Dáil Éireann Debate, Wednesday - 17 January 2024
1546. Deputy Mark Ward asked the Minister for Health his views on the new Commission on Social Connection to address loneliness as a pressing health threat; if resources will be allocated to the development of the committed-to action plan to combat loneliness; and if he will make a statement on the matter. [56754/23]
View answerI welcome the establishment by the World Health Organisation of the Commission on Social Connection. The Commission will consider how connection enhances the well-being of our communities and societies. I look forward to reviewing the report which is expected to be published in 18 months.
Evidence shows loneliness is a significant issue for population health and a number of different studies have linked loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor to increases in social isolation. Loneliness can be detrimental for our physical and mental health, while reconnecting with others post-COVID-19 pandemic has numerous physical and mental health benefits.
The 2021 Healthy Ireland Survey - which was carried out while significant restrictions were still in place - found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the pandemic started.
Given the detrimental impacts of loneliness, a significant body of work has been undertaken, across diverse areas of the Department of Health and the HSE, to address this.
In response to the increase in loneliness which particularly impacts older people, the Ministers for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, aimed at older people, to encourage them to rebuild their social connections and re-integrate into their communities. Post-pandemic, with vaccines and sensible precautions, it is safe for older people to reconnect with the world, to say “Hello Again World”, make up for lost time and re-establish important connections with their community.
Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness, and offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing. HSE-funded Social Prescribing services are now available in 44 locations across the country. These services are delivered in partnership with community and voluntary organisations such as Family Resource Centres and Local Development Companies, and as part of the Sláintecare Healthy Communities Programme.
Mental health of older people is a priority in Sharing the Vision, Ireland's national mental health policy, with actions including improving access to Mental Health Services for Older People, promoting evidence-based digital mental health interventions in the general population and with older persons, and linking recommendations with the National Positive Ageing Strategy.
Healthy Age Friendly Homes is a support coordination service which seeks to improve the health and wellbeing of older adults and to enable them to remain in their own homes and communities for as long as possible. The programme is an innovative collaboration between Health, Housing, and Local Government, through the Age Friendly Ireland Shared Service.
Referral into the programme can be made by the older person themselves, or by a family member, friend, GP, carer, or member of their community. On referral into the programme, their Local Coordinator will carry out a home visit to conduct a holistic assessment of needs in the areas of health, housing adaptations, home energy assessments and retrofits, community and social supports, and assistive technologies.
Following a successful Sláintecare pilot in 9 local authorities, I secured €5.2m in Budget 2023 to roll the programme out nationally to all 31 Local Authorities. This provides for a Local Coordinator, employed by Age Friendly Ireland (Meath County Council), to be situated in each local authority across the country. The programme will be coordinated nationally across six regions aligned to the six new HSE Health Regions.
A sample of participants were invited to take part in a research study conducted by Maynooth University. Overall, improvements were demonstrated in a number of health and wellbeing indicators, including measures of loneliness.
The HSE have advised that in line with the Enhanced Community Care Programme (ECC), their objective is to deliver increased levels of health care with service delivery reoriented towards general practice, primary care and community-based services. The focus is on implementing an end-to-end care pathway that will care for people at home and over time prevent referrals and admissions to acute hospitals where it is safe and appropriate to do so and enable a “home first” approach.
As part of the ECC programme, the Integrated Care Programme for Older Persons (ICPOP) model aims to shift the delivery of care for older people away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices. This supports them to live well in their own homes and communities without the need to access acute care settings. As of Quarter 3 2023, 94 of the 96 Community Healthcare Networks and 24 of the 30 ICPOP teams have been established across Ireland.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Co-ordination Service across the country. The Support Co-ordination Service will support older people to live independently at home for as long as possible, through support coordination and access to services such as practical supports, befriending, social prescribing, assistive technology, and also the coordination of linkages to local community groups. This service is being led out under the Enhanced Community Care (ECC) Programme.
These services will support the Enhanced Community Care model and facilitate all Community Health Networks (CHN’s) to deliver a coordinated system of care, integrated around older people’s needs, by collaborating with the Integrated Care Programme for Older Persons (ICPOP) teams, and further expand the ALONE Community and Partnerships to co-ordinate and deliver services in each Community Healthcare Organisations (CHO).
The end goal of the Support Co-ordination Service is to improve the quality of life for older people by improving access to integrated care through working with provider partners, statutory bodies, volunteers, and to provide the right level of care, in a timely manner, in an appropriate location, ideally in a setting of older people’s choice.
Acknowledging the disproportionately negative impact of the pandemic on older persons, the Programme for Government (2020) commits to the establishment of a commission on care that will ‘assess how we care for older people and examine alternatives to meet the diverse needs of our older citizens’, learning the lessons from COVID 19. On 3 October 2023 the Government approved the proposal that the Minister of State for Mental Health and Older People and I brought forward for the establishment of a Commission on Care for Older People, for which €1.24 million was allocated in Budget 2024. The Commission will examine the provision of health and social care services and supports for older persons and make recommendations to the Government for their strategic development. Subsequently a cross-departmental group will be established under the auspices of the Commission to consider whether the supports for positive ageing across the life course are fit-for-purpose and to develop a costed implementation plan for options to optimise these supports. The Commission will be an independent commission, the members of which will be appointed by Minister Butler and Minister Donnelly. On 14 December 2023 we announced the appointment of Professor Alan Barrett, Chief Executive of the Economic and Social Research Institute, as Chairman of the Commission. The other members of the Commission will be appointed in the coming weeks.
At a local level, Mental Health Day Services provided by the HSE are available to those who may require them, which provide mental health and medication supports, as well as wider assistances associated with daily living. Over many years, both Day Care and the Meals on Wheels service have proven to be important components of the community services offered to older people, particularly in rural communities. In May 2023 I announced the allocation of €5.25 million funding for Meals on Wheels and Day Centres for older people to organisations across the country.
Budget 2024 has seen increased investment in both areas building on recent investment to support these services. Community services are the backbone of social care provision and play an important part in keeping older people out of hospital and in their own homes and communities for longer. We will be investing an additional €2.7 million in 2024 for Day Care Services, which includes an additional €500,000 provided to increase the provision of in-home dementia day care and an additional €1 million for Meals on Wheels nationally.
The Roadmap for Social Inclusion 2020 - 2025: Ambition, Goals and Commitments was published in January 2020. The primary ambition of the Roadmap was to “Reduce consistent poverty to 2% or less and to make Ireland one of the most socially inclusive countries in the EU."
The Roadmap for Social Inclusion is an overarching statement of Government strategy, which acknowledges the range of sectoral plans already in place that have social inclusion as a core objective, in areas such as education, health, children and childcare, community development and housing. These plans remain key to ensuring that social inclusion is at the core of public policy and service strategy across all government departments and services.
