Oireachtas Joint and Select Committees
Tuesday, 24 April 2018
Joint Oireachtas Committee on Housing, Planning and Local Government
Housing for Older People: Discussion (Resumed)
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No. 3 on the agenda is housing for older people. On behalf of the joint committee, I welcome Ms Mary Hurley, Mr. Sarah Neary and Ms Patricia Curran from the Department of Housing, Planning and Local Government; Mr. Niall Redmond and Ms Frances Spillane from the Department of Health; and Mr. Derek Tynan and Mr. John O'Mahony from the Royal Institute of Architects of Ireland
By virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of the evidence they are to give to the committee. If, however, they are directed by it to cease giving evidence on a particular matter and continue to so do, they are entitled thereafter only to qualified privilege in respect of their evidence. They are directed that only evidence connected with the subject matter of these proceedings is to be given and asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or an 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 they should not comment on, criticise or make charges against a person outside the Houses or an official, either by name or in such a way as to make him or her identifiable.
I invite Ms Hurley to make her opening statement.
Ms Mary Hurley:
I thank the Chairman and members of the joint committee for inviting me to attend and giving me this opportunity to brief them on the very important issue of housing for older people. I am joined by my departmental colleague, Ms Sarah Neary, principal housing adviser.
While Ireland is a relatively young country in comparative terms, one of the key challenges facing it is planning for and addressing the needs of the rapidly ageing population. In recognising and valuing the achievement and benefits of the population living longer, we need to ensure quality of life is maintained and nurtured. Government policy on housing for older people, as set out in the programme for Government and Rebuilding Ireland, is to support older people to live with dignity and independence in their own homes and communities for as long as possible. Research has consistently shown that older people wish to age in a place close to their family and friends and in the community where they may have lived for many years. This policy approach is also seen as being both cost effective and contributing to a greater sense of well-being for older people.
For many, living in adapted or specialist housing reduces reliance on health and social care services and can result in measurably improved health status. My colleagues in the Department of Health are best placed to speak about these issues. However, it is important to acknowledge that housing policy on older people is broader and more complex than the mere provision of housing. Addressing the needs of older people requires a cross-departmental approach and inter-agency co-operation. The provision of housing for older people, particularly as we look at the future needs of the ageing population, will require a good mix of housing and health policy. Towards that end, the Department of Housing, Planning and Local Government and the Department of Health have been working closely together in recent months. We are finalising a joint policy statement on housing for older people which it is envisaged will be published this summer. We want to ensure older people will have a wider choice of appropriate housing options suited to their needs, including housing with care services and supported housing, and to give them an opportunity to plan for their changing needs in good time. As consulting key stakeholders and interested parties is a crucial part of this work, we may develop policy options that are responsive to the diverse needs of older people.
The policy statement will be a first step in the broader process and it is proposed to hold a conference later in the year. It will be a consultative forum for all stakeholders and interested parties to identify and discuss the range of issues ikely to emerge. The conference will be hosted jointly by the Minister of State with responsibility for housing and urban renewal, Deputy Damien English, and the Minister of State with responsibility for older people, Deputy Jim Daly. St. Michael's estate in Inchicore has been identified as a housing with support pilot model under Rebuilding Ireland and will deliver 52 care homes which are due for completion in 2020. It is a collaborative project between the Department of Housing, Planning and Local Government and the Department of Health, the HSE, Dublin City Council and the Irish Council for Social Housing. It is intended to set a new standard for the future of housing provision for older people to act as an exemplar for others to follow. The project has been approved for funding of almost €15 million under the Department's capital assistance scheme, with a contribution of €450,000 from the Department of Health towards additional communal facilities for the residents.
On the challenge we face on housing generally, I reassure the committee that Rebuilding Ireland contains specific commitments to meet the housing needs of the vulnerable in society who include older people. In addition, local authorities have been advised that the delivery of social housing targets under Rebuilding Ireland should be consistent with the housing need identified in the annual summary of social housing assessments, which means that the housing needs of older people will be addressed. It should be noted that Part M of the building regulations also sets out the minimum statutory requirements a building must achieve in respect of access and aims to foster an inclusive approach to the design and construction of the built environment underpinning the principle of universal design. If the committee wishes, further detail can be provided on Part M requirements, the implementation of which is very important in meeting the needs of a range of individuals, including the older population.
In line with a commitment in Rebuilding Ireland, the Department, in collaboration with the Centre for Excellence in Universal Design, ran the homes for smart ageing universal design challenge which aimed to stimulate and encourage the design and construction industries to be innovative in designing and delivering housing solutions for older people. The challenge attracted more than 60 high quality entries, which was testament to the high level of engagement by the industry in designing and delivering innovative housing solutions for older people. The competition winner, the Abhaile project, has established itself as a new enterprise and is actively pursuing pilot projects and clients with its innovative housing solution.
As members are aware, the Department of Housing, Planning and Local Government provides significant funding for social housing projects incorporating housing for older people. In addition, we support adaptations to private housing through the housing adaptation grants scheme for older people and people with a disability. The Department also provides funding and policy support for the local government sector in respect of the age friendly Ireland initiative which is active across all local authority areas. These supports are aimed at facilitating the changes needed to make the homes of older people and people with a disability more suitable and to enable them to continue living independently in their own homes for longer, as well as facilitating early return from hospital stays. Rebuilding Ireland has committed to increasing the funding available for these grants. In fact, funding has increased year on year since 2014.
Total funding in 2018 is €62.2 million, which represents an increase of 11% on the total for 2017 Further consideration will be given to increasing this funding in the coming years in the context of Rebuilding Ireland. The grants are also being made more accessible with a new single application form to be issued soon, with an easy to read guide to filling in the form.
With my colleague, Ms Sarah Neary, I will be happy to take questions from members and engage on the issues raised during the course of the debate.
Ms Frances Spillane:
I thank the joint committee for the invitation to attend the meeting on the subject of housing for older people. I am joined by my colleague, Mr. Niall Redmond, principal officer, services for older people.
People are living longer than ever before. Success in improved health and extended life expectancy has been achieved in recent decades and should be acknowledged and celebrated. Life expectancy for a woman aged 65 years in 2015 is estimated at 21 years, up 22% from life expectancy for a woman aged 65 years in 1995. For men, the figure is 18.4 years, a rise of 36%. However, as well as opportunities, the ageing population poses significant challenges that need to be recognised and addressed across a wide range of areas. Every year there is an increase of 20,000 in the over-65 population.
People of all ages make up a community. By and large, engagement with senior citizens clearly indicates that they would prefer to stay at home for as long as they can. We all recognise the benefits the older population has to offer society as a whole. The Department of Health, with its partners in the health sector and beyond, is looking at how we can facilitate and support their wishes and preferences. A particularly important factor in realising this objective is improving home support services in order that people can live with confidence, dignity and security in their own homes for as long as possible. This year the budget of the Health Service Executive, HSE, for the provision of home support services is €408 million, which will deliver over 17 million home support hours to about 50,500 people. While the existing service is delivering crucial support across the country, it is recognised that home support services need to be improved to better meet the changing needs of citizens. The Department of Health is engaged in a detailed process to develop a new stand-alone statutory scheme for the financing and regulation of home support services. A range of community services aimed at supporting older people are also funded at a cost of approximately €300 million by the HSE. They include short-stay beds, day care centres and meals on wheels services. Many of these services are provided by voluntary organisations.
The report of the Committee on the Future of Healthcare, Sláintecare, supports a significant shift in the model of care to one that is focused on prevention and early intervention and which will provide the majority of care in the community. It is crucial that the appropriate supports be in place to match each person’s needs at whatever point he or she is at in his or her interaction with the health care system. The national positive ageing strategy has shown us that a whole-of-government response is required to address the range of social, economic and environmental factors that affect the health and well-being of older citizens. The Department of Health and the HSE engage with many stakeholder groups on issues of concern to older people. The Department also funds TILDA, the national longitudinal study of ageing, which provides valuable evidence which feeds into policy development by Departments and, in association with the HSE, Age-Friendly Ireland and Atlantic Philanthropies, leads the healthy and positive ageing initiative, HaPAI, a research programme aimed at measuring progress towards achieving the objective of making Ireland a great place in which to grow old.
I am pleased to inform the committee that the Department of Health and the Department of Housing, Planning and Local Government are working together in finalising a high level policy statement, to which my colleague, Ms Hurley, has referred. It will provide a framework by which the Government can facilitate and promote a variety of housing options, including housing with care services and supported housing for older people. In tandem with it, the Department and the HSE are participating in a demonstrator project in Inchicore in partnership with the Department of Housing, Planning and Local Government, Dublin City Council, the HSE and the Irish Council for Social Housing. The project is aimed at offering older people who do not require nursing home care the benefits of living in their own homes, connected to their communities, with support and care provided in a cost-effective way.
We envisage that this demonstration project will be adapted and replicated in other areas.
The overall aim is to develop new models of housing for older people where care, support and community dimensions are provided on-site, integrated into the community and designed with the active participation of older people themselves. The results of an evaluation of the first phase of the project will be published shortly. It is hoped that this project and the learning derived from it could act as a blueprint for the future.
I hope that this provides an overview of the Department of Health's involvement in housing for older people and we will be happy to answer any questions.
Mr. John O'Mahony:
The RIAI thanks the joint Oireachtas committee for its invitation to speak on the topic of housing for our ageing population. The RIAI is the support and registration body and competent authority for architects and the support body for architectural technologists in the State.
I am John O'Mahony, a director and council member of the RIAI and I am its housing spokesman. I am also an architect specialising in housing. I am joined by Derek Tynan who is also a director of the institute and is heavily involved in public and private sector housing.
Housing for older people is an issue that the RIAI is researching, specifically how, through planning and design, we can meet the needs of the ageing population. The purpose of our research is to assess the changes to the types and locations of housing demanded for an ageing population. The RIAI research will be finalised in the coming weeks and we would be pleased to make it available to the committee once it is completed.
As with all sectors of housing provision, housing for the elderly is complex, challenging and needs to be planned. We are ahead of the curve in recognising the issues, however. We now need to design the solutions.
Excuse me, I have a cold coming on. My voice is going.
Mr. Derek Tynan:
In Thinking Ahead, research carried out by Amárach Research, Professor Ronan Lyons and Dr. Lorcan Sirr, there are key findings and recommendations which are of use to public officials, healthcare providers and legislators and for developers and designers. Among its many findings, it concluded that the vast majority of older people, 89%, wanted to stay in their current homes, as we have already heard. That means, for the vast majority of our elderly population, continuing to live in our suburbs and in the countryside, but are our suburbs and our countryside ready for the changes that demographic forecasting promises over the next decades? I want to look at the why, the where and the what of housing our aging population.
In the first case, as to why, as we have heard already, in Ireland, as elsewhere, people are living longer. The population of Ireland in the 2016 Census was 4.8 million with projected population increases for the next 30 years ranging from 8% to 25%. The population aged over 65 has increased by 19.1% between the last two censuses with an increase of 67,500 aged over 85. However, the pattern is not uniform. Fingal and Kildare have the youngest population, both rapidly growing urban areas with office-based employment. Kerry, Mayo and Leitrim, Ireland's least densely populated rural counties, have the oldest population.
Most of the housing built in Ireland over the past century has been three and four-bedroom houses. Of the 2 million homes in Ireland in 2016, according to the Census of 2016, 1.7 million of them were family houses. There were 860,000 families with children in the State at that time. There were, therefore, 900,000 more family homes than families. We need one and two-bedroom apartments in villages, towns and cities, both as starter homes and step-down homes for older people.
The RIAI housing policy of 2016 expands on the principle of densifying our suburbs and of rejuvenating older neighbourhood centres into higher density urban village centres by examining the principles of what makes a good neighbourhood. These are the sorts of neighbourhoods with a mix of homes to satisfy the needs of all members of society, not just families but also single people, young couples and, in particular, our older citizens.
These are places that have a mixed population in the sorts of numbers that make public services, neighbourhood amenities, shopping and public transport affordable and accessible. The question is whether our current suburbs and neighbourhoods can accommodate both an increase in population while also allowing older people to remain in their community.
The architect, David Dwyer, director of Box Urban, has looked at the issue of increasing the population in our existing suburbs. He analysed two typical suburban neighbourhoods in west Dublin. Ballycragh, built in the 1990s and Ballyroan, built in the 1960s, both at a density of 17 to 22 units per hectare, that is, eight to ten to the acre, the standard old-style density in Ireland. He defines a good neighbourhood as being able to provide all one's daily needs within a five minute walk of one's home and as needing a population of between 7,000 to 10,000 people to support a financially viable modern neighbourhood village centre. The study investigated the opportunities to rejuvenate existing neighbourhood centres and increase the numbers of houses within a five minute walk.
Ballyroan neighbourhood centre serves a population of 4,000 within five minutes walking distance. Ballycragh neighbourhood centre serves a population of less than 1,500. Therefore, they significantly underperform on the viability test.
The study concluded that by making better use of the existing neighbourhood centre lands, by removing existing barriers to pedestrian movement within the area, by making better use of corner sites and back-lands and by building along the edges of main access roads and redundant open spaces, it was possible to increase the five minute walk catchment in Ballyroan from 4,000 people to 11,000 people and in Ballycragh from 1,500 to 10,800.
The figures confirm that in Dublin if we build out all currently zoned lands at the minimum recommended density of 50 units per hectare and densify just 40% of our suburbs at the quantum that he achieved in his study, we would comfortably accommodate population increase over the next 30 years without having to rezone a single acre of new land.
Realistically, however, there is a job of education needed, firstly to demonstrate to people that building more homes and services in their backyard will bring real benefits and, secondly, to have support from our public representatives to promote sustainable mixed communities. It is necessary to halt the sprawl of our cities and our larger towns. It is unnecessary and unaffordable.
We all recognise that our rural towns and villages have suffered the consequences of recession and consequent migration. Meanwhile, there are large numbers of older people living unconnected lives in the countryside. A possible win-win situation would involve encouraging them to move back into their local towns and villages.
Local authorities are starting to plan for the future densification of their areas, whether urban, suburban or rural, and to prepare masterplans that promote the principle of densification and the provision of universal access. With careful planning, we should be looking at regenerating our towns and villages by adapting existing domestic housing for older users, improving the public realm, services and amenities and centralising our services to encourage older people to move into town.
We need to revisit the concept of downsizing. It is not a bad word. Downsizing can be liberating for those who wish to enjoy less encumbered lives and may wish to be nearer the centre of a supportive community. We must plan it properly and architects are well positioned to make a significant contribution, not just in designing exemplar homes, but also exemplar places.
Currently in Ireland there are just two types of housing for the elderly, either at home or in a home. In the private sector, as a housing architect, Mr. O'Mahony's experience of over 50s planned living, as it is known in the UK and USA, and which he has looked at in some detail over the past couple of decades, is disheartening. Rather than replicating the good neighbourhood model of young and old, single people and families living together in a supportive community, what he has seen is gated communities of considerable means living lives segregated from the surrounding community in what he termed as "gilded cages". He considered that we should discourage this model and while not a lover of regulation that is not backed by evidence, regulation needs to be introduced that ensures a quantum of age-appropriate housing is delivered in all our private housing schemes and mixed tenure developments. Currently it is necessary to audit the availability of local crèche facilities, for instance, before making a planning application. Similarly, local retail capacity studies are required to accompany commercial development applications. The same should happen with housing for older people. It is now time to propose that housing typologies in housing developments, particularly private developments, match the age demographic of the area in which the development is being proposed.
Community facilities provision in large scale developments, including build to rent housing, should also be carefully assessed to complement the needs of future older residents.
In public sector housing, there have been social housing options in the form of old people's dwellings, OPDs, and sheltered housing facilities in the past. However, there are no options for those who are above the financial thresholds to access social housing but do not have sufficient means to support their older age accommodation needs. The research identified a very large grouping of older people who did not want to be in residential care at any cost. They still have the facility and mobility to live independent lives but require some supports to allow that to happen. Over the next 30 years, we must provide for these people with housing options to downsize within communities that include an element of care but reinforce independent living and are affordable. The "Thinking Ahead" study called it housing with support and public sector proposals for an exemplar scheme in Inchicore are being developed by Dublin City Council in collaboration with the approved housing body, AHB. In its vision document, the following carefully considered thoughts of a future occupier are shared with us
I would like an opportunity to live in my place, with my books and music, with people I like and some whom I love - who will know when to talk and when to stay quiet. I would like that place to be where I can be myself, I would like that place designed to be a gathering place and a place of contentment and a place of aloneness. A place where I can be as independent as I can be and dependent when I have to be.
Who could ask for a better definition of home than that?
I welcome the witnesses. I thank Ms Hurley, Mr. O'Mahony, Ms Spillane and Mr. Tynan for their contributions. We had engagement about this at a previous meeting and we have loads of information. I do not think anyone in this room needs to be convinced about the need to have support housing. I am glad to say that the witnesses have overlapping coverage of a recurring theme, and it is positive that we have looked at design, health and planning issues. It is complex. The other big issue is isolation. I am familiar with gated developments since I live in Dún Laoghaire. I will talk about them in the private sector. People tell me that they have had to rent in these little schemes in townhouses. They are locked and gated. Many people leave these gated communities every day to work. There are opportunities for integration and such. When one looks at the demographics, ageing and elderly people, we have to talk about that key word, community. In some parts of the country, we have wonderful libraries where old people can go and sit down. They would have been thrown out a few years ago. The reality is that there are elderly people who live on their own in this city, the county and all over the country who have very little income. They are lonely and isolated. They literally walk the streets or go to cafés, train stations, public libraries or, in some cases, the waiting rooms of hospitals to interact. Sad as it is, that is the reality.
I will address a few issues, starting with social housing targets in this context. I am disappointed in the social housing targets but that is another debate for another day. It might have occured to the policymakers that they might have set down, as part of the social housing targets, a breakdown of those targets. What percentage of those would be specifically for downsizing? We talk about downsizing and I want to ask Ms Hurley if she might share with us. There has been much talk about a downsizing pilot scheme in Dún Laoghaire-Rathdown and we might hear a little about that and its success. I am conscious of a place in St. Laurence's Park in Stillorgan which I have shared with people here for months. Two elderly people live in isolation in local authority units because they do not want to leave. They want to stay there. I do not hear much support from the Department for those two people who wish to stay. I want to use this opportunity to make an appeal that those two vulnerable old ladies are allowed to remain in their homes in St. Laurence's Park in Stillorgan. If we are to be meaningful about our dialogue, discussion and policy formulation, we have to put it into reality. How can we stand over a public housing policy that has spent years emptying out 16 maisonettes in Stillorgan which are next to doctors, a leisure centre, a library, churches and various supports? If we are talking seriously about engagement, this is the type of site that we should keep and maintain, and support elderly people to live in.
The reality is it has been de-tenanted for years and slowly people are being picked off. Now two vulnerable ladies are living in two houses that are being described as holding up the potential for development. I do not want to be too specific but I want that site to be identified for downsizing and support housing for vulnerable people and elderly people because of the importance of community. I ask representatives of the Department for breakdowns in any further social housing targets to identify the percentage of one-bedroom and two-bedroom properties.
Let us deal with the facts we were told about last week. We have a rapidly ageing population. We have a large number of people over 55 on all our social housing lists who are unable to get accommodation. Many of them are single, elderly and vulnerable with very low incomes. What are we doing about that? How are they worked into our social housing priorities? There is an increasing elderly population particularly on our social housing lists. Right across the spectrum it is a demographic with chronic health issues and disabilities. Are we setting aside some of this accommodation for people with disabilities? We are not. If we are, we are certainly not delivering. We know there are a number of occupiers in the private sector who have no mortgages and who are willing and want to downsize in line with everything the witnesses have advocated and yet we know there are no small units for them to downsize to in their communities. We know that older people, and for that matter younger people and all of us in this room, thrive best when we have community supports and loved ones, family and friends around us. It is something we all want by our very natures.
I will ask some questions. I will address the first one to Ms Hurley, not because she is from the Department but because it concerns the central tenet of the policy contained in Rebuilding Ireland. Can she provide an update on the two - she should note the emphasis on the word "two" - items contained in Rebuilding Ireland on providing housing for older people? I want her to deal with that.
Reference was made to the cross-departmental approach and inter-agency co-operation. I have touched on that. It is excellent. The Department is currently finalising a joint policy statement on housing for older people which it is envisaged will be published this summer. Will Ms Hurley keep the committee in the loop as that progresses? I look forward to being at the launch, not reading about it but being there and hearing about it. There will be a conference hosted jointly by the Minister of State with responsibility for housing and urban renewal, Deputy Damien English, and the Minister of State with responsibility for older people, Deputy Jim Daly. I ask Ms Hurley to keep the committee informed on the progress on that work. She might indicate a timeframe for when she thinks she will have that work complete. Everyone knows what the challenges and issues are. It now must become policy. The emphasis is on these social housing targets and breaking them down specifically with a focus on demographics and ageing and the challenges and priorities that need to come from that.
Ms Mary Hurley:
I will work through that range of issues. The targets that have been set for social housing have been set on foot of a very detailed analysis of what is in the pipeline and what the different needs are in each local authority area. When we started the exercise to set targets for each local authority, we provided guidance and wrote to each local authority area. We are very clear on the particular needs. The Senator is right about singles and two-bed apartments, in particular. There is a huge need. Our social housing list shows that over one third of our population is single. In framing the targets, we have worked very closely with local authorities and have established, on a scheme-by-scheme basis, the type of delivery we expect in the coming years.
In terms of older persons, we can see what we will deliver through the CAS programme. In terms of sustainable communities and mixed developments across various sites, we can see how many of the units will be for older people and how many will be for people with a disability. That was the target-setting process.
When the Minister attends later in the month, we can touch on that matter further. In setting the targets, we had regard to the waiting list in each local area and the mix and types of need in areas. There was also engagement with each local authority on its particular needs. In 2018, targets have been set across building, leasing and acquisition. This issue is very much on our minds.
I will work through some of the other issues that the Senator raised regarding downsizing. It has to be done sometimes. It is an option. Some people want to downsize and some do not. We have an adaptive policy. For example, we had two projects in Dublin last year. At Broombridge, we delivered 51 housing units for older people with a mix that included downsizing. A number of the committee members might have attended the opening of the second project, that being, Annamore Court in Ballyfermot. An interesting project, it delivered 70 units last year, 16 of which were for people who wished to downsize. Those units were designed and developed in a particular way that was supportive of older people with needs.
We view the St. Michael's project, which is advancing, as important. As my colleague from the Department of Health mentioned, this model sees the Department of Housing, Planning and Local Government working with Dublin City Council, the HSE and the Department of Health to get the best possible housing for older people. That will be reflected in the design. In order that we might learn from the project from the outset, we have developed a toolkit, which we will provide to local authorities so that what is best for older people's social housing can be determined. This part of the learning process is important.
The social housing agenda is about the mix and meeting the needs of older people, people with disabilities and a range of other persons. That is reflected in our targets and is something to which we are committed. We will work on it.
The Senator mentioned the St. Laurence's Park project, which is close to his heart. He has been working with the Department in this regard. It is an important project. We have been liaising with Dún Laoghaire-Rathdown County Council, to which I expect we will revert over the coming days so that the project can proceed. The local authority will work with the individuals in the premises to whom the Senator referred. It is a good project that will advance shortly.
Regarding design, my colleague, Ms Sarah Neary from our building regulations section, has been working with the National Disability Authority and the Centre for Design Innovation on how we can design homes that are Part M compliant and meet older people's needs. A great deal of innovative work has been done in this regard, as evidenced by the competition that we ran last year where 60 applicants sent in interesting ideas. The Abhaile Project won that competition and we are moving forward with some of the ideas.
I will focus on the community piece, which the Senator mentioned. We have a collaborative and close working relationship with the Department of Health. We are also working with our colleagues in the Department of Rural and Community Development. Be it through a seniors alert scheme grant or a housing solution, we must all join together to keep people in their homes. As such, the question of community is on our radar. At our cross-sectoral and interdepartmental meetings, we are conscious that housing the elderly is not just about the house, but about home care, security and feeling safe. That is something we are progressing with the housing piece.
Ms Hurley might touch on the only two actions that are contained in Rebuilding Ireland where our discussion is concerned. I take it from this meeting that the two people in St. Laurence's Park will be safe and remain in their homes.
I welcome all of the different bodies here today. It very important that they made joint submissions. Joined-up thinking is what it is all about. The one thing I did not hear mentioned yet is the question of the conservation of energy and heating in homes. One of the most important things to keep older people in their homes for as long as possible is to make their homes as energy efficient as possible. I welcome the schemes that the SEAI have and the community groups. I know that in my county, in Dunleer, for example, people sign up for a scheme and it is ensured that their energy needs are met. Notwithstanding everything else, will the witnesses comment on that? What priority are they giving to that? Is there any survey done of the energy deficiencies, if any, in local authority estates? The older people are, the more likely they are to have been living in their home when the area was built. There is a significant deficit in older homes. How do the witnesses propose to address that?
I refer also to people who suffer from dementia. That is a big problem that I find locally. If one of the people living in a home suffers from dementia, the changes that have to take place, which I know are done through the housing adaptation grant in some cases, concern downstairs facilities such as toilet and shower facilities, and there is the expectation that might be done more quickly. While I welcome the increase of 11% in the housing adaptation grants, the problem is at the local authority end of the business. Some local authorities do not provide matching funding or enough matching funding in many cases to meet the demands in their communities.
I the architects, I think it was, mentioned two or three counties where a proportion of people who are older live for whatever reason, perhaps due to emigration etc. Can we match up actual need to the moneys that are there? Is there an index of age related residents and the housing adaptation grants for those counties? There are inequalities in different counties. I mentioned that County Louth did not provide the matching funding two years ago because of the county council's debt. In discussions with the Deportment of Housing, Planning and Local Government last year there was a significant increase in the availability of money. Once the need is identified, should there not just be a one-stop shop, be it the Department or the local authority, rather than having matching funds? Unfortunately, it mitigates against people when they cannot get the grant and they have to live for a year with a significant disability with no action being taken because the council has not applied for the funding or does not have enough matching funding to meet their needs.
The key thing for me is the Department of Health and keeping people out of long-term care. More than 22,000 people live in long-term care. Many of those, I believe, should be living at home. They are not living at home because the facilities and community network are not there. In respect of proposals and research, I refer to the Great Northern Haven in Dundalk where a lot more technology is being put in. Obviously, that is a new build. The technology helps people when they get out of bed at night, when the light goes on in the bathroom, when they are reminded that water is spilling out of the basin or whatever.
When they leave the window open in the middle of winter, they know it is open. How much of that technology is in our plans? How can it be adapted and what key elements can be put into existing homes? Not everybody will be able to move into a state-of-the-art home right now.
Local authorities had a policy in the past of building perhaps 200 houses in the community that might be some distance from town centres, shops and facilities. There might be six, seven or eight older persons' dwellings, OPDs, in an area where they are squeezed in and very badly placed. They are often subject to vandalism and the actions of young people who might be out of control and causing problems for people in those sorts of neighbourhoods. I support mixed residential areas but the problem is having OPDs far away from facilities. I agree with the analysis by the architect who spoke about building in existing infill sites in the centre of towns or cities. We should maximise that and zone such areas specifically for older people's residences. Nobody else should be allowed to use those sites for any activity. There would be connectivity with nearby shops and services. I welcome the advances that are being made but we are not doing enough. I welcome the reports and preparation to deal with the issues identified by other speakers.
I am seeing increasing examples of dementia in my community and there is a lack of ability of family members to cater for those who are affected. This is an illness that brings significant problems for people living in housing on their own. I have met families where a person with dementia is mobile 24-7 in a house. The person is up and down the stairs and usually never rests, so the families are exhausted in trying to look after that person. I say this to the architects more than anybody else. Is this an issue? Are there dementia-friendly environments so we can adapt homes to make them more accessible? When a diagnosis is given, there should be a fast track for people to change their downstairs bathrooms, for example, or whatever they will need. There should be adjustments to the home to help the other people living in the house to care for the affected person. I would not underestimate the importance of what I am saying about dementia. I do not know if other public representatives have the same findings but I am finding increasing instances of it. When I speak to older people they mention that there are not as many heart attacks as there have been, cancer remains a big killer but, more frequently, dementia is coming up. I will leave it with the witnesses.
Mr. John O'Mahony:
I have been involved in Drogheda with dementia care. It is very specialist housing. A professor came from Britain who has highly developed ideas about housing. In particular, dementia is almost like a separate housing typology requiring minute detailed issues such as carpet colours and the nature of lighting. It almost separates it completely from traditional housing. Does this mean we cannot adapt traditional housing? We can do so but the care issues are very much about communal care. When a person reaches the stage where the dementia is taking hold, he or she would be suitable for very specialist housing. It is important to emphasise just how specialist it is. People like us must be well educated on the design issues associated with that.
It is very specialist care and very specialist design.
There should be a fast-track grant or fast-track support available to people. Once that is available, it can happen for the person. Many families are suffering greatly as a result of their inability to deal with things such as downstairs toilets and the like.
Mr. John O'Mahony:
Yes. There are three levels of housing for the aged. There is independent living, independent living with care and dependent living. The big problem at present is that we do not have enough one and two bedroom apartments for independent living, let alone for independent living with care. The standard apartments we design and build at present satisfy Part M. They satisfy two ends of the spectrum, the starter home and the downsizer, as long as the downsizer is independent living. However, we do not have enough. There are plenty of family houses that are not adapted for older living but we have a huge shortage of one and two bedroom accommodation which allows for communal living and facilitates the mixed tenure communities one is trying to create. The level after that is how one adapts that type of housing for the housing with care. That is quite easy to do and relatively inexpensive if we apply the current Part M and other regulations. It is when dealing with highly specialised dependent care that there is a need to look at sheltered housing and so forth. Unfortunately, at present, the only example we have of housing for the aged is the sheltered, highly specialised care type. It is the other types that we need to build.
Mr. Niall Redmond:
The Deputy is quite right that dementia is a major issue. Currently, there are approximately 55,000 people in Ireland living with dementia and approximately 4,000 new cases per annum. One can see where this is going in the future given that we have an ageing demographic. Interestingly, this year a new model of residential care, called CareBright, opened in Bruff. It is specifically aimed at dementia. It is not quite a nursing home and not quite independent living. It is almost in between. It is largely based on models designed in the Netherlands and has been brought here as a testing model. It opened at the beginning of March, so it will be interesting to watch how that develops and to see what it brings to the table in terms of a particular model for dementia, which is particularly challenging.
From the Department of Health's perspective, we published the national dementia strategy in 2014. As part of that work we have introduced intensive home care packages for dementia largely on a trial basis. We are supporting 150 people at present. These are very intensive packages that allow people with dementia to try to live at home for as long as possible. They are also being independently evaluated by Genio in NUI Galway to try to understand their effectiveness and whether they are something we can pursue in the future in a more mainstream model. At the end of January this year 301 people had benefited from those packages since they were introduced in 2016. There is a great deal of work happening with dementia.
As a matter of interest, we will publish a mid-term review of the dementia strategy in the next couple of weeks. That will also point out some of the other work we are doing in this area. Obviously, it is broader than the issue of housing but it links closely to it as well.
Ms Mary Hurley:
With regard to location and the place for older people, at the heart of the national planning framework is having well-connected facilities for older people. That is in objective 30 of the national planning framework.
The Minister of State, Deputy English, is advancing a piece of work on urban renewal. We would consider it to be very important that older people are in areas where they can access community supports, transport services and social supports.
On the issue of energy efficiency, the Department has a retrofit programme and provides funding for energy efficiency measures. We work directly with local authorities on that. The SEAI has a separate private grant scheme which is also very important. There is some provision under the housing adaptation scheme to provide heating support. If a person's heating is not working at all, he or she can apply for grant assistance.
Ms Mary Hurley:
Yes, it is part of the guidelines and it is at the discretion of the local authority. The housing adaptation grant is very much at the discretion of the local authority. Local authorities would work very closely with the HSE and with occupational therapists in an area to make sure that the needs of individuals are met. The continued funding of the scheme is important. The housing adaptation scheme is great because it allows people to stay in their homes. It makes life easier for people through the provision of rails, bathroom adaptations and so forth. It is a scheme for which we have sought increased funding over the years. At the moment, the Department provides 80% of the funding and the local authorities provide the remaining 20%. Generally, additional funding has been provided throughout the year for housing adaptation grants. Local authorities prioritise the works for those who need them most-----
They do not all do that. I got a list of grants paid by local authorities, the amounts involved and compared that against population. Some local authorities do not adequately provide for the scheme. As I understand it, all of the funding available in the Department was not taken up. There-----
That is another way of looking at it but my point is that some local authorities do not provide enough matching funding. In that context, should the grant not just be provided by the Department without the involvement of the local authorities? If a person qualifies for the grant, he or she should not be on a waiting list. People have to be in category 1 or practically dead, to get the funding and that is unacceptable.
Ms Mary Hurley:
Our finding is that local authorities do not have too much difficulty in providing the funding. The 20% requirement is important from the point of view of additionality. We can give an amount but it is important for local authorities to recognise that they need to put something back into communities as well. It is the additionality that is important with the 20%.
I do not agree because some councils have huge debts, like Louth County Council. It bought land for €20 million which is now valueless. It could not put anything into the scheme because it had to service its debt and the need in the county remained unmet until 12 months ago. I have made my point.
Mr. Derek Tynan:
I wish to express my personal support for what Deputy O'Dowd has been saying regarding the supports that need to be put in place. My mother had a long leaving of 14 years, suffering from dementia. Thankfully, she moved from an isolated rural house to a house in the middle of Athy and therefore lived within 500 metres of the town square, the church and all other amenities. She was also in a small community which looked after her. The housing unit helped, as did the support of the community. That is extraordinarily important in terms of how we move forward. We have spoken about intensification in terms of identifying sites within towns that could be used for supported living or at least for smaller units that are mainstream in one sense but with some support.
That brings me to a bigger issue about our towns.
I am originally from Athy, a town that is in serious difficulty in terms of its urban fabric and what supports it. Rather like the Department's living-over-the-shop initiatives which are not really working, tax incentives do not generally begin to ensure implementation of such policies. There may be a policy to incentivise the conversion and rehabilitation of lots of existing housing stock that could be used as housing for general use and as housing suitable for elderly people. It may take a policy of saying there will be a grant of €50,000 to €75,000, but I would have thought - I am not involved with the Department - a sum of that figure would be needed to actually persuade people to do it, rather than saying they can avail of a capital grant which they will receive in the next five to ten years.
I thank each of the delegates for his and her contribution. We are playing catch-up in this area as we have an ageing population. Even in my area of Fingal which has a young population in parts there are towns with an ageing population. I want to focus on the supply of houses and what we can do to plan suitable housing for the age cohorts. I have specific questions for the Department of Health that are related to the housing adaptation grants scheme. How does the HSE prioritise applications for housing adaptation grants based on need? We have all come across people who remain in hospital because their home has not been adapted and they cannot be discharged. If the medical need has been identified in so far as the patient cannot be discharged because works such as the installation of a shower or wetroom or whatever else may be required in the home have not been undertaken, it does not make any sense to me that a direction is not being given for the work to be done. The Department of Health will probably need the assistance of the Department of Housing, Planning and Local Government to do that, but we should look at this solution and actually do it.
I wish to elicit information from the HSE on occupational therapy reports. What is the average turnaround time to process a needs assessment or an occupational therapy report? Again, to avail of a housing adaptation grant, that is required. The occupational therapist needs to go into a house to see what is needed to allow Mr. Darragh O'Brien to be discharged from hospital and live independently. The position varies from county to county and also from area to area in a local authority. If we want to do some practical things, without the need for a conference or the relaunch of a programme, let us see what we can do on the ground. Does either Mr. Redmond or Ms Spillane believe we have sufficient occupational therapists in each area in an ageing Ireland to process all of the work required? Is there another way to do it? Could it be done privately and paid for by the Department or do we have to wait for HSE-appointed occupational therapists to complete the reports? I know that this is a major problem.
I was very glad when Mr. Tynan mentioned, on behalf of Mr. O'Mahony, that "downsizing" was not a bad word. It has become a bad word because of the hamfisted way in which housing for the elderly has been approached in some, but not all, instances, particularly when people are described as bed blockers which makes them feel bad about being in hospital or when the Government makes announcements that there are 900,000 more family homes than families which make elderly people or those in the seniors category feel that they should be getting out of the family home, the house for which they have paid. One of the reasons 89% of people want to remain in their own home is there are no alternatives. If there were alternatives and choices, people would look at the options. I speak for my own parents, seniors who have recently downsized. It was not a bad word for them. It has actually made a lot of sense for them.
Before I turn my attention to the contributions of the Departments of Health and Housing, Planning and Local Government, in its contribution the RIAI stated: "However there are no options for those who are above the financial thresholds to access social housing but who do not have sufficient means to support their older age accommodation needs".
That is blindingly clear to everyone. What would the representatives from the RIAI do to address that problem? Would they insist on it being provided for in development plans by local authorities?
Mixed unit developments are of importance. Where is it being done well? I have seen a couple of places where it has been done well. The apartments in those schemes have not been designated specifically for elderly people and I do not think that should be the case. There should be a mix of duplexes, semi-detached houses and apartments in open settings which allow people to see others. I am fortunate to know of such areas and the developments work very well. Having a community mix is also of great importance. What three things do the representatives from the RIAI think are doable relatively quickly?
I thank Ms Hurley for her statement. I am struck by the fact that the delivery of social housing and housing for the elderly is very important and may be the focus of the Department. There was discussion of a couple of semi-independent living schemes. On the housing mix in local authority or social housing estates, is the Department setting the mix to be used in new estates being delivered? I know of such estates in my area of Fingal. Is the Department stating 10% or 15% of units are to be set aside and that it will design them for life such that they can be used by young families, elderly people or those in the middle? What directions is it giving through the planning and possibly building control elements and also to approved housing bodies? I have seen a couple of magnificent schemes delivered by the St. Vincent de Paul housing trust. One such scheme in my town of Malahide, St. Benedict's, is being extended. Is the Department aware of the level of demand for the extra 16 units? There are hundreds of people looking for them. That puts the housing association and the local authority in a difficult position where they will have to make a Solomon's choice between persons who are desperate to access housing. What do the delegates think we should be delivering per annum and how does it compare to the actual targets set?
Ms Hurley mentioned the joint statement, which is important. Without giving us a sneak preview, what will it state? What is the Department's objective in real terms and will it be backed up by policy? I am sure a report will accompany the statement. Reports are welcome, but more important are the actions contained therein. I am jumping back and forth, but I will try to stay within the five minutes allocated to me.
In terms of the HSE's perspective, does the Department have statistics for the numbers of elderly people in inappropriate accommodation such as long-stay or other beds in hospitals because their homes are not appropriate for them or they are waiting for occupational therapy reports to receive housing adaptation grants? Does the Department track that information for each local authority such that it can identify what the council in, for example, Fingal or Roscommon is doing, what the turnaround time is and how it can be driven through? Like Deputy Fergus O'Dowd, it is welcome that €62 million has been made available, an increase of 11%, but what are we getting for it? Is the service improving?
Is there a local authority to which Ms Hurley would look in terms of best practice in the provision of private and public housing? Will Mr. Tynan and Mr. O'Mahoney also offer their views in that regard? There probably is not; there is not. Perhaps the delegates might identify the best of a bad bunch, without being unfair to anyone. I do not wish to be unfair and did not mean my last comment. Where is there a better focus on trying to deliver a proper housing mix?
The delegates have provided figures for increased densities in existing areas and making them into communities. There is a role for local and other politicians in that regard because if one tries to increase densities anywhere, there will be a furore among existing residents who will say it cannot happen because a lovely field would be lost or they like the car park or because of some other issue. It is about having a proper mix and people getting real.
Like every aspect of housing, these are ticking time bombs. I hate to say this two weeks in a row, but they are. We can, however, deal with this with proper planning and design. I would love to know if the Department is instructing local authorities for private developments. We have to be able to look for more mixed developments and more whole of life developments. Are we going to instruct the local authorities by way of planning guidelines for when they put together their local development plans and their planning bibles to say "this is what you must do"? The private sector will have a major role in this. The Department will not solve it by delivery of social housing. There are people who have already paid for their three or four bedroom family home who do not want to be there anymore. They will stay there, however, because there is nowhere else for them to go.
Ms Frances Spillane:
I will respond first to the Deputy's initial question on occupational therapists. There is unmet need for therapists in general in the health services. This applies to older people and also to services for children and adults with disabilities. In budget 2018 an additional €1 million was provided that will allow for the recruitment of an additional 40 occupational therapist posts.
The Deputy asked about how long it takes for an occupational therapy report for a housing adaptation grant. I do not know the answer to that. We will get that information from the HSE and we will write to the committee separately on that issue.
When Ms Spillane is doing that will she indicate if there is an acceptable turnaround time in general? Does the Department of Health set a bar? I am aware that when the Department is doing an occupational therapy report they are not all uniform as it depends on the size of the house, but does the Department set an acceptable time? Is it two weeks, four weeks or some other timeframe?
Ms Frances Spillane:
We will find that out too. The Deputy also asked about older people in inappropriate accommodation. This is not really something the Department of Health and the HSE would have detailed statistics on-----
My point is that the Department would know how many people from hospitals. Those statistics are available from time to time. Does the Department know how many people are still there because their house has not been adapted or because they do not have a proper setting to go to?
Mr. Niall Redmond:
That category of people generally is called "delayed discharge". They have finished their acute phase of care in the hospital and are discharged but, for various reasons, they cannot leave immediately. One of the reasons is housing adaptation. The HSE looks at the figures for delayed discharges on a weekly basis. At the beginning of the year there were six people in acute hospitals waiting for discharge where housing adaptation was required.
Mr. Niall Redmond:
Yes, just six people. In a snapshot of that at the beginning of February it was seven people and at the end of March it was six. Every week it changes. I shall run through a breakdown by month for the committee; in January it was six people in the first week, two people the second week and three people the fourth week. It was then four, seven and seven-----
Mr. Niall Redmond:
With regard to delayed discharges, the biggest category we would typically see tends to be people who are going into and who have a need for residential nursing home care. This would be the biggest cohort of people who make up delayed discharges because they are waiting for a placement and going through the fair deal or home care packages application process. The number awaiting the housing adaption grant is generally quite small.
Ms Mary Hurley:
The Deputy asked about local authorities, if there were any star performers and what is the mix in the older piece. There are a number of local authorities who are ahead of others. One I will refer to is Limerick. Last year 81 homes were delivered in Lord Edward Street, which was a very large capital project. Reference was made to mixed developments and this project's mix is really excellent. It is not just about older people; there are one bed units, two bed units, families and older people. It is a really good development and I can organise a visit to the development for the committee at any time. It is a model. Dublin City Council has a range of schemes under way. This council is particularly good at delivering mixed developments. We have been doing some work with the Deputy's own local authority in Fingal, along with Age Friendly Ireland, which is particularly good. The Deputy also spoke about private housing.
Fingal has been working with the Construction Industry Federation, CIF, and with developers on best practice not just for social housing but for private housing which is a key element. There is work under way on that and I can get further information from Fingal. Age Friendly Ireland has been working with the 31 local authorities. There is a big body of work being done.
Ms Neary will talk about the projects, the approval process and how we endeavour to make sure that in local authority areas there is a mix of one and two-bedroom homes and homes for disabled persons too.
Ms Sarah Neary:
At a national level we have guidance for social and private housing, quality housing and sustainable communities which refers to having a good mix and providing for sheltered accommodation or housing with supports for the elderly and people with disabilities. We are not keen to set targets because we have the comprehensive information from the housing needs assessment. We take a more tailored approach to each local authority. There are different age mixes in local authorities and different types of accommodation required. We set the targets for developments in each local authority. Our stage 1 approval, the capital appraisal process, examines the specific needs, the different types of houses and age profiles and ensures that projects are coming on stream to address that mix. Before the formal approval stage we have a technical meeting and discuss general schemes, density, types of unit. It works on a case by case basis. Age Friendly Ireland is doing great work in Fingal in training and dealing with private sector and social housing.
The capital assistance scheme, CAS, is a unique funding mechanism for sheltered housing or housing with supports. We encourage that and work constantly with local authorities to bring it forward through approved housing bodies, AHBs. We also encourage the use of existing units in towns and villages for social housing through the repair and leasing schemes and the buy and renew scheme.
On the private housing side the national planning framework has set the overall agenda, on the basis that our population is ageing and it has tailored the vision for that which will be translated to each local authority through the development plans, and that will cater for the range required in each local authority. Each local authority also has to produce a housing strategy which finds the needs in the area. That affects planning permission------
Several of the development plans have been made for 2017-22 and they do not have to have regard to the national planning framework. Does the Department oversee what is being done with proposed and granted development to make sure there is a mix? Has a circular been issued recently on this?
Ms Sarah Neary:
The new planning guidelines are the most significant element to have increased the number of one and two-bed units in any particular apartment block. The number of one-bed or studio-type apartments has gone up to 50% which represents our changing demographic. There is no target required for three or four bedroom apartment types. It is geared to the one and two bedrooms.
Ms Sarah Neary:
That applies to the apartment block. It applies immediately and we are already seeing it come on line because it is more affordable too.
This is a good thing in terms of this debate about downsizing. It provides choice for people.
The other aspect, and Ms Hurley mentioned it in regard to the urban renewal side, is that we now have vacant housing officers in the local authority with vacant housing plans. They are doing surveys on who owns the units and on how we can bring them back into use. These are ideal for the step-down situation, or where people want to move, but within their community. In regard to the statistic of 89%, I believe that is more about staying in a community rather than in the specific accommodation people are in at the moment.
We are doing work on guidance in terms of making it as efficient and as economical as possible to bring forward those vacant existing units. We hope to see more of those units will be brought back into use, which will be particularly good for the demographic we are talking about at the moment.
Mr. John O'Mahony:
The whole idea about not having a big sign saying, "I am an old person living here", is very interesting. That whole point about mixed community is really critical. I refer to one of the areas we have been looking at, particularly since apartments are moving outside the range of affordability. The studies of the Society of Chartered Surveyors Ireland, SCSI, and of Department have shown that it is proving very difficult to try to bring traditional apartments - core, served apartments - down to a level where they fall within the affordability range so we have been looking at is other models. When one looks at density, currently there are densities that are as low as 20 to 25 per hectare, the old traditional eight to ten to the acre jobs. Then one has the 150, the typical apartment. What we have been working on is a model that bridges that and Ms Neary referred to this a few times and is aware of this.
What we have been doing is building up models of walk-up apartments which are three or four storeys high that effectively treble the traditional density; that provide one and two bed apartments and surface car parking; that minimise the amount of service and maintained elements that one needs; and that minimises the amount of managed space so all the while trying to keep it as efficient, as easy and as economical to build as is possible. We have been pricing those models and we find that they fall right into the affordability level.
There is very good scheme, which was carried out in 2004 and which would need adapted. To me it was the perfect model of how one uses public land and private developers to deliver an affordable model of housing. It was carried out in Ballyfermot on Dublin City Council land. There was a competition, the rules of which were: to provide affordable housing at the same cost as traditional housing and apartments, with no underground parking and surface parking only; to use modern methods of construction; to be built as quickly as possible; to cover as wide a need as possible; to be sold within the community at a fixed price which would be less than the market; that there would be a clawback; that no developers or investors would be allowed to buy into the scheme; and that the developer would build it and give back 30% as social housing. One effectively had 30% social housing, and the balance was affordable housing. This model worked and 375 units were completed. The density was close to 95 per hectare. It was sold out, although there was a high demand at the time. The developer made a profit, the council got its housing back in return, and it was an exceptionally successful scheme.
We are again seeing that as a model for a public private partnerships, PPP, delivery system. Unfortunately, what we find is that local authorities are really well-intentioned but delivery is highly bureaucratic and even housing architects in our local authorities are tearing their hair out because the delivery programmes are so slow. We could mix and develop both, bring in the efficiencies of the private sector and deliver on the public sector land bank. It would not have to be sold on either in that it could be leased on. Why give it up if one can come up with a leasing model that allows one to get a long-term value back on one's land while delivering affordable housing?
We have asked for the system we are currently looking at to be priced. We are doing this with one of the large contracting companies. The idea we are trying to fix is that one of these properties can be built for the same price as a domestic house. It works. We have got the prices back. We are looking to develop that. We are looking at models like new suburbs with no traditional housing that start with the intermediate model of housing before going to the higher densities. Given that we have 900,000 family houses, as has been mentioned, why should we be building more?
One of the difficulties we have is in convincing the private market to stop building houses. It is easy for financial institutions to provide short-term funding for developments that are sold in phases because they get their money back quickly, and Bob's your uncle. The problem is how to convince them that there is a market for other types of property. It is starting to happen. I know of a developer who was building duplexes as an add-on because he had to achieve a certain density. In order to get up to the minimum density, he threw in a few duplexes. The duplexes walked out the door so quickly that his mind was changed. It is a case of changing attitudes. One bedroom and two bedroom properties satisfy both markets. They satisfy first-time house buyers and they also satisfy the independent living requirements.
I want to make the point that this is about places as well as homes. We have spoken about how towns, villages and suburbs can be adapted. Suburbs need to be densified. Local authorities have to identify where that densification will take place. Now that we have the 2040 framework plan, the next thing is to look at where we densify and how we achieve densification. It is like a softening-up process. People are going to have to accept densification. It is a question of where it is going to happen. Local authorities can start looking at that now. They can start the process of convincing local populations of what those changes are going to have to be.
I would like to explain the idea behind the urban design toolkit that is being developed by the Royal Institute of the Architects of Ireland. The toolkit will be offered as an award within the Tidy Towns competition to a town that wants to participate. Architects will engage with particular villages and towns that will be selected to develop plans for how to improve the public realm by adapting it for older people, etc. The aim of this approach is to start to convince people that design is not just about the house one lives in - it is also about the place one lives in. That toolkit is going to be available to everybody. It will probably be available this summer.
I thank the witnesses. It strikes me that we have not mentioned An Bord Pleanála in all of this. It will be a major influence over what we deliver and where it is delivered. The planning guidelines are crucially important, particularly where they can be legally strengthened by way of directives. Mr. O'Mahony made a point about duplexes, apartments and mixed developments. They absolutely work. Such developments ensure questions are not asked about what we are building for seniors and young families. If they are done properly, communities are built. I would love to know how An Bord Pleanála will adhere to the guidelines. I have seen some decisions of the board that make sense and follow the guidelines. Those who propose developments of more than 100 units will go straight to An Bord Pleanála. I do not know what interaction, if any, the Department has had with the board at a policy level regarding the specific question of mixed development.
I hate to be in any way critical, but I have to say, as a follow-up to the point made by Deputy O'Brien, that there has been no proper joined-up thinking between An Bord Pleanála and the Department. While there is good work going on in the Department to identify ways and means of helping elderly people to stay in their homes, I have to say frankly that it is nothing like what it should be.
It falls far short of where we should be as a first world society in terms of providing housing for the elderly. Unfortunately, I cannot spend much time on the issue because I have another commitment. I would like to have the time to drill down into the failure of the Department to a large extent in this area.
As regards housing adaptation grants and housing aid for older people, when is the last time the criteria and guidelines were updated for either of those schemes?
I have several questions which I have waited an hour and a half to ask, so, with the permission of the Chair, I will continue.
Does Ms Hurley think it acceptable that the Department has not carried out a forensic analysis and update of the scheme in view of how the demographics of society have changed? The qualifying age was changed in 2013. Prior to that, when was the scheme last updated, changed, improved or looked at?
Ms Mary Hurley:
We consider our schemes on an annual basis. The largest review was in 2013. There was consultation in that regard and various tweaks were made to the scheme in terms of the types of product and adaptations that were eligible. The most significant change involved the change of the qualifying age from 60 to 65.
Ms Hurley should not get me wrong - I acknowledge that thousands of people around the country have correctly benefited from the scheme. Deputy O'Dowd raised the issue of local authorities providing 20% of funding for the scheme. However, that a local authority has incurred debt as a result of purchasing land that is probably still lying vacant is not a reason for people in need of the scheme to suffer. There must be some wriggle room. Although I buy into the local contribution, it is not good enough that citizens suffer as a result.
Furthermore, the scheme is being abused. It should be far more uniform. Local authorities that are not drawing down and spending their allocation should be asked to justify that. It should be properly audited and transparent and published.
The scheme is being abused by some members of the public. I know of several applications to the scheme involving elderly persons who are on the verge of passing away or going into a nursing home. I mean no disrespect to them. Their families draw down money from the scheme and upgrade the property, thus increasing its value. The elderly person then goes into a nursing home and we discover that the property is rented out. In other cases, sadly, the person passes away and the taxpayer has pumped €20,000 or €30,000 into a property and upped its value. The person has died and there is no recourse. I gave the Minister a position paper 12 months ago to which I have received no reply, wherein I stated that there should be some sort of safeguard on a 60-month basis whereby if a person passes away within a year of benefiting from the scheme there would be a clawback of 50% of the moneys allocated under the scheme if the property is sold or rented. That would reduce to 40% in year 2 and continue to reduce annually such that after five years there would be no liability. More people would benefit if there were safeguards in place to ensure that those who should not benefit from the scheme do not do so inadvertently.
It annoys me more that the Department accepts the word of local authorities in respect of the scheme. As I understand it, a person applies to the scheme and an inspector or engineer then visits the property.
He or she inspects the work, says what needs to be done and then allocates the jobs. They go into a queuing system and the work is done. Possibly the same inspector or an engineer comes out to inspect the work and says, "Yes, it has been done." Does the Department at any stage cross-reference or perhaps take a sample of 5% of the grants allocated? Do its officials go to see if the work has actually been done in an appropriate way, from its perspective?
I will try not to go over the same questions that have been asked.
I look forward to reading the long-term policy report that is due out in the summer. Realistically, in the intervening period all we have for older people is the housing adaptation grant or some funding from the Sustainable Energy Authority of Ireland, SEAI. Does the €66 million come from the Department or from the Department and local authorities?
Sometimes there is a need for flexibility in the schemes. I refer to a specific SEAI scheme. An elderly couple in their 80s have come to my office on a nearly monthly basis to see if there are upgrades available. As they live in a terraced house, they do not qualify for the wraparound insulation scheme, even though they should. There is no flexibility in any scheme to allow this to happen. Many older people do not even know that there are housing assistance grants for older people available. I do not know how we get to the people who need these grants and are not aware that they are available to them.
Reference was made last week to universal design. The potential cost of having a universal design for a new build is an additional 3%. What element of Part M would the delegates change in the building regulations? I am aware that it is very trendy to have wetrooms and that everybody is putting them in. We must all have a walk-in, if not a drive-in, shower, yet they are the very things older people need. Is it fair to say we should incorporate this feature into Part M of the building regulations?
A statement was made that 85% of us wanted to stay at home when we were older. I can understand that. Deputy Darragh O'Brien made the point well when he said it was because there was no alternative for us. The only option is to stay at home. People also want to live in communities. If we were to provide the right community and the right facilities within it, people might be willing to downsize or move out. They would not see it as a negative. In County Wicklow in the 1980s we looked at this matter more than we do now. Carnew Community Care centre provides 28 homes with independent living. There is also a day care centre attached to the facility. Crinion Park was built in Wicklow town beside the old health board building. Back then we were planning for older people better than we do now. People living in these areas want to move into such facilities when they see how well they actually work. They do not see a move into them as a negative. We could do more in that regard.
I might come back in to make one or two more points later.
I thank the Chairman. I do not mind waiting until the end because the discussion has been very interesting.
I appreciate that part of Ms Hurley and Ms Spillane's job is to present the best possible picture of what their Departments are doing. I am also aware that they are extremely limited by resources. The reality, however, for many older people in almost all of our constituencies is very different from what the delegates have presented. Part of the problem is - a little like the position in the provision of accommodation for Travellers and people with disabilities - that older people are left as a peripheral element of the discussion. The fact that two years into the term of the committee we are only having these dedicated discussions thanks to the Chairman's initiative shows that, as a committee, we are as guilty of not fully integrating the issue into the overall discussion on housing policy as the local authorities and the Departments.
The fact that Focus Ireland had to launch a campaign last week highlighting a 40% increase in older persons' homelessness proves that point. Probably more shocking than the 40% increase is that we are only talking about 119 people. The idea that we cannot find housing solutions quickly for those 119 people is probably more of a scandal than the fact that it has increased by 40%.
The Chair's proposal that we have these hearings and prepare this report is timely. As social and private housing delivery ramps up, albeit not as fast as I would like but at least it is moving in the right direction, now is the time for us to put in some more substantive solutions and get it right to ensure we are not here in a decade's time or more having the same conversations.
I direct my questions, first, to Ms Frances Spillane of the Department of Health. Will she elaborate on the funding for home care teams both in terms of total allocation of funding and funding versus the demand? We all know there are very significant demands that are not being met. Does she have figures for the number of delayed discharges that are a result of the lack of sufficient home care packages? Those figures would be interesting. Will she indicate, from the HSE and the Department of Health's budget, cost comparisons between nursing home settings versus supported housing? I presume supported housing, in terms of year costs, are significantly cheaper. If she has figures on that, I would appreciate them.
I am not convinced there is very much co-ordination at local authority, HSE and community care regional level in the way we manage the bricks and mortar element, the community element that the local authority does, and the care packages and support for independent living for older people. Are there protocols in place.? How do we ensure at a departmental level that whatever the policy is at the macro level, it is feeding down to the practice on the ground?
Moving on to the officials from the Department of Housing, Planning and Local Government, I do not want to go too much into the adaptation grants because in some senses part of the Chair's report will be about much bigger items than that. The amount of €60 million odd is nowhere close to the demand that exists. In my local authority, and we are not unique in this, one can have to wait for a year to be processed and for two to three years for the adaptations to be put in place. Those are for cases where is a clear and evident medical need for the adaptations. The process is far too cumbersome. On the eligibility criteria, the hiking of the age up to 65 is unjustifiable. I know that is a political decision, not a departmental one, but that urgently needs to be reviewed.
The occupational therapists' reports highlight a remarkable situation. For example, in the South Dublin County Council area where I live, half of the county council is in HSE area 6 and the other half is in HSE area 7. In HSE area 6, the HSE covers the cost of the occupational therapist's reports for council tenants. In HSE area 7, the HSE does not have the staff and has not had for many years. The cost used to be covered by the local authority and it is now covered by the council tenant. We have a bizarre situation where, depending on which side of the Naas Road a person lives, he or she either has to pay for it himself or herself and is never reimbursed if that person is a council tenant or the HSE provides for it. To what extent is that lack of consistency prevalent throughout the country? That is not only an academic matter. I know of cases where people with significant adaptation needs, including older people but also people looking for the disability adaptation grants, have had their application delayed for a year or more because they have not been able to scrape together the money to cover the cost of the occupational therapist's report. In all of those cases, there is a need, notwithstanding the comments of my Seanad colleague before he left, to review the scheme again and, in light of increased fiscal space in the budget for next year, to revisit some of these issues.
A pertinent point was made by some of the older persons' advocacy organisations last week about the scheme, which point I believe needs to be mentioned, namely, that a person applies for it at the point of crisis. Somebody has a crisis, urgently needs adaptations and only then gets into the system. I appreciate that is because there was limited funding, but we need to move to a position where there must be some mechanism for trying to future plan to a greater extent and ask if something else can be put in place. Rather than waiting until someone has gone for an operation and they are discharged needing significant mobility adaptions for which they have to wait a year, two years or three years, something could be put in place for that person in advance.
On the bigger ticket items, I have a concern that local authorities in their social housing construction pipeline are not paying adequate regard to the need for a supply of accommodation for older people. I do not believe the Department should set targets but it should expect the local authorities to demonstrate clearly that they have that planned not just with respect to individual projects but also their overall social housing construction pipeline. If that is happening, the officials might give us more information about that.
When I sat on a council, however, and it is a council that has a better record than some, it was never part of our discussions on the social housing programme at that stage, so that needs to be examined.
On underprovision of units for singles, to what extent in the social housing construction pipeline are local authorities being asked to come forward and demonstrate provision for singles? One third of the South Dublin County Council waiting list is for singles but there is no corresponding one third of the units in the social housing construction pipeline for singles. When I refer to singles I mean units for single persons or a couple household that does not need a second bedroom. That is crucial.
"Downsizing" is not a bad word. I have a list as long as my two arms of council tenants who are desperate to downsize. They would love a bungalow in the housing estate in which they live or nearby, which would free up a three bedroom family home for a family on the housing waiting list or in emergency accommodation, but they are just not available. I am aware that some dormer bungalows are beginning to be included in the social housing construction pipeline but it is nowhere close to what is required.
Universal design is probably one of the big issues we will examine in the report. While we can fix the other problems in terms of the stock we have, if we are not more ambitious in the requirements for both the public and private sectors in the new housing that will be developed, we will not fix the problem in the long term. In terms of the Department, will the witness tell us what type of discussions are happening about mainstreaming universal design into planning guidelines? I am acutely aware that there will be a need, not just in terms of the county development plans but also given that there will be strategic housing developments, for central Government guidelines to ensure anything that goes straight to An Bord Pleanála is captured. Has the Department started discussing the potential cost implications? One of the people who made a presentation to the committee last week said that it could add approximately 3% to the overall construction price of the house. How can we manage that in a way that it does not prevent producing the right type of guidelines?
Then there are older renters. We are seeing an increasing number of people renting at a later stage in their lives. Part of the difficulty is that people might have an income that puts them over the threshold for the housing assistance payment, for example, and social housing eligibility, but they know that in five years they will be out of work and on a small occupational pension or the State pension and eligible for social housing. People can only join the list at that point and the list could be five to seven years for older persons' accommodation. Is there any attempt to look at that?
Will Mr. O'Mahony and Mr. Tynan give their thoughts on universal design? I am aware it is a spectrum and can be a range of things, but what would they like to see the committee highlight in the report it will produce in terms of the key game-changing policies the Government could introduce with regard to universal design? What would be in it? Should it be in the county development plan or in central Government guidelines? Do they have any thoughts on cost and cost implications? I was struck by Mr. Tynan's comments on housing typologies in private developments. Perhaps he could tell us a little more about those and how he thinks we can achieve them.
We hope to produce a report that will contain many recommendations. If there are a small number of recommendations the witnesses think we could make, what would be their top two or three? I would invite the Department's officials to give their top two or three but they might not be at liberty to tell us what they would like to see change in Government policy. However, they could send it anonymously to the Chairman by email or somehow at a later stage and we will be happy to see it.
Ms Mary Hurley:
I will respond to some of the housing adaptation and social housing issues the Deputy raised and Ms Neary will talk about universal design, what we have done to date in that regard in some of the social housing developments we have been involved with and also in terms of our engagement into the future.
With regard to the housing adaptation grants, we have seen a year-on-year increase of 1,000 grants. We are aware there is huge demand in local areas for these grants. This year the target is 10,000. We provided 9,000 last year. As regards the funding, in response to Deputy Casey, the €66 million includes the contribution from the local authority. That is the amount at present. As in previous years, where there is additional funding in the Department, we know this is an area of need so we will move the money over to that area. Local authorities are aware of that. That is the funding piece.
Regarding prioritisation of grants and meeting the needs of those who need the grants most, we are very flexible with local authorities. They have discretion in respect of particular cases that arise. The group last week raised a good point in terms of future-proofing and anticipating where people will need a grant in the future.
Obviously, we must prioritise those who need an adaptation, but there are certain circumstances where we know that a person will be going into hospital for a particular procedure and it makes sense to carry out the adaptation that will be required by him or her after discharge. We are very flexible with local authorities in these circumstances. They should be doing it, where possible.
Ms Mary Hurley:
I will come back to the Deputy, but it is a known procedure. I am not talking about years in advance but where we know that someone is going into hospital for a particular procedure and if he or she is working closely with the local authority, it has happened.
On the scheme and the issue of consistency, one of the reasons we undertook a review in 2017 was to streamline the scheme. We have issued guidelines on it and more streamlined, single forms will be issued shortly. We have worked with Inclusion Ireland on their design because we recognise that forms can be very difficult at the best of times but for people in their later years, they can be especially daunting. Work has been done on the forms and guidelines have been issued to the local authorities, which should improve the consistency of the scheme. We have told the local authorities that there is scope for discretion. There will often be special cases in local authority areas and it is a matter for local authorities to assess and deliver on them.
On the supply of accommodation, Ms Neary's team and the social housing team have technical meetings with each local authority on a quarterly basis. We sit down with the local authorities and "older people" is an item on our checklist. The aim is to ensure we get the right mix of accommodation. The Deputy is absolutely right that one bedroom and two-bedroom units are very important. We are encouraging and working with local authorities to move away from the standard three-bedroom unit. We need more one-bedroom units. Extensive work is being done in that regard. We are also telling the local authorities that where the opportunity arises to acquire particular types of unit under the capital assistance scheme, they should proceed to take it. Last year under the scheme 10% of units purchased went to older people. The units were spread throughout the community. Therefore, work is being done on that issue.
Ms Mary Hurley:
I do not have the percentage. I have sight of 400 units that are being advanced that will be for older persons. I can come back to the Deputy with the information sought. I will also come back to him with information on a range of projects that are being advanced. We have spoken a little about land in the context of mixed developments, including the O'Devaney project and various projects in south Dublin.
Ms Mary Hurley:
We will see a mix of units in those projects. We are working with the local authorities to achieve the required mix, which is very important. We will obviously be taking a range of social housing in those projects in order that they will be good mixed developments.
I will ask Ms Neary to speak about universal design. She has been leading the work being done in that area and working closely with the local authorities on it.
Ms Sarah Neary:
I will read the definition of universal design first in order that we are clear on what it means. It is defined in the Disability Act as:
the design and composition of an environment so that it may be accessed, understood and used—(i) to the greatest practicable extent,
(ii) in the most independent and natural manner possible,
(iii) in the widest possible range of situations, and
(iv) without the need for adaptation, modification, assistive devices or specialised solutions,by persons of any age or size or having any particular physical, sensory, mental health or intellectual ability or disability.
There is no doubt that to apply the concept of universal design and capture every single piece or part of the built environment is a huge ambition or vision and that it will cost money. In providing for older people, rather than talking about a bespoke or very different unit, we are talking about slightly smaller units, including apartments. We are talking about one or two-bedroom units or about two-bedroom units for three people, rather than two-bedroom units for four people, for example. The units do not look very different from standard units. They are not accommodating every type of physical, sensory or mental disability, but they are certainly very suitable for older people.
It is a question of community and wraparound supports. There are over 400 units, many of which have already been built. It is about examining different aspects of universal design but perhaps not to the full extent of the definition. It is about considering urban renewal and some units being lifetime adaptable using assistive technology. There are such elements in the case studies. It is not a matter of one size fits all.
The National Disability Authority, under the national disability inclusion strategy 2017 to 2021, has been assigned the task of considering universal design solutions for new houses and will make an impact assessment. We are watching it and the timeframe for it is quarter 2 of 2018.
Will the Department apply the concept of universal design only to a certain percentage of dwellings because it covers a wide spectrum of things that could be built into the design of a property? Could there be elements of universal design in an increasing number of dwellings, with a percentage having an even higher level of universal design? The two are not mutually incompatible.
Ms Sarah Neary:
The study will, we hope, reach the point of what is practical, economical and efficient in implementing part of, or the full suite, for a certain amount. That is where the research is going. Part M is the first step and there are features embedded in it that embrace the principles of universal design. We work very closely with the Centre for Excellence in Universal Design, CEUD, and the 'Smart Ageing' competition that we ran last year was based on the principles of universal design. Rather than be absolute in meeting the definition, we have always supported the principles and tried to incorporate them as much as possible. In respect of Part M, we refer to accessible approaches to dwellings, level thresholds, having a WC downstairs, suitable door and corridor widths. These are suitable for everybody, regardless of age, as a base level for housing.
Mr. John O'Mahony:
Part M and the disabilities access certificates go a long way. Within the private sector housing developers want to identify the widest market possible. Nowadays wetrooms, low profile and accessible showers are becoming almost standard elements of the interior design of apartments. There is also wheelchair accessibility. There has been a huge improvement. Retrofitting is the area that really needs investment, when we consider the number of houses that are not adaptable. That is why the Abhaile project which won the award last year was very interesting. It was predicated on the simple idea that a typical three-bedroom semi-detached house, that one could walk around blindfold in most parts of the country, could be adapted to two units which could create an income for an older person whose only asset was their home. It allows for an element of community because there is contact with the other person in the house, produces an income and allows for adapting access to the house. The cost is €50,000. Grant-aiding that work would be of huge benefit.
If a person is on a limited income even €50,000 it is going to be tricky. Perhaps a way could be identified of grant aiding that element of it. When the €14,000 tax-free income that is allowed for renting a room is taken into account, suddenly it starts to look like a very attractive option. That also helps to increase the density in our suburbs in a very simple way. Mr. Tynan will refer to exemplars, and I keep going back to the big picture. We have been warned now and we know it is coming. We know that by 2050, Ireland could have a population of 6.5 million people, 25% of whom will be a huge demographic of 65 year olds.
When we as architects identify density, it is units per hectare. This is a blunt instrument because units per hectare does not mean anything, it does not look at the demographic and it does not define the real housing need. With private development especially, we have to start forcing the issue that it is not suitable just to provide family houses in a development. It may not suit the demographic. Developers must do demographic studies. We do this for retail and other elements when we apply for planning permissions. We should look carefully at who we are building for and if it satisfies the demographic in the area. Is a suburb with predominantly three and four bedroom apartments a sustainable way of developing housing? It probably is not. The issue can be forced and the densities can be forced to increase so that appropriate housing can be provided that is more suited to starter homes and older people as well as families. This leads to the issue of family-sized apartments. The solution lies in higher density development. The vision, the look, the scale and the size are going to be completely different. As architects we can demonstrate this and show what it is going to be like. In some respects it can be very advantageous and a much more well-adapted suburb with better and more high-use facilities. It can keep the population close.
Mr. John O'Mahony:
Yes. I believe that one should be able to prove that what is being delivered is appropriate. This will probably meet with a lot of resistance, but in the long run it is the only way. If we can manage to stop the spread of our cities into our rural areas by saying "no more", it forces the issue into the densification within that ring. It means new solutions and different typologies.
Ms Frances Spillane:
Deputy Ó Broin asked about funding for home care schemes. The total HSE home care budget in 2018 is €408 million. This includes an increase of €18 million in this allocation. There is, however, unmet need in the area of home care, especially in home care for people who are still living in their own homes. The Department recognises that there is a policy vacuum in the area of home care, particularly when compared with the nursing home care scheme. We are actively working on a plan for a new statutory home care scheme and also for the regulation of home care. The funding available is an administrative scheme. Last autumn both of the Ministers launched a consultation process on the new home care scheme. We received 2,600 submissions in response to a discussion paper. We will publish the results of that consultation in May. This will help us in formulating proposals and so on.
The Deputy also asked about the cost of nursing home care compared with the cost of supported housing. The average cost of nursing home care is about €1,100 per week.
Mr. Niall Redmond:
On supported housing, Age Friendly Ireland did a piece of work looking at the Great Northern Haven example in Dundalk. It came up with an operation per week figure of €459. That may differ across different types of models and different set-ups but the main story is that it would be considerably less cost than nursing home care.
Ms Frances Spillane:
With regard to the arrangements for the occupational therapist assessments needed for the housing adaptation grants, I will get that information from the HSE when writing to the HSE about the other query. I will hand over to Mr. Redmond on the question around delayed discharges.
Mr. Niall Redmond:
We keep a close eye on the weekly reporting of delayed discharges. I do not have a figure but we can get it for the committee without any difficulty. Obviously, it can change quite considerably from week to week. The last figure I have in my mind dates from 16 March, which was the tail end of winter, so it would have been particularly high. The figure for people who are destined to go home and who are waiting for home supports was about 136 at that point.
Mr. Niall Redmond:
Not on an individual basis. We measure in terms of bed days, with three categories of 30, 60 and 90 days. This would not be specific to people who are waiting to go home. It relates more generally to delayed discharges. Delayed discharges as a whole category probably average around the 550 mark. This is a mix of long-term residential care, rehabilitation, home care and the small number of people awaiting housing adaptation.
Deputy Casey referred to the more than 90% of people who would prefer to stay in their homes. If there were more options, these people would look at the other alternatives. The Department has a piece of work that was done under the healthy and positive ageing initiative as part of the national positive ageing strategy. This research has not been published yet and is due to be finalised in the next while. It will be published later this year. I can give the committee a snapshot as it homes in on what has been said here. The study looked at 10,500 adults aged over 55 and their attitudes to future housing options. A total of 30% of people in the study said they were positive about moving towards an adapted housing type such as housing with care style models. This builds on the points made here and shows the evidence base for this type of development. It is an interesting statistic.
Mr. Derek Tynan:
I wish to comment very briefly on the suggestion of putting certain standards into development plans. As a practice that now does more student accommodation than we would like to and which does not do the 40% of social housing that was our business back in 2008 and 2009, we are well aware of the requirements under the variation of the development plan to quantify the percentage of student accommodation in any particular area. That is part of a planning application and it is very easy to put that in place. Likewise, one could have the regulation where it is stated that the developer must advance the issue of housing for older people.
As Mr. O'Mahony has said, it is an issue of demographic change. This is true for smaller units, be it for general mainstream housing or housing for older people. This is where the challenge is. Whether this is for 100 units per hectare, which I would call the "missing middle" where we would have to increase that density, or for larger schemes, we have to look at the models and develop those. The Netherlands has been far better than the UK in this regard. I recently came across the Housing our Ageing Population Panel for Innovation, HAPPI, which the committee may have heard of. It is five or six years old and is a series of exemplars of Dutch, Swiss and German principles for smaller unit, higher density five and six storey accommodation. I believe this is where we need to be. The difficulty is that the bungalow model will not work as we go forward. We have to look at encouraging and incentivising people into larger-scale buildings that can accommodate their needs and which are adaptable, in response to the Part M regulations. In the majority of cases, what we are building now is suitable for people of reasonable mobility as distinct from people who need specialised care.
We now have three people left to ask questions. I am conscious that the witnesses have been sitting there for two and a half hours. Does any of them need a break or do they want to proceed? We can all get up and move around but the witnesses are a bit stuck. If any need to take a break for a couple of minutes-----
I want to follow up on Mr. John O'Mahony's and Mr. Derek Tynan's point about the Netherlands. I lived there for nine years. It strikes me, having lived there, that its methodology for densities is incredible. The problem here is cultural. We are used to older people living in their family homes and it is no longer smart living. It is inefficient in many senses. It is not efficient to adapt the house because it is three bedroom and maybe one person is living there. What communication mechanisms does the Department have in place? What the witnesses have identified here is clear, that we need to change the way we do business with regard to housing for older people in Ireland and housing in general. The models are there in other countries. What is the Department doing to inform older people of the options? The witnesses identified that if older people are provided with options, they may consider it. How will we do that cultural shift to help people to go into secure, proper, energy-efficient housing? If we do not communicate the message to older people, we will keep coming up against friction. The point is to help and empower older people to make good choices about housing.
How do we support families who support older people? This issue of housing for older people is not just about the Department of Housing, Planning and Local Government or the Department of Health but also the Department of Communications, Climate Action and Environment and Department of Transport, Tourism and Sport. In the Netherlands, when an area is being developed, the infrastructure, such as roads networks, is developed first and the housing often goes in afterwards. Here in Ireland, older people have reduced mobility when walking and have difficulties going to services and supermarkets. We have a real problem with overall support for older people. Housing is part of that but we have to give the older people the chance to live in their communities. We identified living in the community as important. To access services of libraries, supermarkets and community centres, they need to be able to get around, both inside and outside of their houses and to access services. How are we doing that? How are the Department of Housing, Planning and Local Government and Department of Health supporting people to live decent and fulfilled lives?
I was late coming in but I too want to agree with previous speakers. My concern relates to all the Departments. The lack of housing for elderly people is a massive issue. We speak here about all the funding that is meant to be there but it is not there. The grants to local authorities include housing aid for older people and adaptation grants. Grant money is given out at the beginning of the year. Many people apply and are disappointed because they get letters back to say that there is no funding there for the grant. One has to reapply the following year. One cannot leave one's file in and have it there as a priority. One is told that there is no funding and to apply again. That is unacceptable. I know people waiting for grants who have died. It is uncalled for, there is no joined-up thinking and I am concerned about it.
The other issue is the age change from 60 to 65 without local authorities knowing. That is massive. That six-year gap is crucial for an elderly person to get work done. The maximum grant, as the witnesses know, is €30,000. Those are all means-tested. When a grant is means-tested, all the income is taken into account. Therefore, the highest grant I have seen in my years as a councillor and now a Senator would be €16,000 to €17,000. I have never seen the maximum grant given out for any housing aid for the elderly or adaptation grant. One submits a figure and a builder will come back with a quote. There were four cases in my clinic yesterday where people had got the grant. They have been given maybe €14,000 but the builder had given a quote of €22,000. They are falling between the stools because they are not able to get the work done and they are losing the grant. Nobody is helping them. There is nowhere they can go. I have put in appeals.
I have another concern. I presume there is an occupational therapist in most local authorities, as there is in my own, who works through the local authority in a private capacity. Occupational therapists do not work for the local authority but are given a grant to assess a person's situation. There are many grants which the occupational therapist has not approved and many appeals have gone back in through the doctor. There are cases where the occupational therapist has said what is recommended and I have had a man or woman come back to me. I have said it is not good enough and to go to a doctor and that the doctor needs to appeal. I feel that I am in an appeal system the whole time. A doctor can seemingly overrule an occupational therapist, and rightly so. I am not saying anything bad about the occupational therapists as I am sure they are doing their jobs. They only give a certain amount then doctors come in. I put in appeal after appeal. People may need to go back to doctors and get another assessment from them and work with the occupational therapist. The situation is unacceptable and should be examined.
Quality of life is crucial for the elderly. I know through the HSE and the councils that it is important. I believe there is a system for stove installation in some local authorities. In the past year, the biggest number of queries I have had from the elderly relate to stoves. People find them safe if they have to go out for a message or such. Even with medicals - I am going in with doctors' letters - there is no money for stoves. Can the witnesses work together and put a system together for elderly people where there is a grant scheme for stoves? I am told that it goes back to local authorities which then say there is no money there.
It is a nightmare if one is looking for windows and doors for the elderly because there is no money. People are living longer but funding is not being provided for grants. That is a major problem. I want to talk about the HSE. The HSE would originally have worked through local authorities. When one gets a grant, whether for a chair for the shower or if one has an elderly person who is looking for a walking aid or such, one has to go back to the nurse or doctor. Years ago, with local authorities, the HSE had a massive say and the local authorities, with the HSE, would say that a particular lady needed a walking aid. The other day, I was trying to get a ball for a lady for her hand as she has arthritis. I have to go back to the nurse then to the doctor. These are simple things but there does not seem to be joined-up thinking. Can the witnesses work together to produce a system, whether for a stairlift, a chair for a shower, a walking aid, a ramp or rail? The timescale is not working. If the funding is gone at the beginning of the year, and one does not get in quickly, then one is left to the following year and has to reapply. There is even a system in the HSE which is letting elderly people down. Fair play to the nurses, they are doing a great job. I am not knocking anyone here. Maybe the HSE would work more with local authorities to see what could be done.
Recently, two or three elderly people came in to buy their house. Last year, a new tenant purchase scheme was given to local authorities but an income level of 50% must be met.
I know people who have retired. They are elderly and have lived in local authority houses all their lives but they do not qualify to buy them. These people have worked all their lives and have the money but because the 50% income level is not being met, they do not qualify to buy the local authority house. I do not mean to be critical but there must be joined-up thinking so the elderly can get the chance to buy their houses. I know there was meant to be a review of the tenant purchase scheme. The couples coming to me were devastated that they could not buy the house in which they had lived all their lives. Will the witnesses do something about that?
Overall there must be a full assessment of people in three bedroom or four bedroom houses that need to downsize. I can understand this is not for everybody but the choice should be given. Recently I dealt with one or two cases of people in local authority houses that have three bedrooms and they now want properties with one or two bedrooms. They are being told there is no money to buy them a house. We have people looking to downsize but there is no programme in place. Could such a system be put in place? There is a massive issue with awareness of how people qualify for the fair deal scheme. People ring my office and I try to help but there must be a programme in place so people can be aware of what they need to do to qualify for the fair deal scheme. This also applies to families seeking respite, as there is no respite. People are ringing hospitals and trying to get respite or cataracts removed. Ultimately, elderly people are being forgotten in certain areas. Respite is one area where people must wait for months. I have contacted the Health Service Executive and hospitals and people are in queues because there are no beds. This must be addressed.
Elderly people might have to wait for up to two and a half years for a cataract operation or even a hospital appointment. In my area of Carlow and Kilkenny, people have been waiting for over a year just for an appointment. These are not all elderly people but some of them are. We need to prioritise the elderly and get the HSE, local authorities and the Department together to form a system where everybody can work together. I am not being negative but I am dealing with these areas.
I know everybody is doing their best. Will different programmes be put in place for the rebuilding of houses for elderly people or the system for grant applications? Will there be a revision to the process of working through the HSE, the nurses and doctors in different areas when people need to access services? The staff are being put to the pin of their collar but there is not enough time for them. All of us are here today and it is important that everybody works together so there can be delivery. I know from dealing with the different Departments that everybody is doing their best. Funding is a massive issue and unless it is put in the right areas, the whole system will fall. There must be accountability, as I have said that it is a major issue too. We need to look at accountability in different areas.
I am delighted that the committee is doing this report collectively. I brought it to the committee but it has been endorsed as something we can do as a joint committee. It is not mine, rather it comes from everybody within this committee. It arose on the back of a weekly programme on Fridays that had a couple of irate panellists who said the Government had some cheek in asking them to give up their homes. We had to really take it on the chin because although it was not the aim, it came across that way. We cannot ask people to downsize or move unless there are options for them. We have a duty to provide solutions or options.
If I am being parochial, allow me to go back to social housing for all age groups and not just older people. There is a difference between "older" and "elderly". I am referring to older people who are absolutely not elderly but who might not need a home with three or four bedrooms. They might want to be in a village or community setting with supports that may be required now or in future. My local authority sold council houses through the tenant purchase scheme and we reinvested the money into all our social housing stock, retrofitting properties to bring them up to proper energy efficiency with the likes of insulation and new windows, doors, boilers and guttering systems. We brought them to a certain standard and in turn this meant we could turn over the properties more quickly if tenants moved to a different type of unit.
I know that is not happening in all local authorities but some local authorities such as Dún Laoghaire-Rathdown are very proactive in such matters. We must give recognition where it is due. I know Ms Sarah Neary has done much work with building standards and guidelines to bring us where we need to be now. There has been a massive deficit for nearly 20 years in this respect. All of a sudden we are trying to get these schemes up and running, having ignored them for decades. We must recognise that Ms Neary has done much work in the Department on this.
My fear about this process relates to cost. Deputy Ó Broin mentioned a figure of approximately 3% being bandied about last week. Do the architects see this as a factor? I am acutely aware that the construction industry is all the time trying to make it more affordable to build or to streamline, whether it is by eliminating lift shafts or parking, but not reducing the standards we now have. Is the 3% figure a barrier to us developing age-friendly and appropriate homes in mixed tenure developments? I know we are discussing Part M but the debate has even got down to saddle boards, handrails or handles and walk-in showers in houses or apartments. Is the 3% a prohibitive factor?
I am reluctant to use the word "incentivise" but how can we encourage applications for housing for older people? We have done it before in other sectors, whether we agree on it or not. Could there be initiatives such as tax incentives to encourage applications, especially in areas where we know there is a higher population of people over 65? There is one local authority in Dublin that would have a higher population than the other three. I do not want to be biased so I will not mention one over the other. Could we encourage applications so as to give people the choice of downsizing; this could lead to financial security or lessen the burden of cost in heating a larger dwelling while also facilitating family visits or other amenities?
Mr. O'Mahony mentioned planning requirements and possible resistance in this respect. I get excited when I hear such comments as it means there is something good in this that needs to be pushed. It might be difficult to deliver but sometimes the harder thing to do is the right thing. I will be led by the witness on whether a planning requirement is something we should push. Nothing is insurmountable and if there is a will, there is a way to deliver.
There was mention of particular sites for public private partnerships delivering schemes like this. I know of four sites with nothing on them right now but with plans somewhere in the ether. With those we could deliver public private partnerships at the level we need of mixed tenure. I would like some comments on that. Would it be a better mechanism for delivering housing for older people, whether in assisted or independent living, or merely within mixed tenure development? Would it be the best or fastest way of doing it? Is it a long-term solution or all of the above? Would the witnesses favour public private partnerships to deliver housing for older people rather than local authorities? They might not want to answer but I welcome their comments.
The witnesses might have examples of best practice in our European counterparts, although they may not have them here. Perhaps they could be sent to the committee so we can make informed policy decisions or refer to them when we put together the document. I know we have gone well over time and I am biased but I have found this really interesting for a long time. We can put together a lovely glossy document, and there are many in these Houses from all Departments, but there is no point in it sitting on a shelf. What key actions or recommendations can we put into development plans or national policy so as to encourage and deliver housing for older people across the country but in particular in population areas where it is needed? I am looking for the key actions.
Like many on this committee, I do not want a glossy document. I want a return for the time we are giving. Yes, it is 20 years away, but we have just lost 20 years in this area. I do not want to lose the next 20 years. The will is there - cross-party - to deliver housing for older people across the board. What key actions can we take and how can we implement them in order to get that return?
Mr. John O'Mahony:
I refer to the cost of universal access. If one can get it early enough and if it is defined clearly enough, then it should cost virtually nothing. The Part M elements that we already incorporate are the expensive ones, including simple things like the widths of doorways, accessibility and so on. When it is brought down to a much more defined and specific level, if the specification is there, it can be designed in early. Retrofitting is where the cost is. Unfortunately, it goes back to regulation. The developer works to what is specifically on the page, not maximum or minimum standards. If one wants to make change, sadly it involves forcing people to accept it. As we have said so many times, the cost of houses is not the cost of building. The cost of houses is the other 53%. There is a recent study by Housing Agency which looked at our costs against four other European countries of equivalent wealth, standard, etc. Our building costs are pretty well in line with those in France, Germany and the UK. In fact, we are cheaper than the UK. This is all about designing in early.
I refer to retrofitting. I am really interested in retrofitting because I went to the Netherlands and I saw this extraordinary retrofitting scheme, where they took a terrace of local authority houses built in the 1950s. In four days they completely retrofitted a house. I think it cost €80,000. A front wall, a back wall and a roof arrived and they were fixed within a day and a half. Then they went inside and they retrofitted the bathrooms and the kitchens and plugged in a whole new heating system in the back. They did it all in the space of four days. They asked all the tenants on the street whether they were going to buy into it. All of them did, except one who was left out of the scheme. It was paid back through a long-term rental system where the money was deducted from rent over a payback period of something like ten years. It was extraordinary. It was all very carefully designed and the retrofitting brought it up to the standards we are talking about, which is A2. It is just a thought; there are ways of doing it.
The question was asked as to whether public private partnerships, PPPs, were a good idea. I mentioned one. For some reason, there may have been a notion that the developer was being aggrandised, which is a political issue as opposed to a factual one. However, it delivered what it said on the tin. I think PPPs are the most efficient and effective way, assuming the rules are very clear and it is an open book, so if one is dealing with a developer, everything is on the table. The profit margins, all the costs and everything should be out in the open, so everybody can see very clearly what is happening. The difference is the traditional developer can deliver efficiencies that it is very difficult to do under a public tendering system.
In the example I mentioned, there was a competition which decided who one would go with. Having done that, it was possible to define all the elements of that PPP. I think it is a very good way of doing it. I am inclined to believe there has to be a better and more effective way of realising the value of land in the long term rather than giving it away just like that and taking the money. The family jewels should not be given away. If that can be squared, that is a very good idea.
Dublin City Council has advertised a number of PPPs over the years. The same land kept coming up and then nothing would happen. It seemed to founder on the basis of what the PPP format should be. Therefore, let us look at the effective, efficient ones and the ones that worked.
We were just saying among ourselves that the whole issue of housing the aged and health issues to do with the aged mean we probably need a Minister for the aged. If 25% of the population will be over 65, it is so complex and needs such tying together of all the issues, that it probably is deserving of a junior Ministry anyway.
Mr. Derek Tynan:
I refer to the question of land development and the PPP model. We have been involved in a couple of schemes where the payback to the local authority has been a certain number of turnkey units. In other words, if there is a piece of land for which there is a design and bid competition, that is developed by the developer and the payback to the local authority is a certain percentage of those units, whether directly to itself or to an approved housing body. That is a means of bringing the value of the land, which is there in the first place, back into the stock.
The Minister of State, Deputy Jim Daly, is our Minister of State with special responsibility for mental health and older people. He has offered to appear before the committee. The Department of Health is coming in. I know the Minister of State is working closely with the witnesses on this.
Mr. Derek Tynan:
I was just saying that if public land is made available under a PPP model, the payback to the local authority can be a certain percentage of turnkey units which it gets, whether as generalised social housing units or which may be given to an affordable housing body to manage as distinct from the local authority. There are models of doing that which are in existence and useful.
Ms Mary Hurley:
I will follow up on a few queries. Senator Grace O'Sullivan asked about the communication piece which is really important. In terms of our interaction with the local authority, the framework is set through things like the national planning framework, housing strategies, development plans, guidelines and building regulations. What will be important for people on the ground and citizens is the strategy and policy statement we will issue because that will set out the different issues around urban renewal, connected living and delivery in centres for older people. That will be an important communication tool.
In terms of the services that are offered, one of the things we always require local authorities to do is to have good information up on their websites. Through Citizen's Information, people are made aware of the various different grants. Hopefully, through that mechanism, people will be aware of what they are entitled to, or what is available to them. When we publish the older persons' policy statement, we would see ourselves doing a lot of work on communicating the different things that are available to people so that they know. It is important in terms of our work, the work of the Department of Health and the HSE that there is a joined up approach on the ground. People should hear about what is available through their GP and through the different health services they go through.
We have spoken a lot about the delivery and the type of mixed delivery that older people need and want. The approved housing bodies piece is important in terms of delivery and the type of homes that come through for older persons. We have seen some very successful schemes where approved housing bodies can give the supports that are required on the ground to those older people.
Senator Murnane O'Connor raised the issue of stoves. That is not something that is encompassed within our housing adaptation grant criteria and that we have funded in recent times. In the past they may have been funded, but it is not something that is encompassed at the moment.
Elderly people are looking for them. It has become a massive issue for elderly people and I am sure it will be noted by local authorities.
Climate change has resulted in colder weather. I urge the Department of Housing, Planning and Local Government to put a scheme in place to help local authorities to provide stoves for elderly people.
Ms Mary Hurley:
When the Senator was not present, we spoke about the things that were funded under the housing adaptation grants scheme. In certain instances, local authorities when carrying out inspections have discretion to decide whether to fund some heating element in a person's house. Stoves are not encompassed by the initiative, but there is a piece on heating. I will ask somebody in my Department to liaise with the Senator's local authority and discuss her suggestion.
Earlier a question was asked about whether the Department inspected the works carried out under the housing adaptation scheme. We work very closely with local authorities on works carried out. The Department receives clear documentation on the works carried out as part of various projects and invoices. The work is certified by local authorities. It is important to the Department that the works are certified, carried out appropriately and to the required standard.
The issue of public private partnerships and land has been raised. My colleague, Ms Neary, will say a couple of words on the matter as she has done some work on same. We are advancing a number of the ideas mentioned. I also ask Ms Neary to mention the costs associated with universal design.
On downsizing, we have mentioned that 89% of people want to continue living in their communities and that it is about providing a suite of other options. If there are other options available, it may very well suit people to live in supported accommodation where would they feel more safe and stable. We are working on various options for older people.
Ms Sarah Neary:
The national planning framework set the context for State land management and structures. The review of cost report contains a recommendation which calls for more active State land management.
On mixed tenure developments, we are very encouraging. We are working with local authorities on a number of such projects. We really like to have a mix of social, affordable and private housing. That is very much the principle of sustainable communities we have espoused for years. Projects at O'Devaney Gardens and Corkagh Park in south Dublin are being advanced. As Mr. O'Mahony outlined, the industry has responded very positively to the projects. The local infrastructure housing activation fund, LIHAF, is another area in which funding is being pumped into lands to facilitate greater housing delivery into the future, certainly at an affordable level.
I wish to address the two questions asked about An Bord Pleanála. Like any other planning authority, An Bord Pleanála abides by guidelines, rules and regulations. The local authorities zone land and set the context for development. An Bord Pleanála then applies the regulations and guidelines as a planning authority.
The work of the NPF will be advanced through the regional assemblies. In 2019 revisions to development plans will be required on foot of the spatial and economic regulations.
On the costs associated with universal design, the housing elements we incorporated into Part M are the least onerous. There are various levels which can be seen in some pilot projects such as the one in Cabra, from which we are learning. The National Disability Authority is carrying out research into universal design, the findings of which will inform what my Department might incorporate into Part M.
Ms Frances Spillane:
Senator Grace O'Sullivan asked the general question of how we support families of older people. I mentioned in my opening statement that approximately €300 million is provided to the HSE to provide community supports. A lot of that funding is given to voluntary organisations and is used for a variety of purposes in local towns throughout the country, including day centres, transport to day centres, meals on wheels and so on. I am talking about groups like Care of the Aged. There is also an interesting project involving dementia-friendly towns, in which this committee might be interested. I shall send that information to the Senator separately.
Ms Frances Spillane:
The Senator asked about specific actions. The project was funded by the State and Atlantic Philanthropies, and was seen to be very successful. My answer also responds to the point made by Senator Murnane O'Connor about State bodies in an area working collaboratively.
Senator Murnane O'Connor mentioned aids and appliances. The funding stream is provided through primary care in the HSE. She also mentioned accountability.
Ms Frances Spillane:
There are two different funding sources so both sides operate in parallel. In general, there is pretty good joint working between the health side and the local authorities.
The Senator may be familiar with the age-friendly cities and counties initiative. The committee may have met the people involved. The empowerment of older people is important as well. There are older people councils in many parts of the country at the moment. It means older people have a voice in decisions that are relevant to them in their communities. The Department of Health, in its own right and through the Healthy Ireland initiative, is very involved in many of these local initiatives.
Senator Murnane O'Connor mentioned publicity about the fair deal or nursing homes support scheme. Many quite strict rules attach to the scheme but it is well advertised. In view of the amount that the scheme costs it is inevitable that many stages must be gone through. It is a statutory scheme. There are strict criteria to do with care needs as well as a means test. My colleague, Mr. Redmond, may wish to comment.
Mr. Niall Redmond:
In terms of being part of the bigger picture, this is not just bricks and mortar but the community and agencies working together. The HSE, in partnership with the ALONE organisation, has conducted a pilot project for the past nine months in community healthcare organisation area 9 on support co-ordination. ALONE staff or volunteers deal with referrals from, for example, general practitioners, GPs, primary care teams and acute hospitals, and act as a point of contact for individuals who need to access various services. The pilot scheme has been very successful. The HSE has provided further funding to extend the scheme a bit further. Last December, the scheme won the HSE Excellence Award For Innovative Support Coordination for Older Persons and 300 projects were in the group. We must consider whether the scheme can be scaled up and brought to a national level. As many as 1,500 people availed of the project last year. The project gives an opportunity to co-ordinate the various services whether they are adaption grants, access to aids and appliances or whatever they might be and provides a focal, single point of contact for older people.
I thank the witnesses for sticking with us today because the meeting has run an hour over time. We are up against the clock as the Oireachtas Joint Committee on Education and Skills is due to meet in this room shortly. The witnesses will be in no doubt that the members have a huge interest in today's topic. If they have further examples or information that can benefit us policy-wise then we would appreciate if they forwarded them to us. They can recommend people that we should meet. We look forward to the ongoing engagement. I thank the witnesses for staying longer than intended and engaging with the committee, and, thanks, likewise to the members of the committee.
The next meeting of the joint committee will take place tomorrow, Wednesday, at 9.30 a.m. In the first session we will discuss the response to national emergencies with Irish Water. In the second session we will discuss the proposal of a Dublin to Shannon pipeline with Irish Water, Ervia and Ms Emma Kennedy.