receive as much care as possible in their own homes, that high standards are set and enforced in all residential care settings and that the cost of residential care is always affordable and never an anxiety. In 2006 and 2007, just over €400 million was provided to enhance service development across the sector, of which €190 million was for community based services over these two years.
While considerable attention understandably has been paid to the number of older people in long-term residential care, it is important to note that only 4.6% of older people are in this situation. More than 95% are at home in their own communities, which is where they want to be. A key stone of the Government's policy for older people is supporting them in their own homes and communities for as long as possible. To cater for the needs of this majority, the Government has invested heavily in this area, resulting in significant service improvements in community supports in recent years. Home help, which is the backbone of community-based services, includes the provision of a range of essential services that make all the difference to the quality of life of each individual. In 2007, nearly 12 million home help hours were provided, benefitting an estimated 53,000 people. In the past three years, more than €50 million has been allocated to expand home help services across the country. Where it is not feasible for people to remain at home, the health service supports access to quality long-term residential care where this is appropriate. This policy approach is renewed in Towards 2016.
For those in need of greater community-based support, the Government has introduced, on a pilot basis in 2005 and a national basis since 2006, the concept of home care packages. These packages are designed to reduce pressures on acute hospitals and long-term residential care systems by supporting older people to continue to live in their own communities. Home care packages are therefore an mechanism over and above existing mainstream community services and are designed to enhance rather than replace existing home support services.
In 2007 the HSE provided more than 4,000 home care packages, assisting in the region of 11,500 clients at a total investment of €110 million. An interdepartmental group comprising representatives of the Departments of Finance, Health and Children and Social and Family Affairs and the HSE is currently preparing for an evaluation of this home care package initiative. The evaluation, which will be undertaken later this year by independent consultants, will examine the current provision of services in this key area and make recommendations for improvements in the years ahead.
For many people, whether carers or those who are being cared for, the availability of day and respite care is extremely important. More than €12 million has been made available for this area in the past two years. In 2006, an additional €9 million was provided for a wide range of new and increasing services, including improved therapy services for specific needs at local level. A further €3.5 million provided in the following year for an additional 1,100 day places per week. The total projected day care provision this year is over 21,000 places.
A fundamental feature of the myriad of services delivered throughout Ireland is the partnership approach involving the State and the voluntary sector. Voluntary groups make invaluable contributions to the well-being of all sectors of society, including the provision of services and expertise at local level in conjunction with State agencies. I acknowledge the tremendous work being done by these groups in the area of older persons.
Additional supports are available through community intervention teams, which assist in preventing avoidable hospital admissions and facilitate early discharge. These teams were developed in 2006 and, while not exclusively available to older people, the majority of those availing of them are aged over 65. The teams operate in addition to existing mainstream community services on a seven day per week basis and provide fast tracked non-medical care or support for an interim period while mainstream services are being arranged for a patient but are not immediately available. This service provides an immediate response for patients who are identified by a GP as requiring new or enhanced supports and offers a link between community services and patients who are discharged from accident and emergency departments but require community supports.
The 2002 report, Protecting Our Future, made a number of recommendations regarding the principles, policies and procedures to be followed and the infrastructure required to address elder abuse. This is a complex issue and is difficult to define precisely. Abuse may take financial, psychological, physical or sexual forms or it may arise due to inadequacy of care. Irrespective of the form in which it presents, it is simply unacceptable. Significant progress has been made on the health service-related recommendations. A HSE national steering committee is now in place, along with regional steering committees for each of the four HSE regions, dedicated elder abuse officers in three of the regions and the appointment of 27 of the 32 senior case workers. My office has commissioned the National Council on Ageing and Older People to undertake a review of Protecting Our Future and this will inform us of future action. The potential abuse of our older people, including financial abuse, concerns us all and it is an area that I intend to pursue vigorously until the best possible measures are in place to protect vulnerable older people.
The report on the national advisory committee on palliative care was published in 2001 and subsequently adopted as Government policy. In 2005, the National Council for Specialist Palliative Care was established by the Government. A baseline study launched in 2006 revealed regional variances in the provision of hospice and specialist palliative care services. Under the programme for Government, we have committed to removing these regional disparities in the provision and funding of care and to ensuring that the needs of those who require palliative care are met. Current spending on palliative care is approximately €75 million.
While helping people to live in their own homes for as long as possible, the Government is also committed to supporting access to nursing home care for those who need it. This commitment is reflected in the new fair deal scheme, which will put in place a single transparent system of support towards the cost of nursing home care. For the first time, there will be a uniform system of financial support for individuals in public and private nursing home beds. The scheme will involve a co-payment arrangement between the individual and the State. At the time of receipt of care the individual will contribute 80% of his or her net income towards the cost of care. In addition, a capped contribution based on the individual's asset wealth will be payable. This part of the payment, however, may be deferred until the settlement of the person's estate. These new arrangements are designed to remove the real financial hardships experienced by many individuals and their families who under the old system of nursing home subvention had to sell or re-mortgage their homes to pay for the cost of care. By contrast, the new fair deal will make long-term residential care affordable, accessible and anxiety free for those who need it. The Bill providing for the scheme is at an advanced stage and is currently being finalised by the Office of the Attorney General. My colleague, the Minister for Health and Children, hopes to publish the Bill at the earliest opportunity following its clearance by the Attorney General and the Government's approval. The Minister has let it be known that the subsequent presentation and passage of the legislation through the Houses will be a priority because we all wish to make the benefits of the scheme available to older people. In advance of the fair deal, a number of key improvements were made to the nursing home subvention scheme, including an increase in the basic rate to €300 per week. Budget 2007 provided €85 million to support these improvements, further underlining the Government's commitment to supporting those in need of nursing home care.
Senators will appreciate that the fair deal arrangements will depend on a number of success factors, including an increase in the number of long-stay beds. For that reason, the Health Service Executive estimates that it will deliver 860 additional public beds in the period from 2007 to 2009. This process is at present well under way and HSE will devote a significant proportion of its capital resources over the coming years to an expansion of long-term residential capacity and upgrading existing facilities across the country.
The development of a national carers' strategy is a key commitment of the programme for Government and the national partnership agreement, Towards 2016, in recognition of the important role played by carers in society. A working group chaired by the Department of the Taoiseach has begun to develop a strategy. The Department of Social and Family Affairs provides the secretariat to the working group, which also includes representatives of the Departments of Finance, Health and Children and Enterprise, Trade and Enterprise, FÁS and the Health Service Executive. The working group has met on four occasions to date, in February March, April and earlier this month.
Issues of concern to carers cut across many Departments and agencies and consultation is, therefore, a key element in developing the strategy. The working group has used a three-strand approach involving consultations with the social partners, organisations representing carers, people with disabilities and older people, consultations with Departments and agencies not represented on the working group and written submissions from the public. These consultations will continue during the development of the strategy. Some 100 submissions from individuals and 48 from organisations were received in response to the public advertisement earlier this year and will also inform the strategy, which it is intended to publish later in the year.
In keeping with its commitment to help older people continue to live in their communities, the Government is conscious of the need to provide accessible and appropriate shelter for the disadvantaged and vulnerable. Sheltered housing is one of the most significant developments in the fostering of continued independent living among frail or vulnerable older people.
When I was appointed in June of last year, I undertook, in the company of staff from the Department of the Environment, Heritage and Local Government, to visit a number of housing projects that have been extremely successful in providing sheltered accommodation for older people. These projects ensure that independence and quality of life are to the fore but there is also an assurance that a good, wholesome meal will be provided in the middle of the day and that residents' homes will be secure at night. The fine projects to which I refer are located in Mayo, my constituency in Tipperary, Cork and elsewhere. We will continue to support and expand on these projects in the future.
Following receipt of the report of the interdepartmental working group on long-term care of the elderly, the Government decided on a number of actions to be progressed. Among these is a commitment to establish a cross-departmental team to develop and oversee policy in respect of sheltered housing for older people and to agree, as a matter of priority, local structures and protocols for integrated management and delivery of housing and related care services. This team, which was established in July 2007, is chaired by the Department of the Environment, Heritage and Local Government and involves the input of the Department of Health and Children, the Health Service Executive, the office for social inclusion, local authorities and representatives from my office. During the current year, the team will develop a policy framework in respect of sheltered housing for older people. This framework will be also reflected in the new national positive ageing strategy to be developed by my office. Through this group, I look forward to the development of innovative housing solutions which will further enhance the quality of life of older people.
As previously stated, demographic changes in the coming decades will lead to the ageing of the population. A range of options will, therefore, be required to meet the housing and accommodation needs of older people. In this context, the new adaptation grants to assist older people and those with disabilities or mobility issues, which were introduced on 1 November 2007 and which are being administered by local authorities, are essential in ensuring older people can remain in their homes for as long as possible.
The housing adaptation grant for people with disabilities and the mobility aids grant scheme provide grant assistance to adapt accommodation to meet the needs of those with disabilities. Many of these individuals are older people with age-related mobility problems. As part of the new suite of initiatives, an additional scheme — the housing aid for older people scheme — provides targeted support to improve conditions in the existing housing of older people. This scheme will provide grant aid of up to €10,500 to cover works such as structural repairs, replacement of windows and doors, rewiring, drylining, installation of central heating, water and sanitary services, cleaning and painting.
The introduction of the latter scheme will also facilitate the implementation of a Government decision, taken in February 2006, to the effect that a more integrated service could be achieved by transferring the special housing aid for the elderly scheme from the HSE to the Department of the Environment, Heritage and Local Government, which already had responsibility for the disabled persons and essential repairs grant schemes. The transfer of the scheme poses significant challenges for local authorities in the context of both workload and resources. In recognition of this, and in order to ensure satisfactory resolution of outstanding issues, it was agreed between the Department of the Environment, Heritage and Local Government and the HSE that the special housing aid for the elderly scheme will continue to be operated and administered by the executive until such time as all issues arising from the transfer are satisfactorily addressed. It was also agreed that the appropriate resources and arrangements will be put in place to ensure that local authorities will be in a position to accept the scheme on transfer. The Department of the Environment, Heritage and Local Government is engaged with the HSE to conclude this process as quickly as possible.
The special housing aid for the elderly scheme is extremely effective in addressing the housing needs of older people. The flexibility and integrity of the scheme must be maintained under the new regime. In that context, the Department of the Environment, Heritage and Local Government, in conjunction with the HSE and the housing authorities, is developing specific mechanisms to ensure the needs of the more vulnerable members of our older community, such as those suffering from illiteracy, social exclusion and isolation, are adequately addressed following the cessation of the special housing aid for the elderly scheme.
Senators will appreciate that many things are changing for older people and that this is a very exciting time for them. I am pleased to be a part of this changing environment and I look forward to working with all stakeholders to initiate real change in the years ahead.