John Crown (Independent)

I welcome the Minister of State. I have a major interest in health policy and hope to contribute to this debate through my membership of this House and, I hope, the health committee. I echo the calls made by some of my colleagues, and outside the House by Professor Des Fitzgerald, for a fundamental long-term strategic evaluation of how we will handle all the health and social issues which occur as a result of an ageing population. It must be remembered that in projecting forward over the years, we have often got it wrong, not because of any malfeasance or incompetence but because things change. I think of the major investment which was appropriately made at the time in fever hospitals, when we no longer have people requiring quarantine for fevers, or in large tuberculosis institutions which, thankfully, we no longer need.

There will be equally dramatic changes in the requirements for certain surgical and other procedures in the years to come as changes occur in medicine and in the delivery of health care. This will also apply to the whole question of ageing because, with current legislation in respect of retirement care, old folks homes and all the related procedures in the health system, there has been a presumption of enfeeblement. The presumption is that people in their 50s, 60s and early 70s will lose their good health and become more dependent. Obviously, this occurs as people age, but the change in our demographics and the change in our ratio of workers to pensioners is not only due to changes in the birth rate or longevity. What is happening is that we are arbitrarily taking a group of healthy people and enforcing retirement on them. There is a real need to change this.

I saw this need in the case of one of my esteemed colleagues, the professor of surgery in our institution until a few years ago. One day he was doing four or five breast cancer operations a week, perhaps being called into the hospital in the middle of the night to deal with emergency surgery and running an avid research programme, but suddenly, on his 65th birthday, he was deemed to be an old person who could no longer be an active contributor to our health system. I put this in contrast with a visit I made to the Dana-Farber Harvard Cancer Center last year where I had the great pleasure of temporarily occupying the office of a Nobel prize winner who had been the president of that institution and who had finally retired the month before. His office was made available to the Irish visitors to use as a base for making phone calls and checking e-mails etc. This man had retired from this institution, where he was still writing scientific papers, at the age of 89.

There are many people who will be enfeebled in their 40s, 50s, 60s and 70s who will need the safety net that the option for retirement, either on health or age grounds, will afford them. It is essential, however, if we are to consider how we can reconfigure pension payments for those who receive pensions and those who wish to retire versus those who wish to remain active, that, as part of the process of an older age policy, we readdress the question of mandatory retirement. I urge the Minister of State and the Leader to bring this matter to the attention of the Government because it is something that will require careful scrutiny in the years to come.