Dáil Éireann Debate, Tuesday - 27 April 2004
544 Mr. R. Bruton asked the Minister for Health and Children if he has set standards for the availability of certain services for older persons per head of population, which would act as a benchmark for service delivery; and the standards of delivery per head of population which he applies here which compare to guidelines in the UK or other European countries. [11440/04]
View answerPolicy on the development of services for older people is as set out in the report, The Years Ahead — a Policy for the Elderly, which was published in 1988. The recommendations contained in the national council on ageing and older people's review of the years ahead report, together with priority areas highlighted by health boards and the Eastern Regional Health Authority, were taken into account when the health strategy, Quality and Fairness — A Health System for You, which was published in 2001, was being prepared. Norms for service provision as set out in the health strategy bear reasonable comparison to those used by other EU and developed countries and are widely accepted as appropriate to meet the needs of older people.
Figures from the 2002 census compiled by the Central Statistics Office suggest that the average age of the population is increasing. The 2002 census indicates that in 2002, 11.13% of the Irish population was aged over 65 years, which represents an increase of 5.4% on the 1996 figure. Forecasts suggest that by 2031 this figure will have more than doubled and that the percentage of the population aged over 65 years will be between 18% and 21% at that stage. The Government is aware of this trend and, in fact, addressed some of the issues arising from it in its health strategy.
In so far as the development of services to meet an increasing population of older people is concerned the health strategy outlined the need for the following developments: in community services — recruitment of a multi-disciplinary range of staff to support the development of primary care services such as domiciliary care and day and respite services and the provision of 7,000 day centre places; in hospital services — 1,370 additional assessment and rehabilitation beds; associated development of acute geriatric medical services and appointment of additional geriatricians; 600 additional day hospital beds with facilities encompassing specialist areas such as falls, osteoporosis treatment, fracture prevention, Parkinson's disease, stroke prevention, heart failure and continence promotion clinics; in residential care — 5,600 additional extended care/community nursing unit places over a seven to ten year period, including provision for people with dementia; improved staffing levels in extended care units.
The provision of the above services is contingent on the necessary resources being made available. With regard to performance, national standards for community and long-term residential care of older people will be prepared.
Since 1997, over €280 million in additional revenue funding has been provided for the development of services for older people. In addition, significant capital funding has been made available through the national development plan for the provision of additional extended care beds and associated facilities around the country. Proposals are also being developed for the provision of an extra 850 long-stay beds in the Eastern Regional Health Authority and Southern Health Board areas under a public private partnership pilot scheme.
545 Mr. R. Bruton asked the Minister for Health and Children if he will commission a report from the health authorities and from other outside experts on the adequacy of day units for the treatment of older persons without admission to hospital and of the adequacy of support services for older persons who have suffered stroke; and if service standard targets for each region of the country will be published. [11441/04]
View answerThe policy of my Department regarding the care of older people is to maintain them in dignity and independence in their own home for as long as possible in accordance with their wishes. This policy was first enunciated in the Care of the Aged Report which was published in 1968 and confirmed in the report, The Years Ahead — a Policy for the Elderly, published in 1988. Numerous research studies have shown that the vast majority of older people have a preference to remain living in their own home for as long as possible rather than moving into long-stay residential care.
Older people who suffer strokes are treated in acute hospitals where appropriate and are discharged subject to the necessary after care package being put in place. Since my appointment as Minister of State, I have been encouraging the authority and the health boards to introduce personal care packages for older people as an alternative to long-stay residential care. Personal care packages are specifically designed for the individual concerned and could possibly include the provision of a home help service, home subvention payments, arrangements for attendance at a day centre or day hospital and other services, such as twilight nursing. Personal care packages allow older persons the option of remaining living in their own home rather than going into long-stay residential care.
There is commitment in the national health strategy to provide 1,370 additional assessment and rehabilitation beds, plus 600 additional hospital beds with facilities encompassing specialist areas such as falls, osteoporosis treatment, fracture prevention, Parkinson's disease, stroke prevention, heart failure and continence promotion clinics. These additional services are, of course, dependent on overall funding resources available.
