Máire Hoctor (Tipperary North, Fianna Fail)

The Government has adopted a practical approach in recent years to improving the lives of older people. Our growing aging population must be recognised and the figures used in 2001 do not compare to the current projected figures. Most of us would like to live as long as possible with services available to us. However, services must be provided for those who need them most and who cannot afford them. More than 95% of people aged 70 and over will retain the medical card, which is important. The Government has made a commitment in my appointment as Minister for State with responsibility for older people to look after our elderly and it is a priority for Government. The establishment of the Office of the Minister of State with responsibility for older people in recent months has led to unprecedented funding increases through the HSE. For example, the total funding provision this year to allow the HSE directly support a range of services for older people is in the region of €1.8 billion. More than €800 million of this is ear-marked for residential care services. Since 2006, in excess of €200 million new funding has been made available to develop or expand community-based services such as home care packages, home-helps, meals on wheels and day and respite care. Our aim has been to ensure that older people receive as much care as possible in their own homes; that high standards are set and enforced in all residential care settings; and that the cost of residential care is always affordable and not an anxiety.

The western world enjoys, as never before, the opportunity of aging. Through our social, scientific and economic progress, human life has been strengthened and prolonged. In ancient Greece, life expectancy at birth was 20 years of age. By the 1700s, life expectancy had only increased to 30 years of age. In 2008, just 300 years on, half of all baby girls being born in Ireland are expected to live to 100 years of age and beyond. Our longevity is something to be celebrated. The Government recognises this and is committed to supporting older people. This is reflected in the current social partnership agreement, Towards 2016.

In the agreement the Government and the social partners have adopted a life cycle perspective, placing the person as the centrepiece of social policy development. The vision for older people, as reinforced in Towards 2016, is to provide the support, where necessary, to enable older people to maintain their health and wellbeing, as well as to live active and full lives, in an independent way in their own homes and communities for as long as possible.

There are specific initiatives for older people in the partnership agreement, such as pensions and income supports; housing and accommodation; community and residential health care; mobility; and promoting education and employment opportunities. The high-level objectives of these initiatives, individually and in combination, are intended to make a real and significant improvement in the quality of life of older people.

A new nursing homes support scheme, in the fair deal legislation, is going through the Houses at present and was approved by Government and originally announced in December 2006. The Bill providing for the scheme was published on 9 October 2008 and is on Second Stage in the Dáil. The Minister intends to introduce the new scheme in 2009.

The fair deal legislation is designed to remove real financial hardship from many individuals and their families who, under the current system of nursing home subvention, have to sell or re-mortgage homes to pay for the cost of nursing home care. There will be one transparent system of support towards the cost of care that will be fair to all, irrespective of whether they are in public, private or voluntary nursing homes.

The scheme will equalise State support for public and private long-term care recipients. This will meet one of the objectives of Towards 2016, namely, that State support should be indifferent as to whether a person is in public or private care. At present, the State pays an average of 90% of the cost for people in public nursing homes. In contrast, the State only meets approximately 40% of the estimated average cost of care in a private nursing home and some people have to sell or mortgage their homes to meet their care costs. In some cases people receive no State support whatsoever. The scheme aims to render private long-term care affordable and anxiety-free, and ensure that no one has to sell their home during their lifetime to pay for their care.

The current standards for nursing homes are set out in the Nursing Home (Care and Welfare) Regulations 1993. The HSE inspects private nursing homes on the basis of these standards, but public homes are not inspected. The Health Act 2007 provides for the registration and inspection of all nursing homes, public, private and voluntary. It provides for future inspections to be carried out by the chief inspector of social services, part of the Health Information and Quality Authority, HIQA. The existing inspection and registration systems for residential services will be replaced by a strengthened and expanded system.

In 2007, the Minister for Health and Children published a new set of draft national quality standards for residential care settings for older people. The standards, when approved and underpinned by regulations, will replace those set out in the Nursing Homes (Care and Welfare) Regulations 1993. Importantly, the new standards will apply to all residential settings, public, private and voluntary, where older people are cared for and for which registration is required.

The draft standards are designed to ensure the protection of residents, to safeguard and promote their health, welfare and quality of life and to ensure that there is a focus on the well-being, dignity and autonomy of older people. As the Health Act 2007 provides that the enhanced inspection function will be taken over by HIQA, the draft standards were formally referred to the authority for consultation and finalisation. HIQA established a working group to finalise the draft standards which included public consultation.

Earlier this year, the HIQA board submitted its final draft national quality standards for residential care settings for older people to the Minister for Health and Children for her approval, as required under the Health Act 2007. Regulations will be introduced to underpin the standards and at the moment the Department is in the process of carrying out a regulatory impact analysis, RIA, on them. As part of this process, we commissioned an independent consultancy to carry out a cost-benefit analysis on the financial impact the standards will have in long-term residential settings. Consultation with stakeholders is also a part of this process and on Thursday, 23 October 2008, the Minister for Health and Children, Deputy Harney, and I hosted a consultation session on the draft standards. Many of the key stakeholders were present and it offered them an opportunity to feed into and inform the RIA before finalisation and to discuss the standards, their criteria and proposed regulations in advance of their introduction.

A comprehensive policy vision requires a comprehensive, cross-departmental approach to policy development and delivery. The establishment of the Office of the Minister of State with responsibility for Older People in January of this year will bring coherence to Government planning, policy and service delivery for older people. This office encompasses three Departments. As Minister of State with responsibility for older people, I also have responsibilities in the Department of Social and Family Affairs and in the Department of the Environment, Heritage and Local Government. I am also a member of the Cabinet committee on social inclusion which ensures that there is an integrated coherent approach to issues relating to older people across Government level. This approach is crucial to delivering the Government's vision of improved integration of services, and thereby further supporting older people in the future.

My office will also continue to develop health policy and will oversee and monitor the delivery of health and personal social services for older people, and the running of the long-stay charges scheme. It will, in short, be the focal point for the development of a more comprehensive policy on older people. The resources of my office, which is currently staffed by officials from the Department of Health and Children, will be strengthened shortly by the addition of the staff of the National Council on Ageing and Older People. These new staff will significantly add to the research and overall capacity of my office.

The voluntary sector in general will also make a positive and essential contribution to the development of policy on older people. This will be primarily through the establishment of a new national advisory council on older people. One of the main functions of this new advisory council will be to advise me, as Minister of State, on all aspects of the lives of older people. The council will also suggest ways of better co-ordination and delivery of services for this sector of society.

The establishment of the office, the inter-departmental network and the advisory council will bring a greater coherence to policy-making for older people. These significant new measures will allow for a much greater degree of cross-cutting and will further develop the partnership approach that has featured so strongly in the planning and development of services for older people in recent years.

Co-operation between Departments and agencies and relevant stakeholders is essential if the provision of services, supports and entitlements for carers is to be fully addressed. The area of carers is of particular interest to me as Minister of State with responsibility for older people. As Members are aware, we are developing a national carers strategy. An inter-departmental working group, chaired by the Department of the Taoiseach, was set up to progress the issue. The Departments of Finance, Enterprise, Trade and Employment and Health and Children, the Health Service Executive and FÁS are also represented in the group. The development of the strategy also involved a wide-ranging consultation process, including meetings with the social partners, the carer representative groups and a written public consultation process earlier this year. The strategy will focus on all informal and family carers in the community and not only those in receipt of a social welfare payment. It is hoped that the strategy will be finalised shortly.

Within the EU member states, Ireland stands out as having a relatively youthful population. While we are undoubtedly on the same demographic path as our EU counterparts, we are still some way behind. The latest statistics tell us that 11% of people living in Ireland are aged 65 years or over. It has been estimated that this figure will rise to 20% by 2036, and to 29% by 2056. Thus, an opportunity exists at present, while our nation is still young, for us to carefully plan ahead. This opportunity has been recognised by Government and manifests itself, in particular, in two key commitments, namely, the development of a strategy for positive aging and a future funding model for long-term care.

I am pleased that one of the key functions of my office is to develop a strategy for positive ageing. The new strategy will be developed on a cross-departmental basis. My goal is to ensure that this strategy is meaningful and innovative and that it will result in real improvements in the lives of older people. The strategy will involve, for example, the development of operational plans by Departments, clearly setting out objectives relating to older people, and joined up thinking on initiatives serving this community.

Other areas for consideration include ongoing mechanisms to monitor progress and to identify challenges. As I said, the policy vision outlined in Towards 2016 requires a comprehensive cross-departmental approach. It also requires sustained and sustainable levels of funding. The substantial funds allocated by the Government to services for older people in the last three years is a testament to its commitment to the principles outlined in Towards 2016. In 2006 and 2007 alone, more than €400 million was provided to enhance service developments throughout the sector, of which more than €165 million was for community based services. A further €25 million was provided in 2008 and funding levels for community services were maintained in the recent budget.

To underpin the objectives in Towards 2016, the needs of older people were specifically highlighted in the social inclusion element of the National Development Plan 2007-2013. Some €9.7 billion will be invested under the older people's programme, with €4.7 billion allocated to the living at home sub-programme and €5 billion to the residential care sub-programme. The Government is firmly committed to using the national development plan as a vehicle to translate policy into practice over the period of the plan.

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