Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I have a couple of comments rather than questions. I used to be involved in the health board in the old days and we used to visit all the nursing homes or, as they were called then, segregated hospitals. One point that comes to my attention all the time is the need for a standardised system that is interdependent and backed up with home help, home care, respite care and access to nursing homes, as required. This lightens the load on the household and carer and recognises that many carers are caring over their lifetime. Very often, a mother caring for a child with special needs has heavy responsibilities, including nursing responsibilities, and this can be the case into old age. This creates obvious serious physical problems for the carer.

Community-based social interaction is important. The person who receives care in the home or elsewhere should be able to meet others and have a chat. It is a little more difficult in rural areas but it can be done. The number of community centres might not be as high. A trip to the pub or elsewhere, for a special outing or otherwise, contributes to the quality of life that the older person should expect.

Mr. O'Shea stated the patient knows best in any event. Nobody feels the burden like the patient, for two reasons. First, the patient feels he is a burden, which creates a further problem in itself. Second, the patient knows how he feels and what needs to be done to address his issues. If the patient gets the impression that nobody understands his position or cares, it presents a huge burden in itself, and it creates a huge problem for people in the older age group. I am mindful of the fact that I am approaching the age group in question, with a certain amount of caution.

The transport element is important. There are a number of rural transport groups up and running throughout the country. The Irish Wheelchair Association has quite extensive services in some areas, but not throughout the country to the extent needed. Services exist, however, and clearly demonstrate the quality of service that can be provided when there are dedicated individuals to offer it. All the services that are needed, to a greater extent among older people, ought to be provided in the same way, as is required, and as they would be offered in an institutional environment. If they do not receive the services, it will create further problems.

I was involved in the provision of services previously in the old nursing homes, old hospitals, district hospitals, etc. This was before there was any direct provision for the private nursing homes. There was a considerable controversy over the old age pension. It was ceded to the hospital or nursing home, generating much criticism. When that stopped, the whole system became very much more expensive. I have thought about it in the meantime. At least the old system, which may be archaic by our standards today, provided residential care of a very good standard at a time when there were very few other services available for older people.

Some 85% of citizens are older people. This is interesting but it is no harm to remember that there is a growing cohort of younger people. Immigrants have generally been younger people. There is a significant cohort of younger people who will be taxpayers into the future. The imbalance that exists will not be as great as in some other European countries. We will be compensated in that way.