Dáil Éireann Debate, Wednesday - 31 January 2024
176. Deputy Bríd Smith asked the Minister for Health if the Citizens' Assembly's final report on older people was ever referred back to the Houses of the Oireachtas for consideration; if not, the reason; and if he will make a statement on the matter. [4521/24]
Amharc ar fhreagraThe Citizens’ Assembly was established by Resolution of both Houses of the Oireachtas and I understand, that as such it is a matter for the Assembly to report back to the Oireachtas. However, I would like to outline some of what we have been doing to advance the response to the ageing population aligned with the principles of the Assembly.
A key focus of our Sláintecare reform programme is recognising the need to enable older people to age well at home and in their communities for as long as possible with the correct wraparound supports. Older people want to age well at home, and it is important that the supports they need are in place.
A particularly important factor in realising this objective is investment in social care services and improving home support services so that people can live with confidence, dignity and security in their own homes for as long as possible. Since Budget 2021 we have provided approximately €230 million in additional funding for home support. As a result, the delivery of home support hours has been increasing year on year. In 2024 we expect to deliver 22 million hours of home support. This is more than has ever been delivered before. Over many years, both Day Care and the Meals on Wheels service have proven to be important components of the community services offered to older people, particularly in rural communities. We are building on recent investment to support these services by investing an additional €2.2 million in 2024 for Day Care services and an additional €1 million for Meals on Wheels.
Housing Options for our Ageing Population is a joint policy statement from 2019 that was developed by the Department of Housing, Local Government and Heritage and my Department. This provides a policy framework to support our ageing population in a way that will increase the accommodation options available and give meaningful choice in how and where people choose to live as they age. Both Departments will be developing a new framework to continue the joint cooperative policy making and implementation, from the national to the local level, to continue to deliver housing and supports for our increasing ageing population. Both Departments are also supporting a housing with supports ‘demonstrator project’ in Inchicore in Dublin. This is a collaborative, cross-sectoral, and cross-departmental project that recognises the need for a joined-up approach to addressing the critical issue of creating housing choice for our ageing population, one that requires housing, social, and care supports to be incorporated into a single model. It is the hope that this project, which consists of 52 individual self-contained units and associated communal spaces, will act as a pathfinder project for future mainstreaming of this form of housing.
The Healthy Age Friendly Homes programme is a support coordination service which seeks to improve the health and wellbeing of older adults and to enable them to remain in their own homes and communities for as long as possible. The programme is an innovative collaboration between Health, Housing, and Local Government, delivered through the Age Friendly Ireland Shared Service. Following a successful Sláintecare pilot in 9 local authorities, I secured €5.2m in Budget 2023 - recurring funding - to roll the programme out nationally to all 31 Local Authorities.
The HSE, in conjunction with ALONE, is also continuing the roll out of a Support Coordination Service across the country. The Support Coordination Service will support older people to live independently at home for as long as possible, through support coordination and access to services such as practical supports, befriending, social prescribing, assistive technology, and also the coordination of linkages to local community groups.
Since Budget 2021 annually recurring funding of €2 million is provided under the National Carers’ Strategy to improve equity of access to supports for carers across the country. This funding is an important step towards delivering on the Programme for Government commitment to develop a Carers Guarantee, providing a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. €1.9 million of this funding is being channelled through Family Carers Ireland for the delivery of a broad range of supports to carers, while the remaining €100,000 is supporting the development and delivery of online supports through Care Alliance Ireland.
Since my appointment as Minister for Mental Health and Older People in 2020, I have made dementia a priority. Through successive budgets, I have worked to prioritise Government funding for the development of dementia diagnostic and post-diagnostic services, in line with the recently published Dementia Model of Care. Budget 2024 provides an additional €500,000 to increase the provision of in-home dementia day care, for people who cannot, or do not wish to, attend centre-based day care. Alongside this, I allocated €300,000 in funding to the Alzheimer Society of Ireland to provide weekend activity clubs for people with young onset dementia. In 2024 a minimum of 18% of all new home support hours are now ringfenced for people with dementia.
The HSE Dementia Model of Care was published on 31 May 2023, outlining care pathways within the health and social care system for people living with dementia from identification of symptoms, through to assessment, diagnosis, disclosure, care planning and post diagnostic support.
Going forward there will be a strong focus on dementia-specific services, which have developed in recent years, like the Memory Technology Resource Rooms and National Dementia Adviser Service which provide invaluable information and supports to people with dementia and their family carers to help them adapt to a dementia diagnosis and continue to live as well as possible.
The Programme for Government commits to "Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high quality, regulated home care". Work is ongoing within the Department to progress this commitment. The Department is developing a regulatory framework for providers of home support services with the aim of ensuring that all service users are provided with high quality, regulated care. This will comprise of primary legislation for the licensing of home support providers; regulations which will set out the minimum requirements that a home support provider must meet to obtain a licence; and HIQA national standards. HIQA has initiated the process of developing standards for home care and home support services.
The Enhanced Community Care (ECCC) programme aims to deliver increased levels of healthcare with service delivery reoriented towards general practice, primary care, and community-based services. The focus is on an end-to-end pathway that will prevent admissions to acute hospitals where it is safe and appropriate to do so. For patients who require admission, the emphasis is on minimising hospital stays and improving outcomes, with post-discharge support for people in the community and in their own homes. As part of the ECC programme, the Integrated Care Programme for Older People (ICPOP) model aims to shift the delivery of care away from acute hospitals towards a community based, planned and coordinated care model which is closely aligned to Primary Care and Acute sector partners. The objective of the programme is to improve the quality of life for older people by providing access to integrated care and support that is planned around their needs and choices and seeks to ensure older people with complex care needs can access care quickly, at or near home, through care pathways specifically designed for older people. This supports them to live well in their own homes and communities without the need to access acute care settings.
Both Minister Donnelly and I were pleased to announce the appointment of Professor Alan Barrett, Chief Executive Officer of the Economic and Social Research Institute (ESRI), as the Chairperson of the Commission on Care for Older People. This appointment marks a significant milestone in the Commission’s formation. The Commission will examine the provision of health and social care services and supports for older persons and make recommendations to the Government for their strategic development. In addition, a cross-departmental group will be established under the auspices of the Commission to consider the supports for positive ageing across the life course and to develop a costed implementation plan for options to optimise these supports. The Commission will be comprised of independent experts and will be supported by a secretariat from the Department of Health.
