Rights of Older People: Discussion (Resumed)

Apologies have been received from Senators Rónán Mullen and Paul Coghlan. Following on from our informative and engaging hearing last Thursday with various groups representing older people in many different aspects of their lives, we are today discussing the value of the UN Convention on the Rights of Older Persons with Professor Gerard Quinn, National University of Ireland, Galway, and the findings of the TILDA study with Professor Rose Anne Kenny, Trinity College Dublin. Professor Quinn is accompanied by Dr. Eilionóir Flynn and Professor Kenny is accompanied by Professor Alan Barrett, Director of Research, TILDA. I welcome everyone to today's meeting. While committee members will receive priority, anyone wishing to contribute will, as far as possible, be facilitated.

By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of the evidence you are to give this committee. If you are directed by the committee to cease giving evidence in relation to a particular matter and you continue to so do, you are entitled thereafter only to a qualified privilege in respect of your evidence. You are directed that only evidence connected with the subject matter of these proceedings is to be given and you are asked to respect the parliamentary practice to the effect that, where possible, you should not criticise nor make charges against any person or persons or entity by name or in such a way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that members should not comment on, criticise or make charges against a person outside the House or an official by name or in such a way as to make him or her identifiable.

I now invite Professor Quinn to make his presentation. Professor Quinn will have ten minutes to make his presentation following which there will be a questions and answers session.

Professor Gerard Quinn

I thank the committee for the honour of addressing it this afternoon. I take this opportunity of my first time addressing it to commend Members on having created the Seanad Public Consultation Committee. The public interest is not just a sum of competing vectors. It requires a forum dedicated to deliberative and public reasoning such as this. Moreover, it requires taking the long view and making honest efforts to balance high principle with the art of the possible. The subject matter that brings us here is a classic example of a field that has been treated as an outlier, which has suffered from silo thinking and in which fresh ideas are so vitally necessary. Consequently, it is fortuitous this new spirit and practice of openness in the Seanad finds as its first subject the rights of older people.

I believe Members already have had the benefit of a rich tapestry of testimony from civil society groups. I take the floor mainly to address the net point of whether the process of drafting a new thematic United Nations treaty on the rights of older people should be pursued much more vigorously in the United Nations and of what added value such an instrument might have both here and abroad. As Members no doubt are aware, there exists a United Nations working group to consider proposals for the enhancement of the rights of older people. One of the main items on its agenda is whether to proceed to begin drafting a new United Nations thematic treaty on the rights of older people. Two sessions of the working group were held in 2011 and another crucial session will take place in 2012. The Global Alliance for the Rights of Older People, which is the main international federation of older persons' NGOs, is involved in the process and is firmly in favour of a new treaty. At present, the European Union is firmly opposed. Older people are seldom mentioned in existing international human rights treaties. The normative invisibility is not helpful in trying to make universal rights equally effective for older persons. While there are many soft law instruments, effectively they are not up to the job and a much more vibrant spur is required. The process seems to be at an historic impasse, which makes Members' hearings extremely timely. Their conclusions and recommendations no doubt will have an impact far beyond these shores. To my knowledge, this is the first time that any European legislature has explicitly addressed the question of the case for such a treaty and, whatever the outcome, I warmly congratulate Members on that.

As time is short, I will concentrate on three points. First, I wish to frame the problem from my perspective as someone involved in human rights and to give Members a sense of my vantage point on the issues. As will become clear, I value the process of drafting the treaty, as well as the treaty itself, as an opportunity to de-problematise the person and reconnect the policy debates about older people back into the mainstream of thinking about justice and human rights. Second, I wish to spell out what I see as the added value of such an instrument and what kinds of issues, topics and rights I ideally would like to be included. Third, I wish to look to the next steps, which is crucial, and in particular to encourage this august body to add its voice to the chorus of others who are calling for a new treaty to be advanced. The Seanad already has done a great service by throwing open its doors to civil society. More must be done, especially in this European year of active ageing.

First, how should one frame the issues? I must emphasise I am not a subject specialist on ageing. However, I come to the issue as someone who was closely involved in the drafting of a sister treaty, namely, the United Nations Convention on the Rights of Persons with Disabilities. I also appear before Members as someone who is a member of an international treaty monitoring body in the Council of Europe system and who therefore is aware of the stresses and strains and the creative ambiguity that is needed in such conventions to allow them to pass muster. Moreover, I appear before Members as someone who sat on the Irish Human Rights Commission with Senator Zappone for nearly ten years. The core mission of that body is to bridge international law and find a way of allowing its fresh air to influence domestic change for the benefit of our citizens.

I am only too painfully aware that, while international law has a certain aura of elegance, it never is an end in itself. It is only valuable if it can help to trigger a process of change where none exists or help to keep such a process trending in the right direction. Members no doubt are aware that Ireland has yet to publish its much awaited national strategy on ageing. It will be important that the emerging national strategy should play its part in advancing any new UN treaty, andvice versa, of which more anon. What then is the core “problematic”, how should the issues be framed and what use would a new United Nations thematic treaty have? This is key and core to the issues currently facing us. After nearly 25 years studying rights and particularly the rights of so-called vulnerable groups, I have come to observe the near universal experience of what the great legal historian Sir William Blackstone called civil death on the part of such groups. Blackstone was writing of women and their legal disappearance as persons upon marriage. It certainly is striking how personhood is somehow discounted with respect to the groups and individuals concerned. It is as though the terms of entry and participation in the lifeworld, that is, the world of social connectedness, public participation and civic engagement, are set effectively to exclude some. The depressing thing is this exclusionary ethic seems deeply embedded in almost all cultures, almost an indelible aspect of the human condition. The truly amazing thing is the exclusion is experienced by most people as natural, even when it flagrantly violates our highest professed values such as dignity and autonomy. As a result, the person is problematised, the exclusion is made feel natural and one’s conscience is salved by minimal levels of welfare.

I consider one of the most important functions of an international treaty on the rights of old people to be that it will hold up a mirror to each society, including ours. It forces us to take a good look at ourselves and to challenge the gap between the myth of the system and the way it actually operates. The ageing process seems particularly captive to this exclusionary ethic or tendency. It is true that one goes through several cycles during one's life and that one's social circle expands or contracts depending on where one is situated in life's journey. The mystic cords of memory or the ties that bind seem to be renegotiated progressively as one's life progresses. However, all this is distorted wildly beyond reality by encrusted cultural assumptions. Culture sees capacity as declining inexorably through old age. There is nothing inexorable to that. Culture does not see the use value of older persons in the economy. Culture does not see the value of social connectedness for all, that is, intergenerational solidarity, not to mention old people themselves. Moreover, social change and economic change in particular has exacerbated this feeling of disconnectedness in our society. The result has been policies that compensate for their absence, policies that maintain people squatting at the edge of society, policies that accentuate institutionalisation, policies that do not proactively stitch back together or rebuild social connectedness as time moves on in one's life. To be even more blunt, the policy focus has been on who pays to maintain older people and how public services get delivered. There is nothing inherently wrong with this on its own but when it becomes the sole focus it tends to reinforce dependence, passivity and to cement into place negative stereotypes.

The great thing about modern science is it shows how out of date are these cultural assumptions and the policies that depend on them. Moreover, it shows the value of moving toward a more positive outlook on ageing with a different set of policy responses to build on this positive outlook. Members should look to the sterling work of the Ageing Well Network in Ireland to get a sense of these policy innovations. The great neuroscientist Antonio Damasio stated the mind is a function of human relations. The policy lesson is clear, namely, build or rebuild those social connectors that help form who we are as persons. Furthermore, new 21st century theories of justice are emerging that emphasise human capabilities across the lifecourse. I refer in particular to the works of Amartya Sen. Consequently, we have the science that shows the usefulness of a completely new frame on ageing, as well as a theory to make it fit well with our legacy values on justice. What we lack is a spur for change, which is where the proposed United Nations treaty comes into sharp focus.

What would a treaty do to reverse decades of perverse cultural assumptions and the policies that were built on them? Allow me to put aside one blockage before proceeding. The United Nations working group and most states seem fixated with the question of whether there are normative gaps in the existing treaties that must be filled. The thinking is that it is only if such normative gaps are found that a treaty drafting process should proceed. I believe this to be completely wrong-headed. Of course there are no normative gaps in the general norms on human rights which, after all, are stated to be universal. The problem is not that there are gaps but that the universal norms are heavily distorted and discounted by these cultural assumptions, which dilute them heavily. The whole point about drafting a new treaty is to redress the imbalance between myth and reality. I digress further. We did not argue for a UN treaty on the rights of the disabled based on these gaps, rather we argued for it on the basis that the existing norms did not have sufficient critical bite in the area of disability. I suggest exactly the same logic holds true in the context of older people.

Before addressing the question of the added value of a treaty, I will outline what such an instrument might, with profit, contain. First, there should be a very clear valorisation of the human difference of ageing. Put another way, the fact of ageing should not be the occasion for the implicit diluting of universal rights we all supposedly enjoy, rather it should trigger a renewed debate about how those rights can be made real for older persons. This should be the key paradigm shift of any new treaty on the rights of old people.

Second, there should be a commitment to centring older persons to take charge and remain in charge of their own lives. As Members are probably, there was a remarkable breakthrough in this regard in the disability treaty. Article 12 of that treaty basically requires states to move away from substitute decision-making regimes and place their policy priorities instead on enhancing residual capacity and supporting persons to make decisions for themselves. I suggest very much the same philosophy ought to map over.

Third, the right to live independently and be included in the community seems vital. While this appears to be a contradiction in that someone might choose to live so independently as to be not involved in the community, but the interplay between the two is a crucial dialectic. Again, social connectedness is the key to maintaining a positive sense of self and personhood. One might say, so what? A new instrument, a new treaty, should provide a very positive philosophy of living independently and being included in the community. I say positive because the accent should not be on institutions as such. In the disability convention we took care to spell out the positive ingredients of the right to live independently. Of course, it implicitly places institutions, all institutions, on the defensive. Some months ago the HSE published a remarkable report recommending the ending of all congregated settings on the ground of disability. This would include group homes of four people and over. It seems that exactly the same logic should apply to institutions for the elderly, including many institutions in Ireland. Members may have seen an interesting article on this inTheNew York Times about a week ago entitled “shrinking the nursing home until it feels like home”. This development, I suggest, it long overdue and the advent of a new treaty should underpin this dynamic of downsizing.

Naturally, any new treaty will have to include a right to protection against violence, exploitation and abuse. Members may have noticed a major report from the English and Welsh Human Rights and Equality Commission a few days ago on just this topic. I did not put this front and centre only because I do not believe the majority of institutions that exist should exist. Even if we successfully unbundle the institutional matrix for the elderly in Ireland, violence, exploitation and abuse would just move to the community. Therefore, some proactive strategy is required but let us not get over-protective such that we chill the right of an individual to live the way he or she wants rather than the way we think he or she should live.

Fourth, economic and social rights must be better harnessed to ensure the dignity and especially the autonomy and connectedness of older people. It is interesting how people reflexively think that elder rights equals social expenditure or that when people think of rights of older people they automatically think of welfare. It would be much better to think through what these social supports are for in the first place and to begin reconfiguring them to have the maximum impact in terms of embedding people in their own communities.

What then of services? The right to live independently and be included in the community, as we expressed it in the disability convention, includes a right to wrap services much more insistently around personal choice. This is a trend throughout the world called the personalisation of social services and it even takes the form of personalised budgets. This is something that will happen over the next 20 years and now is a good time to make a start in the context of older people.

What then of the added value of such an instrument? One answer is that it would have no added value. It might be said that we have enough treaties already with two general human rights treaties, one focusing on civil and political rights and another on economic, social and cultural rights, as well as a plethora of thematic treaties which deal with the rights of particular groups such as women, children, migrants and persons with disabilities. One might argue why crowd the field further and thus risk even greater fragmentation. One might also argue are the existing treaties not of limited use anyway, especially in a dualist country like Ireland that often seems to strive over-mightily to keep international law out. I disagree with that argument but I agree with some of the sentiments behind it. Take, for example, fragmentation - it is bad. It disconnects the particular from the general and risks undermining general values, rights and principles. However, I ask Members to reflect that the intention behind drafting a thematic treaty is never to create an island of norms disconnected from the mainland of the two UN conventions on human rights. Exactly the opposite is the case. The intention is to particularise what the general rights mean in the specific context of a particular group. The object is never to grow ever disconnected bodies of jurisprudence on women, migrants, people with disabilities, racial minorities and now the elderly. The intention is to grow the relevant jurisprudence in order to trigger the attention of the mainstream treaty bodies. That strategy has worked remarkably well in the disability context. Therefore, to me, the argument that a specific treaty might detract from the general human rights treaties does not stack up.

Nevertheless, Members might be wondering, so what, we have a treaty that might inform other treaties but surely this is a high luxury out there in the international ether - we are more concerned with what is happening in Tralee and Kinvara. I am with them on this. Far too much attention has been lavished on the elegance of international norms, as if this alone ever changed anything. The trick is to get traction going between the international norms and the domestic process of change. This gap has been well known for decades but, I suggest, there is no need to be defeatist about it. We need a new approach to international law. Innovation can be mapped onto any new treaty on the rights of older people. For example, article 33 of the new disability treaty envisages a sort of triangulation between the domestic focal point and co-ordination mechanism for change in the executive branch, the domestic independent monitoring mechanism, which I assume will be the soon-to-be merged Human Rights Commission and Equality Authority, and civil society. This is the key to keeping the dynamic of change trending in the right direction and closely aligned to the UN treaty. I suggest it should be no different with respect to a new treaty on the rights of older persons. There are ways of opening the window onto international law without ceding command and control. The other impediment, the fact that Ireland tends to take an extreme view of dualism even relative to other common law countries, is a separate debate that deserves to be more fully and separately aired.

Some argue that we should appoint a UN special rapporteur on the rights of older persons. I have no problem with that. Mechanisms such as that one can prove extremely important provided they are adequately resourced, but an office of a special rapporteur is no substitute for a legally binding instrument. The two can sit side by side. The UN Committee on the Rights of People with Disabilities, which is the relevant UN treaty body on disability, sits side by side with the UN special rapporteur on the rights of persons with disabilities. One should not be seen as the enemy of, or the substitute for, the other.

As to the next steps to be taken, the next session of the UN working group is due to be held in summer 2012. As members are well aware, Ireland's position on such issues, when negotiated through a multilateral forum such as the UN, is forged in close alliance with our EU partners. Reportedly, the EU is adamantly opposed, or certainly not yet convinced, of the value of a treaty. I am not convinced that this opposition is based on close consultation with civil society. For example, how many older people in Ireland were even aware that this process was taking place in New York in their name? The argument that we need to prove normative gaps exist before a treaty drafting process is allowed to proceed is completely wrong-headed and was definitely not the position we took in drafting the disability treaty. It is the discounting of the humanity of older people that counts more and is the uniting experience between them and others who have had the benefit of a thematic treaty. If gaps were an insurmountable hurdle, there would never have been a convention on the rights of the child.

A new treaty should primarily valorise positive ageing and turn around encrusted layers of stereotypes and presumptions.

It should aim particularly at forging and retaining social connectedness to enhance the personhood and inclusion of older people, and the insights gained should be used to trigger the attention of the existing treaty bodies. Ways can and should be found to ensure a new treaty helps anchor national strategies. It is hoped Ireland is about to announce its national ageing strategy. Despite the very best intentions behind such strategies they tend to lose momentum as the political moment passes. The value of a new treaty would be that it would help keep us focused on the long term and not only on quick fixes from election to election.

In a few short years we will mark 1916. Freedom in a civic republic is primarily public and not private and is the right to belong, to be seen to belong, to be valued and to participate. This is the type of freedom a new treaty should embody. I commend the process of drafting a proposed treaty on the rights of older people to the House and I urge Senators to add their voices to those of others advocating for the process to proceed.

In case people think my stopwatch went crazy I was reminded correctly by Senator Zappone that the time we agreed to allocate to both principal speakers was 15 to 20 minutes and Professor Quinn used approximately 21 minutes.

At this juncture I recognise and acknowledge the presence in the Gallery of a large number of postgraduate students from NUI, Galway and Trinity College Dublin. Other observers are also in the Gallery. They are all welcome and I hope they find this very enlightening.

We will now have questions from Senators and the first to indicate was Senator Darragh O'Brien.

I thank Professor Quinn for his presentation. There is much on which I could comment but I will focus on two aspects in particular. I was interested to hear his comments on shrinking the nursing home until it feels like home. This is why a treaty would be important as there is no cohesive strategy on what should be done in any area. How does this fit in real terms? There seems to be a move through HIQA for smaller nursing homes, public and private, to go by the wayside. I agree 100% with the point Professor Quinn made but there seems to be a feeling that a critical mass of patients in a nursing home is required for it to survive. How do we get past this?

I heard loud and clear what Professor Quinn stated but the real interest in a UN treaty would be its implementation. How would it sit in law in this country? As legislators in a House of the Oireachtas we are interested in how it could be implemented in real terms and what it would look like in Ireland. I know it is a very broad question.

I took the point made that when strategies are published there is political momentum behind them but afterwards the matter is considered to be finished. I would like to get past merely ticking boxes on this.

I will allow three Senators to ask questions at a time and Senators Bradford and Bacik are next.

I welcome Professor Quinn and thank him for his most enlightening presentation. To follow up on what Senator Darragh O'Brien stated on nursing homes, on many occasions I have stated in the House that the only aspiration the country seems to have set for the elderly is that we provide them with a clean bed in a clean nursing home and this is a depressing aspiration for our elderly. How can we look beyond the concept of nursing home care? I missed the pleasant phrase about shrinking the nursing home until it is almost a home. I would like us to go beyond this. How can we get into the public mindset that care of the elderly must be much more community and home based?

With regard to the treaty, I have previously asked questions on the possibility of having a constitutional amendment to protect the rights of the elderly. Perhaps this is too aspirational. The advocacy groups that came before the committee last week certainly felt it was a step too far. Is it possible for a progressive new treaty to become the equivalent of a constitutional amendment to guarantee entitlements fully?

Professor Quinn spoke about popular culture and that as far as the elderly are concerned it is seen as a capacity issue and they are viewed as a group in society which does not contribute. How do we actively change this? We debated an increase in the retirement age which was seen as a negative and not as a positive that we should hope people would work at 67, 68 or 69 years of age. Is there a cultural issue that we must address? Have we become happy with the idea that at 65 or 66 years of age people would be deemed to be retired and ready for "shady pines"? How do we shake ourselves out of this type of thinking?

I thank Professor Quinn for an excellent presentation given with his customary eloquence. It was somewhat poetic at times. I thought it was wonderful to hear him speak about the exclusionary ethic that has developed and the encrusted cultural assumptions. Some of the phrases he used sum up the difficulties we face and the stereotyping of older people. We heard quite a bit about it last week from the nine advocacy groups working with older people. It fits in very well with what we had already heard.

Some of the submissions we heard last week focused on the processes described by Professor Quinn and the question of a UN treaty. The focus from the groups was on the idea of realisable rights and that rights would have to be meaningful rather than tokenistic. Several of the points made in the course of the presentations were very resonant and should be included in any draft treaty if they could be regarded as realisable.

Senator Bradford touched on the issue of retirement age about which we spoke at length last week. I have seen a draft which refers to a right to be included in decisions about when to leave active employment. Another right which was very well expressed by a number of groups last week was a right to age well at home, which fits in with the idea of shrinking the nursing home. How can this be guaranteed in practice? Is it a right we should see in a treaty?

I read with great interest the paper submitted by Professor Quinn and Eilionóir Flynn. It set out very clearly the way in which the process has developed. It spoke about special rapporteur as something that could be complementary. Some states suggest it could be a stepping stone in that a rapporteur role could be established which would lead to a treaty after the review of the Madrid action plan was finalised. Is this a better view to take or would it be more of a blockage? There is muchrealpolitik in this and it may be difficult to give a final answer. Is it realistic to state that if we cannot have a treaty now we should have a rapporteur?

I ask Professor Quinn to be as concise as possible in his reply. I do not want to be caught for time when our next witness comes before the committee. If he hears me ringing the gong he will know I am getting excited.

Professor Gerard Quinn

I thank the Senators for their superb questions. Senator Darragh O'Brien spoke about nursing homes and perhaps was more radical and went a little further than what was reported inThe New York Times. If one congregates people on the basis of something arbitrary from a moral point of view, such as that they share the same age, skin or a disability, what happens to third parties such as neighbours and people on the street is that they never look beyond the group to see the person; they see only an agglomeration and there is no incentive to get involved or engaged.

This is quite perverse in our culture because we have such dense and rich social capital and community development. Therefore, there is something wrong with this dynamic, and the smaller the entity is the more opportunity there will be for a very fruitful, creative interaction of people in their communities. There is science on this and perhaps Professor Rose Anne Kenny will focus on it. A colleague of ours in Geneva wrote a superb literature review on dementia and the slowing down of institutionalisation as a positive good. I am not sure whether it has been circulated among the committee but we can certainly make it available. As torealpolitik in this country and how one moves towards that, I am quite sure that if one decided to move towards it, it would have to be a transition; it is not going to happen overnight. Some states in the United States are beginning to socially engineer this transition, so it is not as if it is a big bang that can be done overnight, but it is something we should be working mightily towards. If we got the right language in a treaty it would underpin that positive trajectory.

As to implementation, I am not sure I got the question right. Maybe it was what could be the potential role of the Oireachtas, including the Seanad, in keeping a watching brief or monitoring the implementation of a national strategy. I would not have a firm view on that other than to say that Senators are really getting a good reputation for themselves and I could see a positive role. However, I may well have misunderstood the question and, if so, my apologies.

Senator Bradford asked about the treaty as a complement or supplement to a constitutional amendment. I see it a little bit differently, apropos of Senator Bacik's question about realisable rights. I tend to view these treaties not primarily as legal instruments or an armoury into which a lawyer can reach for a weapon and then clobber an executive branch of government. I tend to see them primarily as both setting out a moral argument as well as a political vision. The implementation mechanism should be robust enough to enable a dynamic to be put in place and then monitored and ratcheted forward through time. I only see it secondarily as a full employment tool for lawyers but, primarily, I see it as an important tool within the policy-making process.

Turning the culture around is actually where it is at. There is an innovative article in the disability treaty on sensitising people to become aware of, and responsive to, the rights of persons with disabilities. It is language like that one is going to need in this convention, and then following through on messaging as well as in the institutional practices of government.

Senator Bacik raised the point about realisable rights but I would say that is secondary from my point of view. It is primarily embedding that paradigm shift and making sure that it does not become hostage to political whims. We are all hostage to political whims, but this is such a transcendent issue of the public interest that I think that would be the value of a treaty.

As to the question of whether a rapporteur should come first, or whether it might be a sequential process of having a rapporteur and then a treaty, personally I do not think so. That is because they fulfil two entirely different functions. A rapporteur has the exclusively moral suasion of his or her office. There have been plenty of special rapporteurs who have played a useful role, such as providing an advance warning of issues coming up on the horizon, or patterns of abuse that might lie under the radar, and conducting in-depth country visits. Treaty monitoring, though, is a different kind of thing and it portends a different kind of spur to action on the part of the states. If one wanted to be crude about it, a person who held the office of special rapporteur on disability was a very fine individual, but after ten years of the existence of that special instrument - the UN special rules on disability - one could not put hand on heart and say there was a causal link between X change and Y country, and the functioning of the special rapporteur. What we are about is change for people. That primarily will be happening in transition over a number of years as we get it right in changing the culture accordingly. A treaty can do that, however, but not a special rapporteur.

The point about constitutional rights was raised, and not for the first time, by Senator Bradford. Professor Quinn does not have to answer it now, he can bank it as a couple of others are offering. Would Professor Quinn see a possible charter of rights or maybe an ombudsman for older people, as an option? He can reflect on that, as Senators Zappone and Cullinane are also offering.

I thank Professor Quinn for his eloquent presentation and convincing arguments. It is a great personal and professional pleasure to sit here with him in this regard. I want to remind my colleagues that I thought the way he started his presentation to us was the first time any European legislator has explicitly addressed the question of the case of such a treaty. That is really important for us to remember as we take a look at these issues in the context of putting out our report. I suggest that we do need to have some view on whether or not we think it is a good thing that it does add value in the way Professor Quinn is arguing. I noted his suggestions about the need for a cultural change, a new paradigm in relation to ageing and how effective a UN treaty can be in that regard. I do not think I would be alone in this because across the world his work and the work of others in the context of the UN convention on people with disabilities has effectively done that within that sector. There is certainly a need concerning older people and it has already been demonstrated that the UN can bring about that kind of cultural change.

Furthermore, Professor Quinn laid out in his excellent presentation the ways in which we are giving concrete examples of how those general rights apply in the lives of older people. A convention has that potential added value too. If Professor Quinn has a paper, including what he presented here, he might consider making it available to the committee. I am acknowledging and affirming that.

Where does Ireland stand as regards a possible UN convention? What is the rationale for some of the other European countries resisting the drafting of such a treaty?

I welcome all the witnesses and commend Professor Quinn for his contribution. I agree completely with his point that rights should not be hostage to political whims. We need to establish what the fundamental rights are for older people, whether at national or UN level, and then ensure we have proper political will which supports those rights. In addition, they must be put on a statutory footing. For example, the EU charter of fundamental rights sets out what such rights are, including the right to collective bargaining. That is only a fundamental right, however, if it is implemented by a member state. Therefore we have these big institutions, including the UN and the EU, that do good work in establishing what fundamental human rights are, but it is no good unless the political will is there at national level.

Professor Quinn mentioned that the working group is examining binding human rights instruments. How binding are they? We were also told that the EU charter of fundamental rights was binding. As we know, however, some of its clauses are subject to implementation at domestic, national level. It is important that we do establish those rights.

Two issues were raised, one of which was the retirement age. There is a human right at the heart of this issue also because it is about choice. Somebody should not be forced to retire at the age of 65, but if they want to do so they should have that opportunity. I am opposed to forced retirement but I have a difficulty if we keep pushing up the retirement age to 68 that it will become 70. Simply because we are living longer it does not mean that everybody is in a position to work until they are 66, 67 or 68. Some people may have done very arduous manual jobs for years and therefore are not physically able to continue. It is fundamentally about choice.

We are under pressure of time, so does the Senator have a question?

My question is about choice. The second question is about accommodation for older people. The issue of nursing homes was raised again. This goes back to whether or not we see it as a fundamental right because, as we know, there is a shortage of community nursing units. The hierarchy should be to ensure that elderly people are cared for in the home first and foremost. If they do not have home helps, for example, because these are being cut, then it makes it more difficult for people to be treated at home.

All that goes back to establishing what are fundamental rights. Professor Quinn mentioned that it should not be a legal instrument that is used to beat governments over the head and that lawyers should have to deal with. At the end of the day, if somebody's rights are being denied, we should be putting in place instruments that vindicate citizens' rights. States and governments should then vindicate those rights. It should be their responsibility and duty to do so. However, if the State fails to vindicate those rights, it should be possible to seek redress through the courts. That is why, irrespective of what instruments are in place, the requirement to uphold rights should be as binding as possible. Thus, if there is a denial of the right of a person, especially an older person, he or she would be able to seek redress in the courts. My specific question is on the binding human rights instruments. How binding would they be in member states?

Senator Cullinane has an unusual way of asking a question but I am trying to be fair. I call Senator Wilson.

I thank Professor Quinn for his contribution, which was most enlightening. I particularly liked the concept of shrinking the nursing home. I thank Senator Zappone for showing me a copy of the article in this regard inThe New York Times in October. Professor Quinn mentioned the personalisation of social services and envisaged this becoming the norm over the next 20 years. How does he envisage this occurring in Ireland? Will he elaborate on that?

Professor Gerard Quinn

With regard to the net point Senator Zappone raised on Ireland's position and the question of the European Union's reported adamant opposition, would it be possible for me to defer to my colleague Dr. Eilionóir Flynn, who was at the last working group meeting?

Dr. Eilionóir Flynn

There were a number of reasons for the scepticism of the European Union and many of the countries regarding the need for a convention at this point. They stressed the phrase "at this point". One reason, to which Professor Quinn has already referred, is the lack of evidence of normative gaps. They are quite concerned about this and want to know exactly what rights it is felt older people are being denied. They want to know how they could be framed and why they are not protected under the current human rights instruments before commencing any work on drafting. As Professor Quinn illustrated, perhaps that discussion is heading in the wrong direction.

A number of other issues, also mentioned by Professor Quinn, which led to countries being sceptical of the need for a convention were treaty fatigue, the idea that there are too many human rights conventions and the failure of countries to report on their obligations under those conventions at present. I refer also to concern that the treaty monitoring bodies for the new human rights conventions, including the disability convention, are not given adequate time or resources to do their job. The expense of putting in place machinery within the United Nations to deal with a new treaty, monitor compliance and examine the relevant reports is also a concern. Those are some of the feelings that obtain.

There was a feeling among some of the more developed countries that the equality of their elderly is secured, and that their elderly have a good standard of living. The countries in question believe the existence or non-existence of an international convention is not really of relevance to them. Many of the developing countries, especially the Latin American states, which are particularly strong on the need for a new convention, referred very passionately to the circumstances of their older people and why they felt a convention would be useful to them.

As Professor Quinn stated, it is a question of a cultural shift rather than one of effecting some sort of direct change in circumstances. All the arguments being used have been rebuttable thus far. It is possibly a case of reluctance to commence the process of treaty drafting all over again so soon after the drafting of the disability convention, which, although it involved a very quick process, took quite a lot out of those involved.

What is the position on Ireland?

Dr. Eilionóir Flynn

To my knowledge, Ireland had no representatives at the sessions and did not take a position. However, as Professor Quinn said, we tend to be very much guided by our EU colleagues.

Professor Gerard Quinn

Although the representatives were not present, the negotiation positions are always worked out in advance at COHOM and in Brussels. I am sure, therefore, they participated in those discussions although there is no way of knowing how they panned out.

I pay tribute to the work of Dr. Flynn. She is possibly one of the few Irish people who was ever at a meeting of the UN working group and she did sterling work in producing the discussion paper and briefing note, which I believe has been circulated.

On the nursing home issue, we all know the system is wrong. We know there are no alternatives at present, but the first step towards wisdom is to at least admit something is wrong and then explore the options for a transition to something-----

What exactly is wrong?

Professor Gerard Quinn

Consider the report to the HSE which states a congregated setting of over four people is impermissible at the end of a transition period. This period is seven years. It is envisaged two of the four would have a disability and that two would be in another category, not necessarily their carers. Exactly the same logic maps out in the context of old age. A process of right-sizing must take place so nursing homes will be best positioned to enable community engagement and involvement. This has been acknowledged around the world. We do not have a way of proceeding in this regard right now. However, if we are capable of acknowledging that what we are doing is wrong and needs to change, we will be able to make the first step towards redesigning the system.

Is Professor Quinn saying nursing home size is the problem?

Professor Gerard Quinn

It is probably not just the size but also how nursing homes are configured. Let me give practical examples. In some of the right-sized nursing homes in the United States, there are projects to retrieve memories, or to enable people to tell their stories with a view to sharing their life journeys with the community around them. This helps them to keep alive their sense of personhood and self-esteem. There are many initiatives such as this that can be carried out but which are not currently being carried out, or which are being carried out only patchily throughout the country. They are done better in the smaller institutions. This is essentially the point.

Consider the question of how we anchor the international treaty in our system. I am not sure we need a constitutional amendment to do so. I am not even sure that we need a charter of rights to do so, or to give statutory expression to the rights in the convention. We have two problems, one of which is that we have an exaggerated tradition of keeping international treaties completely at arm's length. That tradition needs to be interrogated and investigated thoroughly because it is closing windows to fresh air that would allow for interaction with our domestic legal order. This is a bigger issue than that of the convention on the rights of the elderly; it affects all international treaties.

The second problem is that some of the changes that will take place will take place progressively over a number of years and will be utilising resources. Many of the obligations in international treaties do not lend themselves to judicial intervention. This is not something with which I completely agree but it is a reality. It would be extremely difficult to parachute some of the more complicated legal norms of the convention directly into Irish law because the default position in Irish law, as matters stand, is quite hostile towards that. It is a real trick to find a mechanism that can be a carrier for these values domestically. That is why the independent monitoring of these instruments is so crucial. I hope and believe that the Irish Human Rights Commission will be designated the independent monitoring mechanism under the disability convention. If adequately resourced, that can work out exceptionally well. It may even enable the commission to obtain a bird's eye view rather than a worm's eye view, and advance the public interest accordingly.

There were other points but I am afraid I have forgotten them.

We may have time to revert to them.

I asked about personalisation.

Professor Gerard Quinn

Yes, that is incredibly important.

We are under pressure owing to time constraints. What was Senator Wilson's question?

The professor said the personalisation of social services will become the norm within the next 20 years.

Professor Gerard Quinn

We are at the very beginning of a revolution and we are actually seeing it in the disability context first. The phenomenon is not just pertinent to the disability context; it is more universal. For example, there are movements afoot towards handing out individualised and personalised budgets for persons to manage themselves such that they can purchase the services they need rather than those others believe they need. This will be advanced mightily by new technology over the next ten or 15 years. An entire department at University of London is dedicated to researching the personalisation of social services. My prediction, for what it is worth, is that our social protection will morph in that direction over the next 15 years.

Before I call the next speaker, Professor Rose Anne Kenny from Trinity College, I acknowledge the individuals who are following the debate in the Gallery, namely, Ciaran McKinney from Age and Opportunity, Sinead Shannon from the Ageing Well Network, Diarmaid O'Sullivan from Older and Bolder, Peter Kavanagh from Active Retirement Ireland and Rebecca McLoughlin from the Irish Association of Social Workers.

Professor Rose Anne Kenny

I echo Professor Quinn's gratitude to Senators for giving us the opportunity to address the committee. I have been asked to speak about TILDA, which I lead in TCD as part of multi-institutional study of longitudinal aging in Ireland. TILDA aims at bringing about a step change in the quality, quantity and prominence of information and research about aging in Ireland. We expect this information will empower policy makers, NGOs, researchers and citizens with the data needed to make Ireland a better place in which to grow old.

TILDA is designed to provide policy makers with the detailed information necessary to inform public policy and change, as well as creating new research and development activity in the area of aging by transforming Ireland into a world leading research hub. Such research could result in new models of service delivery, new services, early disease detection, new treatments and technologies to enable independent living in one's home until the very end.

To give Senators a sense of the richness of our data set and the arduous process required to collate it, we were the last western culture to instigate a longitudinal study of aging. This has advantages, however, because we have been able to learn from the progress and errors of other studies and develop new questions that others may have raised but were unable to embed because of the longitudinal nature of the research. As we did not have the luxury enjoyed by other studies of being able to draw our participants from extant panels, TILDA had to cold call almost 27,000 homes, randomly selected, to ascertain whether any of the occupants were aged 50 or older and, if so, invite them to participate in the study. I acknowledge the significant contribution these participants have made to our detailed assessment in terms of creating a rich national treasure. We trained 100 field workers to deliver detailed computerised questionnaires to older people, which were then downloaded onto a web server. We also supplied self-completed questionnaires for more sensitive questions.

A substantial majority of participants also took part in a detailed health assessment. In some cases these assessments took as long as three hours to deliver and the majority were conducted in the health assessment centre in TCD or in UCC. We delivered health assessments at home to the 15% of participants who did not wish to travel to the health assessment centre or were unable to do so. We also helped to enrich Ireland's research and development capacity by training 17 nurses to deliver those assessments in the home and in the use of new technologies in the health assessment centres.

The UN World Assembly on Ageing in Madrid focused on intergenerational solidarity. We capitalised on the national recommendations arising from the assembly when developing TILDA. The theme of the assembly was a society for all ages. We propose that a society in which it is good to grow old is also better for people of all ages. The national level plan contained six elements, of which TILDA addresses the following three: national data collection and analysis for policy planning, monitoring and evaluation; education, training and research on aging; and independent monitoring of progress on implementation. The other elements, which are also pertinent to general discussions in this domain, are national agencies on aging; effective organisations of older people; and mobilisation of resources by organisations representing and supporting older people.

I propose to share with Senators some of the highlights of the output from TILDA. The first wave of study collected copious amounts of data, the results of which are available on the TILDA website. The most striking finding from our analysis is the enormous contribution older people make to families and communities in Ireland. One third provide regular practical household help to children, such as shopping or household chores. One half provide care to grandchildren. In those components alone, they are releasing others to participate in labour markets. One quarter are what we refer to as the sandwich generation, which means they are potentially caring for parents as well as children. One quarter have given gifts of €5,000 to one or more of their children over the past ten years. The median gift was €20,000 and the mean was €60,000. Conversely, 9% of older persons have received gifts from their children. Intergenerational transfer is, therefore, largely from older participants to their children.

Disabilities are not uncommon among those aged 50 and older. Some 10% of those between the ages of 50 and 64 and 30% of those older than 75 have some level of disability. As this is a community study we have not yet involved people who are resident in nursing homes or other residential institutions but we will be following participants over a ten year period or, hopefully, longer. Every two years we will follow up the participants, some of whom will probably enter institutional care.

It is interesting that the primary source of support for disabled recipients of care is the family and, by and large, the spouse. Only 3.5% of those aged over 50 are cared for by State-provided home help services. The large majority of care for those with disabilities is provided by older adults.

The detailed health assessments are unique to the Irish study and they have given us a cutting edge over other longitudinal studies. This will be an advantage when it comes to developing research and development programmes. Not only do they allow us to find out what disorders people understand they suffer from but we have also measured the diagnoses objectively to get a sense of the unmet needs in respect of these disorders, whether physical or cognitive. One half of the people we identified as having high blood pressure were unaware of their disorder, while approximately one third of those with cholesterol were unaware of it. None of the men who had osteoporosis had been previously diagnosed with the disorder. Remarkably, 65% of women with osteoporosis were unaware they suffered from it.

In the context of the earlier debate, mental illness, particularly depression, is common in Ireland, with 10% of people over the age of 50 having significant depression. Of those who are ascertained objectively as having significant depression, 80% have not been diagnosed. Therefore, there is, again, a huge unmet need. I have given Members an executive summary which summarises in much more detail a number of these features.

Education is consistently important as a factor that influences almost all dimensions of how we age, including health, social interactions, happiness, quality of life, wealth in older life, labour market participation throughout life, expectations and levels of disability. There is a big gender difference with respect to pension coverage. For those at work, 41% of women and 20% of men are not covered by occupational, PRSA or private pension schemes. In addition, there is a significant socioeconomic gradient with respect to pension cover.

The UN assembly in Madrid made recommendations about international co-operation. I want to contextualise TILDA in that sense also, because the changing age demographic is not isolated to Western civilisations; it will be global. Many developing countries have little or no extant infrastructure to accommodate this major shift in the proportion of older people. This may be an opportunity for research and development and employment in Ireland, given that we are to some extent ahead of developing cultures with respect to these frameworks. The recommendations from the UN included the promotion of training and capacity building in developing countries, exchange of experiences and best practice among researchers, exchange of research funding and data collection initiatives which would support policy and programmes in those cultures, and the establishment of income-generating projects, in addition to dissemination of information.

Within TILDA, because we were aware of these international recommendations, one of our objectives was to design the study in such a way as to maximise comparability with other longitudinal studies. We are currently actively engaged with newer studies that are taking place, such as the Chinese, Indian, Korean and Brazilian longitudinal studies of ageing. TILDA is considered unique among these studies because of Ireland's size, and based on the design of the study we were able to introduce many objective measures that other countries do not have the capacity to introduce. Given that we have used a number of new technologies as part of our assessment and are working closely with technology groups, we hope to develop technologies that can be translated into the field by other longitudinal study users.

Much has been learned from this first analysis of the data that has emerged from wave one of TILDA. However, substantially more will be learned in the coming years as the data becomes truly longitudinal and we understand not just a cross-sectional snapshot of what it is like to be living in the community and growing older in Ireland, but also the longitudinal trajectory of the process of ageing in Ireland. By following the same people over time, we will be able to develop a much clearer picture of this process and disentangle many of the causal relationships that underpin the observations we have made. We hope also to create a space for research and development and put Ireland at the forefront of research and development in ageing worldwide.

I thank Professor Kenny for her efficient delivery; she is well within the time.

I thank Professor Kenny for her interesting presentation. The executive summary of the TILDA study makes for interesting reading and will inform decision makers with regard to policy decisions into the future.

The response rate of 62% for the study is probably very good.

Professor Rose Anne Kenny

Yes, it is more than acceptable. It is important for the future that we minimise attrition from the study. The whole purpose of the study is that it is longitudinal - we revisit the same participants at regular intervals. A response rate of 62% is very good in the context of a longitudinal study. I know of a recent study in a European country which had a response rate of between 40% and 50%, and those running it have had to go back to the drawing board to improve this response rate before entering the field.

I thank Professor Kenny for an excellent presentation. It is exciting research with a rich data set, and I compliment her and her colleagues on it.

The key question we must consider when looking at the rights of older people generally, but which really comes out in the study, is the definition of older people. The TILDA study starts at 50 plus, which is the title of the report. In the changing demographic, however, 50 is in many ways no longer old. Many people at 50 are still caring for primary-school-aged children, given the change in fertility patterns that is mentioned in the summary. What clearly emerges from these results is a very different picture of those aged between 50 and 64 compared to those aged 65 plus. In devising any rights framework or policies with regard to older people, should we be dividing them into two groups in that way, or should we in fact not consider people between 50 and 64 as being in the category of older people any more? I understand this is an international question and not just a question for us. It is something that came up at this committee last week, when the different needs and life experiences of people in those different cohorts were discussed.

I thank Professor Kenny for her presentation, which was very impressive. I would like to ask a general question. The culture of ageing that surrounds us is archaic, bigoted and out of date, with a perception that as people get older their faculties and intelligence grow weaker, and so on. I totally agree with what Professor Quinn said in that we need a paradigm shift. I feel I am participating in that because I know that at my age, all my skills and abilities are far better than at any other time in my life. Most people would be retired at my age because of mandatory retirement. Professor Quinn spoke about the fact that in former times, when a woman got married, her identity was lost, and it is only now that women are being recognised in their own right. A good example of this is the tombstones of famous men, whether in business, politics or any other area. On their gravestones is written what they did in their lives, with "Was married to so-and-so" as the last line, although their wives may have been a huge contributor to their achievements. Every person, as soon as he or she is born, is getting older, indeed as soon as a person is conceived he or she is getting older. We are all on that path. Is there another, better word than "older"? I am tired of having to listen to it.

No, not even that. We need a new word. The baby-boomers are going to be joining these ranks shortly and they will be impatient. I believe the market will call the shots, and the spending power of the baby boomers will affect the attitude of marketeers. It is not only the face of a 25, 30 or 40 year old we will have to market but also the faces of 60, 70 or 80 year old men or women. All of us must fight the ageism that surrounds us. I was reading recently about face lifts and cosmetic surgery, how the marketeers decide one must look a particular way and about the botched jobs, of which there appear to be many. Marketeers are driving this ageism, awful word, but the growing propensity of the grey group to purchase will help to drive the change whereby it will not be seen as a negative to be increasing in age. In fact, it could be the greatest time of one's life, if one is healthy.

Professor Kenny spoke at the CARDI conference about the percentage of people who do not know they have blood pressure. It is all related to social class, having money and being able to mind one's health. This is a passion of mine. I am anxious to hear the witnesses' comments on the culture that surrounds us, which we must get rid of. It is like sexism and racism. It is time to say goodbye to it.

That is a very long statement.

I have published a document on it.

Senator White is a very wise person on this topic. On the comment about women losing their identity, many of my comrades seem to lose their identity when they get married. It works both ways. I am anxious to bring a little balance to the debate. That could have been the case historically but I have a feeling it has changed somehow.

I invite the witnesses to respond to the questions from Senator Cummins, Senator Bacik and Senator White.

Professor Rose Anne Kenny

I responded to Senator Cummins's questions regarding the more than adequate response rate.

With respect to Senator Bacik, this comes back to the concept of personalised tailor-made perceptions of individuals and choice regarding ageing - choice about when we retire, choice about going into nursing home care or not, choice about having services in the home and choice about who delivers those services. Probably the biggest deficit in the system at present is that lack of choice, and our inability as a society to enable personalised descriptors and personalised services.

The age issue is very difficult, because the biological and chronological age do not necessarily dovetail. Somebody aged 80 years old, for example, can often be biologically 60 years of age. We know the current cohort of 60 year olds are biologically equivalent to what a 40 year old was 20 years ago. That is a generalisation. Indeed, all people over the age of 50 are clearly not the same. It is a heterogeneous group and statements in aggregate are inappropriate and should be treated with caution.

I am very encouraged by those remarks.

They are very encouraging for all of us.

Professor Rose Anne Kenny

How one defines ageper se is an age old issue.

That makes a 40 year old about 20 years old.

Professor Rose Anne Kenny

We have chosen 50 plus in Ireland. The reason we chose 50 is that we could afford to do the study in that group. If we chose 40 in order to understand the ageing process even better, the numbers required would have to be far bigger and the cost of that study was prohibitive. Fifty seemed to be a reasonable cut-off age at the time to understand the process and to understand what it is like for people between the ages of 50 and 64 years as they approach the current retirement age. In fact, 58% of our sample is in the age group of 50 to 64 years. Then we look at what that retirement trajectory is like and what it is like into what we might call older age. From the quality of life work we have done, we found one is happiest between the ages of 65 and 75 in Ireland. It is less in the 50 to 64 year old group, particularly if they are from poorer socioeconomic groups, and it declines again after the age of 75. Many people in the Chamber therefore possibly have a great deal of happiness to look forward to.

Le cúnamh Dé.

Professor Rose Anne Kenny

Senator White focused on the issue of ageism and how difficult it is. Unfortunately, it pervades our professional and public policy structures in many senses and, of course, our media in a major way. In the recent presidential election campaign there was consistent reference to the successful candidate's age.

Professor Rose Anne Kenny

That was not normally the process when describing somebody on the day of their inauguration. There is a big task ahead to change the attitude in the media as well as in many other domains.

It applies to ourselves as well. All of us must change our attitudes and lead by example.

Next we will take questions from Senators Zappone, O'Donnell and Noone, in that order.

I thank Professor Kenny for her excellent contribution and her extraordinary leadership in this area. As some of my colleagues might know, Professor Kenny was head and heart-hunted for the role she is fulfilling now in helping to bring about that cultural shift that Professor Quinn spoke about as well as creating an extraordinary research and development capacity on older people, which she referred to in her presentation.

It is a longitudinal study and the first wave of results is in. This offers the opportunity to look at the process of ageing over time. It will be very interesting to look at that cohort again. Will Professor Quinn be looking at the way policies and laws relating to older people might have changed between the first wave and the next wave of that cohort in terms of making some type of commentary on the implications of law and policy on the process of ageing?

Professor Kenny made excellent points on inter-generational transfers and the larger percentage going from the old to the young. Much law and policy is based on the notion of the younger giving to the older and the concern of the State about having to give to the old when, in fact, it is the older who are giving to the younger. That is critical. Do the discussions about inter-generational transfers going the other way than we usually think have implications for policy or law?

In the excellent executive summary, Professor Kenny often references socioeconomic differences in her discussion of results. We surely need to attend to those in terms of public policy or law. In light of some of the emerging findings from TILDA, will she comment on the public policy implications for pensions?

Professor Kenny did not telephone me. Perhaps I look about 37 years old because I did not get the telephone call. There are three short parts to my question. One aspect of the executive summary surprised me greatly. What is the one finding in the study that surprised Professor Kenny? What is the one finding that appalled her? Finally, what is the one finding that encouraged her?

That was succinct. We must have been thinking alike. I had a similar question but you stole my thunder.

I have some brief comments. I was interested in what Senator White had to say about gravestones. The position is similar with personal public service, PPS, numbers. Sometimes a woman's PPS number is the same as the man's PPS number with an extra letter at the end. It is similar although it is neither here nor there but it is of interest. There is a general problem with people's upbringing. I was brought up in a house where, thank God, I was taught to respect my elders and not only my elders but everyone. Ageism is not exclusive to people who are perceived to be older. I have suffered from ageism since I arrived here-----

It is because the Senator is too young.

-----because I have been seen as too young to know certain things.

The "novice Senator".

I was brought up in a house where I was equal to my parents, my aunt and various other significant older people in my life. It is important to remember that it is not only about labelling people in groups. We live in society and we are all of value to it. We must find ways to educate younger people.

I have been rambling on about underage drinking and the selling of alcohol to those underage recently. It seems we are heading in a bad direction with the current generation of those between 15 and 20 years of age. The last thing on their mind is the elderly or older people. They are simply obsessed with getting their next drink and getting out and having some fun.

We need to get back to basics in this country and find ways to educate the public. I witnessed a situation where a general practitioner put it to an older person that they were doing well to be as good as they were. That is unacceptable. People should be doing well as long as they are on the earth and it does not matter what age they are. How do we educate the people in a more round sense about people generally being treated properly regardless of their age?

One more Senator is offering and we will let him in at this stage. I call Senator Mullins.

I join the previous speakers in welcoming and thanking Professor Quinn and Professor Kenny for their enlightening contributions. It should help us to focus our minds on how we look at the elderly and take care of them. While we all aspire to see a United Nations convention on human rights, as politicians we should reflect on our own house and we should get our house in order within the country.

Unfortunately, I have lost four elderly relatives in the past six months but, thankfully, all of them lived in their homes up to the finish, some with assistance and some without. We need joined-up thinking between the HSE and the various community facilities and social services to best channel scarce resources. Whether in Ireland or any other part of Europe there will be a major financial challenge for every Government for the foreseeable future in respect of how they can best utilise scare resources in every area. We are keen to ensure that our older people do not lose out when things get difficult and tight. How do we set about getting such joined-up thinking organised?

Pensions and income were referred to as was the question of whether it is a good or bad idea to have the age of retirement increased to 67 or 68 years of age. There is a situation now through a scheme the State initiated whereby we are forcing people into retirement in their mid 50s, be it 56, 57 or 58 years of age. These people have a great contribution to make, hopefully for many years to come. How do we leverage the vast talents and experience that will be lost to the State in an official capacity? How do we utilise these for the betterment of older people in an ageing society in future?

We have approximately six minutes because the business of the House is due to resume in 20 minutes. We will allow the professors to respond.

Professor Rose Anne Kenny

Senator Zappone asked how we evaluate the policy impact. This is one of the rich benefits of a longitudinal study. We can examine and evaluate the impact that a policy change has made on specific outcomes and targets. I hope this study will inform policy change and evaluate the impact of whatever process is used to implement it. This is embedded in the methodologies.

The study acknowledges the importance of intergenerational transfers. I will skip to the questions pertinent to this area. I was asked about the three things I found most surprising. I was most encouraged by the great contribution that older people make to communities and families in Ireland. This message should be broadcast because ageing is often perceived as a burden but it is far from a burden. It is enabling those of us not yet at retirement age to survive and to continue. This is a significant contribution.

I was appalled by the unmet need in the context of health services. I refer to Senator Noone's comment about ageism from health care professionals. This is not uncommon and it is something with respect to education and training that we have a responsibility to change. Unfortunately, the case Senator Noone cited is not unique.

I was asked about one thing that surprised me in respect of the study. I was heartened by the fact that education is so important and that we can potentially do something about this. We must ensure that we offer educational opportunities so that people age with health, quality of life and independence and so that people can have better participation in the labour markets. We can do something about this.

How do we set about joined-up thinking? This is such a vast issue. None of the age-related problems occur in isolation. Often one does not have poor health without an economic impact on the family in some way or an impact on social care, security, happiness etc. Poverty does not occur is isolation. Poorer socioeconomic groups are more likely to suffer from disability and ill-health. None of these domains are isolated and joined-up thinking is important at every stratum of ageing not only at a policy level but across the issue. One of our challenges is not to look at this in isolation.

I wish to offer a one sentence reply. I will read the whole study but one striking aspect of the executive summary was the area of depression. Did Professor Kenny expect this or was she surprised by it?

Professor Rose Anne Kenny

I was surprised not so much at the prevalence of 10% of clinical depression but by the prevalence of sub-clinical depression amounting to a further 18%. That corresponds to almost one third of people over the age of 50 years. I was surprised and shocked by the level of unrecognised depression among those clinically depressed. However, this is an opportunity and we should be able to inform policymakers about it. This is low-hanging fruit that we can do something about quickly and then we can evaluate the changes as the study evolves. I will defer to my colleague, Professor Alan Barrett on the pension issue.

We still have a few minutes. On the question of depression, is it not the case that it should come as no great surprise? Historically, Ireland and perhaps some of the Nordic countries appear to have had a stigma attached to depression for whatever reason. It has been brushed under the carpet in a way similar to suicide. I wonder whether we are beginning to learn. Is it the case that the findings on depression probably should have come as no surprise except that the issue seems to be swept under the carpet rather than being addressed in a transparent and obvious way? Most people do not want to say they suffer from depression.

Professor Rose Anne Kenny

That is right. Over 85% of people said they often enjoyed the things they do, look forward to each day and that their lives are full of opportunities. When we started to objectively unpack the components of depression we realised it was common.

I was not in the Chamber for Professor Quinn's presentation but I was in my office and followed it on the monitor. Both presentations were most inspiring. We are now moving into a new Republic post-Celtic tiger which is much more respectful. I am positive in terms of where we are going. Engagement within the community with older people is something that has been taken for granted at government level and to an extent has gone unnoticed. The research referred to the level of engagement, through voluntary groups or whatever, of older people and their level of activity in the community. Do the witnesses have any comments on that? Is it being recognised at government level? What could be done to streamline and appreciate it? Is there anything practical we can do as Members of Seanad Éireann to highlight this outside the debate?

Professor Alan Barrett

Senator Zappone asked about the pension policy implications which came out of the study, which gels with the question asked by Senator Bacik on why we took into account people aged over 50. One of the things we were most interested in was finding out what sort of provision people are making for retirement. We want to get a sense of what the upcoming issues will be.

Professor Kenny touched on this in her presentation. The finding that 40% of women over the age of 50 were not covered by pension schemes was very troubling. We had good information on the totality of people that were not covered. One does not worry about people aged in their 20s and 30s because they have plenty of time to catch up. We found out that women in particular are disadvantaged and, after conducting socioeconomic analysis, are doubly disadvantaged. Women in lower socioeconomic groups have a terrible level of under-coverage which is a significant concern.

A significant percentage, as high as 25%, of people aged over 65 are solely reliant on the State pension. At one level all parties over the years can congratulate themselves that they have insulated older people in terms of the State pension, which is very good. The greatest economic issue for older people is economic insecurity. One can live from week to week on €200 but one is always worried about a roof collapsing or a boiler having to be repaired. We are not doing as well collectively at insulating older people from such issues. We have done well with the pension but less so on other issues of economic security. There are problems for the younger and older age groups.

I thank the witnesses for their contributions. They were very enlightening and thought-provoking. We appreciate their effort in coming before the committee. Senator Zappone may get the credit or blame for initiating a lot of the debate on this issue. I thank the members of the committee for their attention and questions, as well as those who are not members. Many Senators who are not members have become involved and asked questions, which I appreciate. We are in uncharted waters as this is a new committee with a new initiative. When we compile our report in a few weeks it is to be hoped it will have some impact on policy and the lives of older people.

The committee adjourned at 4.15 p.m. sine die.