Kathleen Lynch (Cork North Central, Labour)

I thank the Cathaoirleach and Senators for giving me an opportunity to make a statement on its report on the rights of older people.

We all acknowledge and indeed welcome the fact that society can only be enriched by the increasing number of older people in the coming years. This not only is a reflection of our shared values and aims but also represents the success of various policies and services developed in recent decades to extend life expectancy through improved health services and to advance the overall quality of life of older people. There is, I am sure, common agreement within this House and beyond that the challenges and opportunities presented by our changing demographics should be addressed in the best and most realistic way possible. The report is timely, therefore, and raises, rightly, important issues that will help inform debate and decisions in the future. Many of the questions raised in the report have been or are being pursued on various fronts, including through the programme for Government, for example. Other issues surfacing in the report will have to be considered with a view to their feasibility in the current climate.

The primary focus of Government policy in terms of health and personal social services is to support older people to live at home and in their communities for as long as possible. This is, after all, where most older people want to be and is realised throughout the country by a range of valuable and widely appreciated community-based services. These are designed to be as flexible as possible to best meet the needs of older people and their families. Alternatively, where home-based supports are not an option, for whatever reason, the State supports access to quality long-term residential care. We are also moving beyond the existing accepted spheres of care delivery towards enhanced transitional or intermediate care options. These not only are designed to deliver more appropriate care in a more integrated setting, but also are a new approach to alleviating pressures across the wider care system.

In tangible terms, the investment dedicated to services for older people is significant by any standard with, for example, slightly more than €1.4 billion being provided this year for the health sector alone, of which approximately €350 million is for home supports. These services are often delivered on a partnership basis with the not-for-profit and private sectors. Existing policies, services and Exchequer funding across the public domain therefore reflect to varying degrees at least some of the eight recommendations and themes contained in the report, balanced against the equity and rights we all should expect and enjoy as a society.

Such balance is key to the call for a new UN treaty on the rights of older people. This, as the report indicates, is being considered at UN level and by the EU where, it is fair to say, there seems to be little enthusiasm so far for such a proposal. This issue is obviously still at a very formative stage, with no guarantee that a treaty will materialise in the near future. There are, however, a number of interesting points raised in the report which I will consider in due course with the Government. These include the view that policies in the past tended to be more passive than active on older people, or the need for clarity surrounding how any new treaty might relate to other legal, policy or rights-based approaches.

On coming into office, the Government made a firm commitment in the programme for national recovery to introduce a mental capacity Bill in line with the UN Convention on the Rights of Persons with Disabilities. One of the remaining core elements to ratifying the UN convention is enactment of new mental capacity legislation. I do not wish to go over my time but I wish to say that it may not be called the mental capacity Bill, which is a harsh title. We will discuss assisted decision making in regard to mental capacity. Language is important. Work is ongoing to ensure alignment of the Bill with the convention, and the Government legislation programme indicates the Bill will be published in the current session. The mental capacity Bill will reform the law in respect of adults who lack some or all mental capacity to make important decisions for themselves and will provide a legal framework to support such persons in fully exercising their legal capacity. It will modernise the law on capacity - largely dating back to the 19th century - and will bring Irish capacity legislation into line with current thinking and modern international legislative frameworks.

Societal and demographic changes make the need for reform of the law on capacity more pressing. Changing family structures, for example, or the isolation of vulnerable persons generally, present challenges for both society, and existing law. Over time, as the population ages, more of us will require the assistance of others to support or intervene in decisions about our personal welfare, finance and property. In modernising the law on legal capacity, the Bill will address such needs while striking a balance between an enabling approach and protection. The main proposals in this regard are: to provide a statutory framework for supported decision making for persons lacking capacity and to abolish the wards of court system; to change existing law on capacity, shifting from the current "all-or-nothing" approach to a more flexible functional one where capacity is assessed on an issue and time-specific basis; to provide that, where it is not possible for a person to exercise capacity even with support, a court or a court appointee may act as his or her representative; to clarify, as indicated in one of the recommendations of this report, the law for carers who take on responsibility for persons who lack capacity; to establish an office of the public guardian with strong supervisory powers to protect persons lacking in capacity; and to repeal and subsume the provisions of the Powers of Attorney Act 1996 in order that its provisions would be brought into line with the general principles and safeguards in the Bill.

I am most conscious of the key role quality home care plays in the lives of so many people, and the need to progress more improvements in the sector generally. As referenced in the report, the Government for National Recovery 2011-2016 commits to developing and implementing national standards for home support services which will be subject to inspection by the Health and Information Quality Authority, HIQA. New statutory regulation of this sector must take account of various issues such as those raised in recent reports of the Law Reform Commission.

Primary legislation and additional resources will be required to introduce statutory regulation for home care services, including the private sector. The question of possible legislative changes, including regulation and inspection for relevant services, is under consideration in the overall context of licensing health care providers. Various options are being examined, including the complex legal issues involved and the need to prioritise legislation across the social care area, such as that relating to children or disabilities. It is important to emphasise that statutory regulation is only one way of improving the safety and quality of services and that other operational measures have or are being taken to improve community services for older people delivered by, or on behalf of, the HSE.

While I acknowledge the point made in the report on the need for improved planning data for community care for older people, the position is that the existing data available to the CSO and the health authorities is robust enough to meet projection requirements. I will, however, take this suggestion on board to see what improvements might be possible, while balancing priorities in the area of health data overall. I also make the point that the majority of HSE home help has traditionally gone to vulnerable older people, and this continues to be the case, with an increasing focus on meeting more personalised care needs for the most vulnerable.

We recognise the tremendous contribution that carers make to society. However, it is important to understand the carer's allowance is primarily envisaged as an income support where someone is unable to work because of caring responsibilities. It is not a payment for providing care. The point at which a close relative who has been providing care begins to claim carer's allowance is usually when the extent of the caring interferes with his or her ability to work. Family members have natural responsibilities for the care of one another beyond supports the State may provide. The State is not the normative way to meet human needs and it is not appropriate to compare the cost of State care with the cost of that provided within the family.

The requirement to be habitually resident in Ireland was introduced as a qualifying condition for certain social assistance schemes and child benefit with effect from 1 May 2004. The effect of the condition is that a person whose habitual residence is elsewhere would not normally be entitled to social welfare assistance or child benefit payments on arrival in Ireland. Each case received for a determination on the habitual residence condition is dealt with in its own right and a decision is based on application of the legislation and guidelines to the particular individual circumstances of each case. I checked on this matter before attending the Seanad, as there is a great deal of concern about it in particular. The Department assured me each case is dealt with on an individual basis, which is important. Sometimes, circumstances arise in which family members must travel home in a hurry. Irish nationals returning to live in Ireland on a permanent basis should experience no difficulty in demonstrating that they satisfy the requirements of the habitual residence condition.

There is no discrimination on grounds of nationality in social welfare legislation and to introduce any such provision would be contrary to the equality principles that Ireland has adopted in its equality legislation, the treaties of the European Community, the Charter of Fundamental Rights and other international conventions.

The free travel scheme provides free travel on main public and private transport services for those eligible under the scheme. These include road, rail and ferry services provided by companies such as Bus Átha Cliath, Bus Éireann and Iarnród Éireann as well as Luas and services provided by more than 90 private transport operators. Funding for the scheme was frozen by the previous Government at 2010 expenditure levels, as outlined in the National Recovery Plan 2011-14 and the 2011 budget. This cap was confirmed in the 2012 budget. The Department of Social Protection, therefore, is not in a position at this time to extend the scheme in any way, including through provision of a taxi voucher scheme.

Some 700,000 customers are in receipt of the scheme, a figure that is increasing annually. The scheme was set up to take advantage of available unused passenger places on public transport services. This is the only basis on which the scheme can be viable in the long term. The use of taxis in place of scheduled public passenger services would represent a significant expansion of the scheme, with considerable additional costs that could not be countenanced in the current economic climate.

The rural transport programme provides a degree of flexibility for older people in rural areas where regular public services are not available. All of the schemes operated by the Department of Social Protection, including free travel, were examined in the context of the comprehensive review of expenditure and continue to be kept under review, given the ongoing need for savings. The review continues to inform the Government's decisions on future spending.

Senators will be aware that, during 2008, an interdepartmental group undertook work, including a public consultation process, to develop a national carer's strategy. However, due to the prevailing economic situation, it was not possible to set achievable targets or time limits. In this context, rather than publishing a document that did not include any significant plan for the future, the Government decided not to publish a strategy. I am pleased to inform the House that the development of a national carer's strategy to support carers and to address issues of concern is a key commitment in the current programme for Government. The strategy will address the needs of informal and family carers. It will be conceptual and visionary and will establish a number of high level principles, goals and objectives and a roadmap to implementation. The State faces challenges in maintaining existing levels of services from within limited resources, in which context the strategy is being developed. It will not be an operational plan but will set the strategic direction for future services and supports for carers in recognition of their role and contribution to maintaining children, adults and older people with physical or mental health difficulties in their own homes.

While issues relating to carers span a number of Departments, the Taoiseach has allocated responsibility for co-ordination of the preparation of the strategy to me, with the support of the Minister for Social Protection. Work on developing the strategy is ongoing and a consultation process with other Departments took place in early 2012. A draft was completed at the end of March as a basis for final consultation with other Departments and with national organisations representing carers. Carers' organisations have made formal observations and it is hoped a draft will be completed for submission to Government during the summer.

Government policy on palliative care is contained in the 2001 report of the national advisory committee on palliative care and the HSE's palliative care services Five Year/Medium Term Development Framework 2009-13. It is worth stressing that palliative care, in which non-statutory players feature prominently, is moving beyond the traditional life-limiting area of cancer to address other non-malignant or chronic conditions. The Government remains committed to the delivery of the best possible palliative care services, as reflected with funding of some €78 million for this year. In this context, I am pleased to inform the House that the centralised medical card registration unit of the HSE operates a scheme for issuing emergency medical cards, which would cover persons in end-of-life situations. A person or general practitioner, GP, can at any time seek assistance from or direct his or her emergency application to his or her local health office. The HSE has also provided functionality to GPs to extend eligibility for one year in certain cases.

The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single-tier health system supported by universal health insurance, UHI, where access is based on need, not income. There are a number of important stepping stones along the way, each of which will play a crucial role in improving our health service in advance of the introduction of UHI.

Given the multidimensional nature of this report, I and other relevant Ministers and Departments will require more time to absorb its content and implications fully. The report will also be taken into account in the context of finalising the forthcoming national positive ageing strategy. Therefore, it is not possible to give firm commitments today on the report of the House. However, I assure the House that, from my initial examination of this recently received report, I regard it as a valuable contribution to the vision we all embrace of enhancing the lives of older people in whatever way possible.

Given the work involved in the report, there is a clear commitment to the general view that the question of how we age is important. We hope to publish the positive ageing strategy this year, given the year that is in it. The strategy will be subject to consultation and it is hoped it will map the way to our future. As I often tell people, it is as if older people are out there and not part of what we are. I thank the Seanad for going to the trouble of producing and presenting this report and for allowing time for this discussion.