Ivor Callely (Dublin North Central, Fianna Fail)

The significant progress that has been made in the growth of funding available for this sector in recent years, is indicative of the Government's commitment to the ongoing development of health-funded services for older people. One of the great achievements of western societies in the 20th century has been the increase in life expectancy. As the standard of living for the young and middle aged in this country has risen, so the quality of life of successive generations is improving. Modern medicine and, perhaps even more importantly, social policies, political will and community enterprise mean that more and more people are living longer and more fulfilling lives, and rightly so. The majority of older people are healthy and fit, and hold good positive attitudes.

Over 60 million people in the European Union are aged 60 or over. Figures from the Central Statistics Office collated from the results of the census, suggest that the average age of the population is increasing. Projections based on the 1996 census indicate that while in 1996 some 11.5% of the population were aged over 65 this figure will have more than doubled by 2031 so that the percentage of the population aged over 65 will be between 18% and 21%. The Government is aware of this trend and has addressed some of these issues in the health strategy entitled Quality and Fairness: a Health System for You.

The Government is committed to developing services for older people, both residential and community-based, to meet the needs of our growing older population. There are economic and financial consequences of people living longer and, more than ever before, members of each generation in their active years must accept a responsibility towards the support of the elderly so that, when they in turn grow old, younger people will support them.

The Government's commitment to the development of a comprehensive range of services for older people can clearly be demonstrated by outlining the resources made available in recent years for service developments. Additional revenue funding alone for the development of services for older people has increased significantly from €12.7 million in 1997 to an additional €111.4 million in 2003. In 2004, a total of €9.5 million in additional revenue funding was allocated to services for older people. This funding has been used for a variety of services including: the nursing home subvention scheme; the newly introduced personal care packages, in which I take great pride; the home help service; and the new elder abuse programme, which I also take great pride in because I pioneered it along with the personal care programme; and support to the various voluntary organisations.

Since 1993, there has been an unprecedented level of investment in the nursing home subvention scheme. Some €5 million was allocated for the scheme when it was introduced in 1993. Under my stewardship, total expenditure on the scheme in 2004 will be approximately €114 million. Last year we finished up with a figure of over €110 million.

In line with a Government decision, an expenditure review of the nursing home subvention scheme was undertaken by my Department in association with the Department of Finance. The review was carried out by Professor Eamon O'Shea. The objectives of the review were: to examine the objectives of the 1993 nursing home subvention scheme and the extent to which they remained valid; to assess the service delivered; and to establish what scope, if any, existed for achieving the programme objectives by other more efficient and effective means. Professor O'Shea's report, entitled Review of the Nursing Home Subvention Scheme, was launched in June 2003, simultaneously with the Mercer report, entitled Study on the Future Financing of Long-Term Care in Ireland, which was commissioned by the Department of Social and Family Affairs.

A working group, comprising all stakeholders, has been established by my Department to review the operation and administration of the nursing home subvention scheme, following publication of the O'Shea report. The purpose of the review is to develop a scheme which will: be transparent; offer a high standard of care for clients; provide equity within the system, to include standardised dependency and means testing; be less discretionary; provide both a home and nursing home subvention, depending on need; be consistent in implementation throughout the country and draw on experience of the operation of the old scheme. The review of the scheme will also need to be examined in the wider context of how we, as a society, will, in the future, fund long-term care. If anybody disagrees with this, they should please let me know.

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