Ms Rosaleen Doonan:

The recent economic collapse in both jurisdictions, north and south, has led to drastic austerity measures by government and health agencies, all of which will have a major impact on family carers throughout the island of Ireland. Reports on reform of the health service on both sides of the Border - Transforming Your Care in the North, and Future Health in the Republic - have many similar strands which will impact on the lives of carers and future carers in terms of the supports available to them. In fact, the interesting thing about those two documents is that they are very similar in what they outline, but the way services are delivered on both sides of the Border is very different.
The Department of Health published Future Health – A Strategic Framework for Reform of the Health Service 2012–2015 in November 2012. According to this document, one of the seven tangible changes patients and clients will experience under the reformed service will be, "More people cared for in their homes: The reforms in social care will help older people and people with disabilities to live in their homes for as long as possible rather than go into residential care". Future Health sets out four pillars of reform, including a commitment by the Government to the development of a comprehensive health and well-being policy framework. The document further clarifies that:

Health is more than merely the absence of disease; it is physical, mental, and social well-being... Prevention policies and programmes can be cost-effective, can reduce health care costs, and can improve the health of the population... The role of the health service must be seen as keeping people healthy as opposed to just treating sick people.

It is presumed that this includes the health and well-being of family carers, who have been proven to be at high risk of illness because of their care burdens. Looking after carers is an example of cost-effective policy. Indeed, if we do not look after carers, they will, in turn, become sick people who are the responsibility of the health service. Future Ireland is very detailed in its methodology of approach as to how the four reform pillars will be implemented, in particular how it will achieve a situation where more people will be cared for at home through its new integrated model of care and its proposals for reforming social and continuing care and primary care. One of the five key principles identified to underpin the delivery of social and continuing care is "[a] shift towards service provision in the community, which includes natural supports (family, friends, etc.) as far as possible". However, the glaring omission in the document is a lack of detail on how the health service will engage with and support family carers, who will be the cornerstone to the successful implementation of the strategy outlined in Future Care.
Mr. Caughey will now outline the situation in Northern Ireland.