National Positive Ageing Strategy: Discussion with Older & Bolder.

I welcome Ms Patricia Conboy, Mr. Sean Dillon, Ms Caroline Lynch and Mr. Ciaran McKinney from Older & Bolder.

Before we begin, I draw attention to the fact that while members of the committee have absolute privilege the same privilege does not apply to witnesses appearing before it. Members are reminded of a long-standing parliamentary practice to the effect that they should not comment on, criticise or make charges against a person outside the House, or any official by name or in such a way as to make him or her identifiable. I ask that all mobile phones be switched off during the meeting.

I want to be able to receive text messages.

I am informed that all mobile phones must be switched off. The Senator's text messages are a matter for herself. I call on Ms Conboy to proceed with her presentation. We will then take questions from members.

Ms Patricia Conboy

I thank the Chairman and members for the opportunity to come before them and introduce them to Older & Bolder and its work in respect of the national positive ageing strategy. In addition to the members of our delegation to whom the Chairman referred, we are also joined, in the public gallery, by Mr. Eamon Timmins from Age Action Ireland.

There are eight member organisations in the Older & Bolder alliance, namely, Active Retirement Ireland, Age Action Ireland, Age & Opportunity, the Alzheimer Society of Ireland, the Carers Association, the Irish Hospice Foundation, the Irish Senior Citizens Parliament and the Senior Help Line. Our vision is of an Ireland that affirms ageing and the rights of all older people, enabling everyone to live and die with confidence and dignity. We are of the view that our vision statement reflects part of the ethos of all our member organisations.

We chose to focus on the National Positive Ageing Strategy as our shared and common purpose because Ireland has demographics that are extremely enviable. We have a young population and time is on our side in the context of being able to plan for the ageing of that population. It is our view that we have an opportunity to think strategically and plan for the ageing of the population and to deal with this issue in an organised and systematic way, as other countries have been effective in doing. The national positive ageing strategy is a way of proceeding in this regard.

It is regrettable that ageism exists in our society. This is manifested in a kind of distaste for older people and the process of ageing. We can discuss this matter later if members so desire. We hope that a positive ageing strategy, in the context of articulating a different kind of understanding of older people by society in general, of the process of ageing and of the diversity of the older population, will help counteract the ageism to which I refer. We also hope that Departments will adopt a strategy to work together in a shared way in respect of planning for population ageing.

The concept of healthy ageing is promoted by the World Health Organisation and every other international body concerned with population ageing. Healthy ageing is not the concern alone of the Department of Health and Children, it is a cross-sectoral concern which involves dealing with ageing across physical and social determinants. In other words, all the relevant actors must be involved in assisting us in creating a society in which people age positively and in which the onset of disability and dependency can, if possible, be delayed.

Looking to the future, our concern need not be with regard to the numbers of older people. The issue is the health status of the older population. If we promote active and healthy ageing in order to delay the onset of disability, we can reduce the costs of long-term care into the future.

We also want to establish a national framework in order that society will be aware of that to which we wish to aspire in respect of older people, in both good times and bad. We know that times are bad at present. In that context, Older & Bolder will not be asking the committee for funding or to protect particular services at this juncture. However, we must remember that in good times, things were not always great for older people. In the past there was ageism in the health service and older people were dubbed "bed blockers" at a time when there were systemic issues with regard to the acute hospital system and how it functioned. The issues to which I refer are those which we are trying to address through the strategy.

From our submission, members will be aware that the Fianna Fáil-Green Party Government has launched a public consultation in respect of the national positive ageing strategy and we are delighted that it has done so. We request that this consultation should meet certain criteria. The consultation process should be proactively publicised in order that it will not be just a question of advertisements appearing in newspapers. Everyone should be aware that this consultation is happening and that older people and others are being invited to participate and respond. The process should be also inclusive of vulnerable groups. In other words, we should seek out those who might find it difficult to attend public meetings — such as people in nursing homes, etc. — to discover their views. In addition, the findings relating to the process should be made available to older people and to society as a whole.

I will now hand over to Mr. Dillon.

Mr. Sean Dillon

Item 6 of our submission deals with engagement with the non-governmental sector and we would like to put to the committee a brief synopsis of our view on that matter. As members may be aware, a cross-departmental group has been established and charged with developing the national positive ageing strategy. In addition, plans are in place in respect of establishing an expert advisory group and a liaison group. Our position is that the terms of reference of these groups should recommend that there be collaboration, direct interaction and exchange of information, views and documents between statutory non-government and governmental stakeholders from the outset in respect of the strategy's development.

As an alliance of 8 NGOs which are both service providers and advocacy groups in the aging sector, Older & Bolder would like to make clear our readiness and commitment to play a constructive role in the development of the national positive aging strategy. We genuinely believe we have a contribution to make on behalf of and with older people and that we have a right to make that contribution.

I thank the members for listening to us and invite them to ask the representatives of our alliance any questions they may have.

I thank Mr. Dillon for a particularly concise presentation.

I met this alliance in the not too distant past. I commend its work. We have a problem with ageism. The key issue should be about competence and not about age. Has the alliance considered that, for example, draft development plans, work on which is ongoing with the new councils, have certain trigger points? If 75 new houses are built to accommodate families, that will automatically trigger a requirement for a crèche. There does not seem to be any similar trigger points to provide for older people but there should be. In the past, facilities provided for older people were removed and converted into apartments and used for various other purposes. I am mindful of what happened in north Dublin, but I am sure that same has happened throughout the country. Have the representatives a view on that? If this alliance were to put forward a proposal that there ought to be trigger points for older people in development plans, we would support that.

I thank the representatives for attending. The main point I understood from the alliance's presentation was that it wants consultation throughout the process rather than somebody merely presenting it with afait accompli that it is asked to accept at the end of the process. One of the representatives might expand on that in terms of how it would work.

The an bord snip nua report is about to be published. We will probably have a fairly tough budget. The Fair Deal nursing home legislation will be introduced in the autumn. Those are measures that will be introduced next year that will affect older people as well as other sectors of the population. Removal of the automatic right to a medical card for those over 70 in the last budget was sprung on people without their being any advance warning that this was likely to happen. In the context of current economic climate, does the alliance expect to be consulted on how the changes that have happened are likely to affect older people and if there are policy areas it is concerned about or areas where it envisages there might be cutbacks or changes?

In the context of the Fair Deal legislation, which will be a positive measure for many older people, although there are concerns about it and we expressed our reservations about it previously, there have also been cutbacks in the home help service in some parts of the country. The preference would be for people to stay in their own homes in their communities for as long as they possibly can. Is the alliance concerned in regard to the way budgets will be applied and the way in which the provision of services will be delivered that there will be more of a tendency for people to end up in nursing home care rather than remain in their own homes? While we would all say that consultation should take place and people should be in the best possible position where they would have freedom of choice and so on, does the alliance have any indication that the current financial situation is likely to have a negative effect on older people? Does it consider it is being consulted on that and is it concerned about particular areas? The cutbacks in the home help service have been highlighted in Donegal in particular. It appears the budget will be tightened in regard to support for older people in their own homes and in their own communities. That would certainly concern me. I am concerned there would be pressure on people not to stay in their own homes. I am interested to hear the representatives' response to that point.

I preface my remarks my welcoming the statement by the Labour Party spokesperson that an bord snip nua report is about to be released. I am very happy to hear that. As one who called for its publication, I welcome the Deputy's announcement and I hope her information is correct.

I want to be associated with the welcome extended to our visitors. It is important for this committee to meet groups and this group in particular. The representatives will not know me but I live in a town south of here, Tallaght, which is third largest population centre in the country and the population living there is young. I make that point in the context that we have an aging population. While we do not yet have thousands of elderly people in our population, we face challenges in that regard. There was a reference in the alliance's presentation to that terrible phrase "people holding up hospital beds". That has been a challenge in many Dublin hospitals, including in Tallaght hospital. There is an important age-related unit in Tallaght hospital and a stroke unit was developed there recently. Other initiatives, including a day hospital, have been developed there, the name of which commemorates a Tallaght person.

In the context of the challenges we face, other contributors have made the point that it is important we do not lose sight of the fact that at any time of our history difficulties arise because everybody has a view about how resources should be spent. This is particularly true in a recession when resources are tight. I am old enough to remember other recessions and we survived them. However, such times are always difficult for people and at such times every group advises us as to how resources should be spent. At this time, every group will tell us the priorities and how resources should be spent. It is important all groups representing elderly people would continue to do that.

I am not being patronising in making the point that I bring all my life experiences to my politics. I have not told many people this but I would quietly say that the big influence in my life was my grandmother who lived to be 84 years of age, my mother having died when I was young. I often remember the values she passed on to me all those years ago and it is a long time ago now. In dealing with age-related issues and helping elderly people who have challenges, I have found the values I remember are helpful. I do not say that in a patronising way. It is important that we do not forget such values. I will hold up my hands in respect of the medical card debacle and other issues, but it is important that we continue to fight for people who are vulnerable. There are many people vulnerable in society and the elderly are certainly vulnerable.

Deputy Reilly made a point about housing provision and development plans. I do not have much experience of housing developments throughout the country as I do not get to leave Dublin very often. Dublin City Council has a good scheme under which elderly people can avail of more suitable accommodation and forfeit their current accommodation. That scheme has not been extended to the other local authorities nor has it been extended to south Dublin where I live. In the debate on the provision of services for the elderly and facilitating our aging population, local authorities should take a more proactive role on that issue. Has the alliance a view on that issue and how it would envisage such a provision should progress?

All groups have aspirations or a shopping list, as it were. When we meet groups it is important that we try to tick off goals that can be achieved. In the representatives summing up of this discussion, are there a few issues which, if it they were to come before this Committee in a year's time, they would like to see achieved? Will the representatives outline such issues?

I invite Deputy Kathleen Lynch to follow that.

I could, by mentioning Cork North-Central at least six times but I will not. I welcome the various groups. As old age is a state we all hope to achieve some day if we are lucky, we are always grateful when other people make noises about how that state should be. What worries me most is how old people are treated by the medical profession. Once one goes past a certain age and perhaps not necessarily a date on the calendar but if one looks like being in one's 70s — this could happen to any of us — then all of a sudden one is not sick any more but just old.

Pneumonia is regarded as an illness of old age and it is a case of whether to do something about it or not. I know of a person who became quite confused but was in hospital as a result of an infection. I imagine that anyone with a severe infection can become very confused. The temperature rises and a person can become bewildered. However, when the infection was dealt with in this case, the confusion cleared up. I ask the delegation to highlight the fact that just because one is old does not mean one cannot suffer from the same illnesses as the rest of the general population and if those illnesses are dealt with the other contributory factors which accompany old age may very well not be there at all. This sort of attitude to treatmentworries me.

I am involved with people with disabilities. I attended a conference last year on the subject of self-advocacy. These people all had an intellectual disability. It was the most inspiring conference I have attended in a long time. When a person speaks for him or herself, he or she tells a story that no one else knows. It is a case of gaining the confidence to tell that story which is important. I know there is a considerable range in terms of self expression and the Senior Citizens' Parliament is an exceptional example. What are the plans for self-advocacy within the other groups? Is it a case of a plan within certain sections of each group? A campaign should be launched — who better to do it than the delegation members — to highlight how people of advancing age are treated in hospitals.

I welcome the delegates. I will not go over the ground already covered but I wish to raise a few points. I have great admiration for the work of the organisations. There is an untapped resource in existence. In the past few years I have had the good fortune of meeting and speaking to some of the retirement groups around the country which are many and varied. These groups are a significant resource and they do a lot of good. The overall organisation is doing important work. It is very important to be able to have a unit or a cell in a local sense to get across the message.

The Older & Bolder project is made up of eight constituent organisations. Who will be in control over the national positive ageing strategy, which I hope becomes a reality? There are many facets to the care of the elderly and the disabled and there is a fair amount of fragmentation. I was always of the impression that the Older & Bolder group would bring this fragmentation to an end. I presume the group is an umbrella group but I may be mistaken. It would appear that the group is bringing together the eight organisations. I refer to the co-operative movement in the farming sector which consists of separate co-ops under an umbrella co-op. Is this the form of organisation being considered?

I refer to another aspect which has not been raised and which worries me. The HSE recently issued a report on the subject of elder abuse in their own homes and in most cases by members of their family. According to the figures I have seen, there has been a significant increase in referrals which I acknowledge are all allegations at present and which have not been proved. It would appear there were twice as many claims this year of elder abuse happening at home compared to last year. If that trend were to continue, it would be a very serious matter for everybody concerned. I would be grateful if the delegation should give the committee some insight into what is known about this matter and what should be done about it.

I too welcome the delegation. I will deal with one specific group because I do not wish to generalise. I refer to older people in long-stay mental institutions who no longer need psychiatric intervention and the failure to transfer them to more appropriate geriatric nursing homes. They no longer require the confinement and the facilities of a long-stay mental institution and these people seem to be a neglected group of older people. I have examined this issue in some detail and I am informed that in the case of many of those people it is inappropriate for them to continue to reside in such institutions and that either a public or private nursing home would be much more appropriate.

I thank the delegates for their contributions. I also welcome the fact that the groups have come together under one umbrella grouping because co-ordination and an integrated approach by the different organisations is very important. The best services are provided when the State and the voluntary groups work together. The voluntary groups have an opportunity to do things that the State cannot do whereas the State has the expertise acquired over time and is in a position to support the good work. The closer the groups come together, the better.

I very much welcome the consultation announcement made by the Minister of State, Deputy Áine Brady. It will provide a great opportunity to put forward ideas. Under every heading and Department there are many changes that could be made and which would not cost a lot of money. The Minister of State announced it would be done within a limited budget and we all recognise there are limited finances at this time. This is an opportunity to concentrate the mind on how we can improve all the various services for the elderly without incurring too much extra expense. No matter what heading one considers, such as under the heading of local government, transport, housing or health services, there are opportunities. The issue of housing has been raised. It is interesting that prior to 1971, before the establishment of the health boards, the local authority was responsible for housing needs or residential care needs because it delivered the health services. In rural Ireland, local authorities decided whether one needed accommodation in health service residential care or in housing for the elderly schemes. It seems to me that a gap can continue to exist, despite what has been done in the past 38 years. If one is housed by the HSE, but it would be more appropriate for one to have a local authority house, there can be a delay. If one already has a house, the local authority house is given to somebody else who is in need andvice versa. We need to consider how we can put in place a more integrated approach to the delivery of residential care. It is obvious that elderly people should live in their own homes for as long as possible. Statutory and voluntary groups can do a great deal of work to ensure that people keep mobile and stay in their homes for longer periods, with support if necessary. I do not want to go into detail about the range of things that should be done. Ribbon development in the countryside is governed by rigid planning laws. If young people want to build beside their elderly parents, who want them to live beside them, it should be public policy to facilitate that. We should re-examine the restrictions that are in place at present. I do not doubt that elderly people benefit tremendously when their own young people are living beside them. This is an important issue in rural Ireland. Other than in exceptional circumstances, elderly people who are placed in residential care should not be more than 20 miles from their own homes.

I could raise a large number of issues in the context of this consultation process. The process, which was announced by the Minister of State, Deputy Áine Brady, gives us an opportunity to address some of those issues. It is not necessarily a bad thing that we have to think harder as we try to improve services for everybody within the constraints of the limited finances of these recessionary times.

I join my colleagues in thanking the members of the delegation for their presentation. It is interesting that we are talking about a national positive ageing strategy. This debate, which has focused on the shortcomings and weaknesses of the strategy, has been like a debate we might have on the health system. When this committee and other forums discuss the health system, one hears about all the things that are wrong rather than about all the positive things. As we think about this issue, it strikes me that ageism is a mindset that prevents older people from participating fully in, and contributing fully to, society. We all know more older people who are working, travelling extensively, getting involved in new leisure activities, participating in various sporting activities, forming relationships and getting married for the first or second time. How do we challenge the mindset to which I have referred? We have seen evidence of it in political parties. When candidates were being selected in advance of the recent local elections, it was often suggested that certain people should not be selected because they were too old. It was a frightful approach. It is important to change that mindset. As part of that process, we need to get advice from groups like those which comprise Older & Bolder.

Does the Chairman suggest that only those who have not yet reached that enlightened state have such a mind set?

Perhaps. Some of us might not be too far away from it.

No. I suggest that the mind set can exist within older people themselves.

That may well be the case.

We feel we are on the under-21 team.

Some of us are in denial about being old.

I ask Ms Conboy to respond to some of the points made.

Ms Patricia Conboy

I would be delighted to do that. I would like to clarify a point of protocol before I respond. I understand that my colleague, Mr. Dillon, may speak too.

If Mr. Timmins wants to join in, he should feel free.

Ms Patricia Conboy

That is fine. My colleagues will join in after I have made some comments. I will begin by responding to the point that was made about positive ageing. We consulted older people at eight meetings throughout the country. They had a fantastic and positive sense of what they could do with their lives. That changed as the meetings went on, however, particularly following the most recent budget. They started to express concern and insecurity about the situation we are in at the moment. We have to recognise that. They spoke about what was good in their lives, such as their sense of being connected, which comes from their friendships and their involvement in groups and activities and has significant benefits for their mental health and well-being. My colleague from Age and Opportunity might speak about positive ageing in due course.

I wish to respond to Deputy Reilly's comments about references to older and younger people in development plans. We would welcome any references to older people in development plans and national policies. It is a question of age-proofing. The national strategy provides for national guidelines. Many members spoke about the links between the actions being taken at local and national levels. Having spoken to interested parties about the national children's strategy, we know it is really important to provide for the right kind of direction from national to local level at the early stages. We agree it is very important for local authorities to get involved. However, the national strategy is necessary to give guidance at national level.

Many members of the committee asked what we would like to see them do. It is regrettable that the policy-making process happens almost secretly, some of the time. A great deal of obscurity is associated with what is going on in policy-making terms. If the joint committee were to take an active interest in the process of developing the strategy, we would be delighted. I suggest it should invite the cross-departmental group to this forum and ask it what is happening. It could pick up on the point made by Deputy O'Hanlon about what is happening in various Departments at present. The committee could ask the members of the cross-departmental group whether there is scope for change in policy implementation in their spheres of influence. That would help to make the process of discussion and consultation more real.

I would like to speak about the role of Older & Bolder. Deputy Connaughton asked who will take the leading role in the strategy. It is obvious that we hope and expect the Government to take such a role, as that would be entirely appropriate. There also needs to be collaboration between governmental and non-governmental sectors. Regardless of any governmental or administrative changes that might take place, I hope there will continue to be a commitment to the strategy. It should not matter who is in power at any given time. We are saying that the strategy should enjoy cross-party support.

I was also asked about the role of the alliance, which has to agree its purpose together. Members who have worked in coalition Governments will have more knowledge of that than I do. Our current purpose relates to the national positive ageing strategy. We are viewing matters at a macro level.

I would like to respond to Deputy Jan O'Sullivan's point about the impending cuts. The alliance is particularly concerned about vulnerable groups of older people. The wrong kinds of cutbacks would push older people who are on the margins into long-stay residential care, when it need not happen. We are aware that our individual member organisations are taking a leading role in many specific areas of policy. The Irish Hospice Foundation takes such a role in respect of long-stay care. Age Action Ireland has a leading role in another area. The Carers Association takes a leading role in relation to the carer's strategy. We are aiming to focus on the macro level. The alliance comes together to speak as a group of eight organisations, while recognising that individual organisations continue to work on their specific briefs.

Our focus is on thinking about the future and longer-term planning. At present, we are thinking in terms of the downturn. We may lose the opportunity we had a few years ago to make plans in areas like pensions and long-term care. Before Christmas some €1 billion was assigned for older people's services in the HSE's budget for 2009. The figure spoken about in respect of NAMA is approximately €80 billion or €90 billion. When these figures are considered side by side, one will realise the cost of older people to the Exchequer is not enormous. There are many areas of expenditure such as those pertaining to community and voluntary groups, in respect of which the return in terms of the mental and psychological health and well-being of older people is simply phenomenal.

Deputy Neville's point on patients in psychiatric hospitals who need not be in them anymore is raised regularly by the Inspector of Mental Hospitals. There are areas in which there is a need for cross-sectoral integration. This should involve bodies such as the Health Information and Quality Authority and the Mental Health Commission. The activity engaged in under their aegis is the kind we would like to see integrated across the board nationally and from national to local level.

Mr. Sean Dillon

Deputies O'Sullivan and O'Connor referred to real consultation and achievable goals we could say to the committee would be met within one year. Many of us have just spent a couple of years investing time and energy in pursuing the national carers strategy. Simply put, we do not want to arrive at a position where, having invested significant time, there will be no strategy. Over 40 organisations made submissions. In addition, there were 500 or 600 submissions made by individuals. We expect perhaps 161,000 carers to be encompassed by the strategy. If the committee were to ask me how one could prevent the collapse of the strategy, I would say we welcome greatly the plan to set up the expert advisory group and the NGO liaison group but that, for them to be meaningful, there must be regular consultation between the relevant bodies. We well understand the cross-departmental group has its job to do, but our wealth of experience and knowledge of the sector and representation must be borne in mind. We would be more than willing to contribute to the consultation process. The risk is that the process would involve no more than the submission of a multitude of shelved documents. There is nothing better than a round-the-table model, as occurs in the social partnership process. Under such a model, we would willingly contribute our understanding, experience and knowledge of issues. We do not expect everything we said to be taken on board because that is not the way the process works. We are as knowledgeable as anyone about the strain on resources as we are used to operating in a resource-poor sector and are lean.

To the best of our knowledge, the terms of reference for the consultation have not yet been defined. The Minister of State at the Department of Health and Children, Deputy Áine Brady, having only been in office for a couple of weeks, met our group to outline what was happening. We said on that occasion that we really believed the terms of reference would dictate the progress or regression of the strategy. That is a tangible aspect in respect of which we could receive support from the committee if it considered it was appropriate to offer it.

Mr. Ciaran McKinney

I invite the committee to regard us, both as an alliance and individual constituent organisations, as a resource. Thus, we would not just be regarded as a pressure group but as experts in the field. We will gladly accept an invitation to be part of a process involving dialogue, planning and consultation. These are not hollow words and I ask the committee to regard our invitation as absolutely genuine.

Age and Opportunity promotes the participation of older people. One of our best known programmes is Go for Life which promotes physical activity. We have just had an external evaluation that recommended the programme very highly but which made the point that so much of it was based on group participation. That is fine as long as one is the kind of person who joins a group, but the challenge for us is to find ways of reaching non-joiners and older people who would not join a group to save their lives. The strategy should reflect the fact that we do not automatically regard older people as those who go down to the parish hall or active retirement association, for example. There are many of us who, at all stages of our lives, do not want to join groups. We should not lose sight of this.

Ms Caroline Lynch

I want to respond to Deputy Lynch's question on self-advocates. The key point is that many hospice developments have emerged from the grassroots. Very often the developments occurred because of the activity of individuals or families who were not able to gain access to hospice services in their own areas. There is now a comprehensive hospice service throughout the country. Many hospice services were developed because families or individuals decided they wanted to develop them in their areas. The Irish Hospice Foundation is involved in supporting grassroots organisations' development and ensuring those concerned are self-advocates for their communities. This is in line with the work of all the organisations which are advocates in their own areas.

What should local authorities, including Dublin City Council, be doing to make provision for the elderly?

Ms Patricia Conboy

Dublin City Council has particular arrangements for an office for older people. It is regarded as a good model by advocates for older people elsewhere in the country. It would be useful if, within local authorities, there were individuals with dedicated responsibility to respond to issues and the questions of older people. We would like older people at local level to be consulted and engaged with on plans and issues. There is work being done on linking the housing and health and social care sectors in respect of the needs of older people, in particular.

Even with the best of intentions, there is a need for direction at national level. There are limits to the responsibility of local authorities. Others need to collaborate with them on matters such as bus stops, transport, etc. We need a strategy that takes into account the lines of accountability and enables people to cross from sector to sector. More thinking and work in this regard is required. There is a need for further direct engagement with local authorities to hear what they have to say to us on the matter.

On how that would be put together, while I am not saying the Disability Act represents a model that works — we have not had the opportunity to put it into effect — it could work. I refer to how the interdepartmental strategies feed into the Department of the Taoiseach across all the various disciplines. The model could work very well if allowed. Perhaps this can be considered.

That certainly gives food for thought. Have the delegates concluded?

Ms Patricia Conboy

I want to make one remark on ageism. Members have asked whether it is always a case of younger people being ageist in respect of older people. We know ageism operates in both directions in that younger people can be discriminated against. We must also acknowledge that older people say they do not experience ageism until they become part of a group, pool their experiences and evaluate them differently. We also find that older people may not want to identify themselves as being older persons. Therefore, the issue is complex. An issue in respect of which we can do a lot of work concerns thought time and understanding. It is not a question of providing for a vast investment but of how we think and talk about people who are our peers and in whose position we will be in the future.

I thank the delegates for their presentation. They have given us much food for thought. We will certainly consider the presentation and determine how we can be of assistance.