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Seanad Éireann debate -
Wednesday, 19 Dec 2012

Vol. 220 No. 1

Adjournment Matters

Care of the Elderly Provision

Nursing Homes Ireland, several other organisations representing the elderly and health agencies are anxious to facilitate a longer-term planning strategy to be developed for caring for the elderly. There are also concerns about the availability of step-down facilities from hospital and comprehensive home care packages for the elderly.

While the Health Information and Quality Authority, HIQA, is calling for certain standards in nursing homes, it is not providing the necessary support and the sharing of information to assist them meeting those standards. Many nursing homes feel it would be helpful if there were more consultation with all groups involved in the care of the elderly. A comprehensive long-term programme for care of the elderly is necessary. A recent report pointed out that 49% of people occupying hospital bed spaces are over 65. We must ensure the appropriate services outside of hospital are available to these people when they are well enough to leave hospital. We can only achieve this if we have more consultation on the matter.

It is always a pleasure to be in the Seanad. I sometimes feel like I am a Member of this House I am so often here. I thank Senator Burke for raising this issue as it provides me with an opportunity to update the House on policy and services for older people. Close co-operation has long been a hallmark of the way both statutory and non-statutory organisations do business in the area of services for older people. This is reflected in significant advances in policy, funding and services achieved for the sector over recent years. This, if anything, has been given greater impetus by the clear commitments contained in the programme for Government and the necessity, more than ever, to collectively advance planning for the changing and evolving role of older people in society.

This aim is reinforced, if we bear in mind our nation's changing demographics and the expected pressures on future resources generally. Notwithstanding the very difficult financial environment we face at the moment, the Health Service Executive, HSE, still spends €1.4 billion annually on older people. This is separate to Exchequer provision by other agencies and includes, for example, long-term residential care and community-based services such as home care, Meals-on-Wheels and day or respite supports. Current initiatives also encompass the review recently commenced by the Government of the nursing homes support scheme and improving services for older people generally in the context of the health reforms now under way.

The concept of supporting older people to live at home and in their communities for as long as possible remains to the fore of the Government's agenda. We have also prioritised, and acted upon, the need to better co-ordinate and deliver the wider ambit of services for older people beyond just health and social services. This is being progressed, for example, through the recently published national carers strategy and the forthcoming national positive aging strategy, due to be published shortly. The positive aging strategy will set the strategic direction for future policies, programmes and services for older people. It will chart a common framework for the development of operational plans by relevant Departments and agencies and will reflect the expressed wishes of the many strands that comprise non-statutory organ for older people.

The Department regularly meets relevant stakeholders, whether statutory or non-statutory, to develop policies and services for older people. In addition to regular contact with a wide range of individual organisations, we have also initiated public consultation and submission processes, as appropriate, which receive full and proper consideration.
The Government has embarked on a major reform programme for the health system. The future sustainability and model of delivery of social care services will be subject to detailed policy analysis and consultation along the lines of the initiatives set out in Future Health: A Strategic Framework for Reform of the Health Service 2012-15. The framework commits to developing a social and continuing care system that promotes independence and maximises value for the resources invested. In light of the strategic direction indicated by the programme for Government and the numerous consultation avenues already in force in relation to older people, I am happy that sufficient mechanisms are available to all stakeholders for consultation.
I recently launched a clinical programme for older people and geriatric medicine. This is an important research and clinical programme which will from the outset operate to a set of standards for dealing with older people. The programme reflects what advocates recommend in the context of planning for demographic change. When someone presents to an acute hospital preparation of a discharge plan will commence immediately. It will no longer be acceptable to release people back into the community without the supports they require. We can allow people to exit acute services at a much earlier stage if we provide proper support. I believe this is the type of planning that the Senator has in mind.

I thank the Minister of State for her comprehensive reply. I acknowledge the excellent work she and her Department are doing on this complex issue. The nursing homes organisations are aware of the Department's consultations with the various groups but believe more could be achieved if the groups met together with the Department as opposed to individually. Even if such meetings were only held every six months, it might provide an opportunity to find out what may be missing or needs to be improved. All of the groups acknowledge that significant improvements have been made over the 18 months since the Minister of State was appointed but this is the one issue they constantly raise with me.

I recognise the benefit in the Senator's suggestion and I will raise it with my officials. If representative groups were invited to sit around a table to discuss the same issues they might offer solutions that we have not thought of heretofore.

The Seanad adjourned at 10.05 p.m. until 10.30 a.m. on Thursday, 20 December 2012.
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