Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I thank the Green Party Senators for bringing forward this motion. I thank all Senators for their constructive contributions. I believe 12 Senators contributed to the debate and I appreciate all of their contributions. The Minister for Health is not opposing the motion. Therefore, it is important that in dealing with something like this we work together and are constructive. The motion, as set out, is constructive. Each Senator who spoke put a lot of thought into their contribution.

The concerns highlighted by the Senators tabling the motion are well-grounded. Evidence shows that loneliness is a significant issue for population health and there are several studies linking loneliness to multiple chronic health conditions. Loneliness levels in Ireland are rising, and the pandemic was a major contributory factor to increases in social isolation. The Government is committed to addressing the issue of loneliness, and there are many policies and initiatives in train that work to promote social inclusion and combat loneliness on a cross-governmental basis. This includes the community mental health fund, the Little Things campaign, the national positive ageing strategy, Project Ireland 2040 and support for initiatives such as day centres, meals on wheels, older people’s councils, which are under the auspices of Age Friendly Ireland, active retirement groups and men’s sheds.

The Government also welcomes recent EU initiatives and action on loneliness, including a European Commission joint research centre report, Loneliness and social connectedness: insights from a new EU-wide survey. We will work to incorporate these insights into our policies and new service developments.

The Department of Health’s Healthy Ireland survey 2021 found a significant increase in isolation and a decrease in the proportion of the population reporting positive mental health. Some 81% reported lower levels of social connectedness and 30% reported worsening mental health since the pandemic started. In response, the Minister for Health and the Chief Medical Officer, supported by Healthy Ireland, developed a nationwide campaign, Hello Again World, to encourage older people to rebuild their social connections and reintegrate into their communities. This campaign was rolled out across 2023 and into early 2024.

Healthy Ireland has also developed a strategic action plan 2021-25, which sets out a roadmap for improving and supporting the lifelong health and well-being of the people of Ireland. Under this plan, social prescribing has been rolled out as an important initiative in minding your mood. Social prescribing recognises that health is heavily determined by social factors such as poverty, isolation and loneliness, and offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and well-being.

In budget 2023, €1.3 million in recurring funding was allocated for new social inclusion measures including social prescribing. HSE-funded social prescribing services are now available in 48 locations across the country. These services are delivered in partnership with community and voluntary organisations, such as family resource centres and local development companies, with one full-time social prescribing link worker per community healthcare network or Sláintecare healthy communities site.

More broadly, under the Healthy Ireland strategic action plan, a mental health promotion framework is currently being finalised, with a focus on universal and targeted mental health promotion interventions across the life course, and in key settings, to support people in protecting and enhancing their mental health and well-being and reducing mental health inequities. The Department of Health and the HSE will continue to improve the early intervention delivery of supports to promote positive mental health and recovery to adults and children, where needed.

The national mental health policy Sharing the Vision recognises that community plays a vital role in supporting people when they are experiencing mental health challenges and in combating isolation and loneliness. The mental health of older people is a priority in Sharing the Vision, with actions including improving access to mental health services for older people, promoting evidence-based digital mental health interventions in the general population and with older people and linking with the implementation of the national positive ageing strategy.

The national positive ageing strategy provides a blueprint for promoting older people’s engagement in economic, social, cultural and community life and fostering intergenerational solidarity. More than ten years on from the publication of the strategy, we have taken great strides in making Ireland a great place to grow old. This achievement was recognised in 2019, when the World Health Organization formally designated Ireland the first age-friendly country in the world.

The national positive ageing strategy’s implementation is a whole-of-government endeavour. This has been advanced through a wide range of initiatives developed and delivered in partnership with organisations in the community and voluntary sector, including Age Friendly Ireland, Age Action, Age and Opportunity and Active Retirement Ireland, to name a few. Age Friendly Ireland operates as a shared service centre of local government hosted by Meath County Council. It supports a network of 31 local age-friendly programmes which are led by local authorities and involve many stakeholders from other public bodies, universities and voluntary and private sector partners.

Under the leadership of the local authority, governance is anchored in the multiagency age friendly alliances, supported by broadly representative older people’s councils actively engaged as co-design partners. The programme has a strong focus on creating walkable, attractive and accessible communities and age-friendly spaces.By introducing actions to address participation and inequality, it is intended that people of all ages will be supported to enjoy healthier, more active and connected lives.

The healthy age friendly homes programme run by Age Friendly Ireland with the Department of Health includes a focus on supporting older people to be and feel part of their communities. An evaluation of the programme conducted by Maynooth University has demonstrated improvements in measurements of older peoples’ self-reported health status, quality of life, loneliness, social supports, self-efficacy and functional ability. The Minister of State, Deputy Butler, allocated €5.2 million in recurring funding for this new programme in budget 2023 and a national roll-out of this programme to all local authorities is under way as a result.

In parallel, the HSE, in conjunction with Alone, is continuing the roll-out of a support co-ordination service across the country. This service supports older people to live well at home independently and for as long as possible through support co-ordination and access to services, including, but not limited to, practical supports, befriending, social prescribing, assistive technology and co-ordinated linkages to local community groups in their area.

Day care centres and the meals on wheels service are also essential in supporting older people to stay connected, particularly in rural communities. Budget 2024 has seen increased investment in both areas, building on recent investment to support these services. Over €6 million is now being invested in meals and wheels to deliver close to 3 million meals per year. The Government is investing an additional €2.7 million in 2024 for approximately 320 day care services.

Lack of social engagement is a well-recognised risk factor for the development of dementia. People with dementia are more likely to be socially isolated. Staying socially active and engaged can slow the progression of dementia and can positively affect mood and a person’s overall health and well-being. In 2023, the Government allocated €2.1 million for the return to full capacity of dementia-specific day care and there are now 52 Alzheimer Society of Ireland, ASI, day care centres in operation. For 2024, the Government has allocated an additional €500,000 for in-home dementia day care for those who cannot or do not wish to attend centre-based day care. We have also allocated €300,000 to the ASI to establish weekend activity clubs for people with young onset dementia.

Community initiatives like dementia cafés provide opportunities for people with dementia and their families to stay connected or to reconnect with their communities and to share experiences with others who are in a similar situation. Although the Department of Health is primarily focused on those who have underlying health and social care needs, it also works through the HSE and in partnership with the Department of Community and Rural Development, including through Pobal, to support those who are more active within their communities. The national network of some 500 Active Retirement Ireland associations throughout the country makes a huge contribution in this area by supporting the increasing diversity of older persons to meet like-minded people and pursue their interests through a range of activities.

Several Members referred to the men’s sheds. There are currently nearly 400 active men’s sheds throughout the island, with a membership of around 10,000. Men’s sheds are reported to have a highly beneficial effect on members’ sense of well-being, connectedness and self-esteem. Within the friendly, informal and supportive environment of the shed, men can share skills, talk frankly about issues of mental and physical health, make new friends and engage with the wider community. According to an academic study, 91% of those involved in the sheds feel that participating in a shed has improved their well-being, while almost 75% feel happier in their home lives as a result of attending the shed.

More widely, public community spaces are being developed in order to increase engagement by people from all walks of life in their communities. Through the new public library strategy, The Library is the Place, the network of 330 public libraries is being positioned as a focal point within local communities where people can stay connected, informed and involved.

Despite our progress to date across government in addressing loneliness and connecting people to their communities, we recognise that we need to do more. On 21 March 2024, the independent Commission on Care for Older People was established by the Government to examine the health and social care services and supports provided to older people across the whole area of care and to make recommendations for their strategic development. The commission is chaired by Professor Alan Barrett, chief executive officer of the Economic and Social Research Institute, and is comprised of independent experts. Collectively, the members of the commission provide expertise across the areas of geriatrics, gerontology, health economics, health policy and management, primary care, health ethics, health technologies and ageing and disability, as well as representation of the community and voluntary sector and of older people.

The commission is charged with examining the provision of health and social care services and supports for older people and making recommendations to the Government for their strategic development. Subsequently, a cross-departmental group will be established under the auspices of the commission to consider whether the supports for positive ageing across the life course are fit for purpose and to develop a costed implementation plan for options to optimise these supports. Engagement and collaboration with stakeholders will be a central component of the work of the commission, including a reference group of relevant stakeholders, older people and carers. This will enable us to build on the policies and programmes in train to support connection within the community, ensuring that Ireland continues to be a great place in which to grow old.

More generally, this motion speaks to the need to prioritise actions to address loneliness across Government policies. The Roadmap for Social Inclusion 2020-2025: Ambition, Goals and Commitments was published in January 2020. The roadmap is an overarching statement of Government strategy which acknowledges the range of sectoral plans already in place that have social inclusion as a core objective. This includes areas such as education, health, children and childcare, community development and housing. These plans remain key to ensuring that social inclusion is at the core of public policy and service strategy across all Government Departments and services. Ensuring that a whole-of-population approach to loneliness, across the lifespan of all and regardless of social context, remains at the core of the work of the Department of Health. There is ongoing research to develop an appropriate evidence base in order that interventions in this space are based on reliable data and are bespoke to the needs of those living in Ireland.

In terms of the call to establish an expert action group on loneliness under the Department of the Taoiseach and to publish an action plan to combat loneliness and isolation, given the variety of existing cross-governmental initiatives that are directly or indirectly relevant, the Minister, Deputy Donnelly, the Minister of State, Deputy Butler, and I recognise that co-ordinated implementation would be valuable to ensure goals are met, progress is maintained, existing initiatives are recognised and duplication of effort is avoided. The Minister, Deputy Butler, is already taking the lead in ensuring a co-ordinated response from the health sector, with a specific focus on the effect that loneliness has on older people. In my new role as Minister of State with special responsibility for public health, well-being and the national drugs strategy, I will work with the Minister, Deputy Donnelly, and the Minister of State, Deputy Butler, to ensure that our combined approaches to addressing loneliness are co-ordinated and effective. We also look forward to working with our Cabinet colleagues, and particularly with our colleagues who have proposed this Private Members’ motion, to ensure that the collaborative and co-ordinated approach to loneliness continues and to embed positive working across Departments to deliver on our shared goal to improve the lives of people who feel alone or isolated. A number of matters have been referred to, and 12 very good contributions have been made. Senator Murphy raised the issue of the postal workers. In the UK, for instance, there was a system whereby postal workers had a role in making the call and cross-checking. The system was called "call and check". That was in place in the UK, and we in Ireland might look at it.

The whole issue of men's sheds was highlighted and they have made a considerable contribution. A group in Ballincollig, which is a new area in my constituency, was one point away from winning the national Tidy Towns competition. A group of people go out every morning to ensure the area in which they are living is clean and tidy, and then meet for a cup of coffee afterwards. The sense of community is phenomenal. They have been at it for the past 25 years and there is a great community spirit there. That is just one area I know of and the same is happening right across the country. There is community involvement with Tidy Towns and a wide range of people are involved.

An order of nuns in the United States agreed to donate their bodies for research after they died. When the analysis was done, there were signs of dementia but while they were living, the nuns had no signs of it because they all played chess or card games, including bridge. Those things can make a contribution to people's well-being and health. That is true of bridge clubs, card clubs and chess clubs. Senators have also referred to the Irish Countrywomen's Association, ICA, which makes a significant contribution to communities.

Many Senators raised the issue in the context of farmers. Perhaps it was before some Senators were born, but in the past, farmers would go to creameries every day and got social contact. Farmers can now be on their farms from one end of the year to the other because milk is collected by lorry and there is no need for them to move outside their farms. They can be very lonely places. During the recent bad weather, I came across some farmers who were getting depressed at trying to manage and to know what was the next step they had to take in order to manage what they have. There was a level of depression and there is a need for support in that regard.

I raised the example of An Post, communities working together and all of us keeping an eye on one another. During the Covid-19 pandemic, there were challenges for people who were living alone.

Senators also raised the example of lone parents, widows and widowers. It can be a lonely time for people when the level of support that should be in place is not in place. It is a matter that a number of Senators raised, and it is an important one.

I again thank Senators. I look forward to working with them to bring forward further change in this area. One thing that has changed in Ireland is that families are smaller and, therefore, the level of contact outside of the family is not there. The children of some families are now living abroad, which is a challenge. One problem that is going to come down the road in the next ten or 15 years relates to people who now live here having come from abroad. Ireland is great because if people run into a difficulty with their health, there is a family hub around them. Many people who have come in from abroad do not have that family hub around them. I recently came across that issue and it is a problem and challenge we are going to face in the next ten or 15 years.

I again thank Senators. I thank the Green Party for bringing forward the motion and I thank all Senators for their contributions. I look forward to working with them in the coming 12 months.