Katherine Zappone (Independent)

I acknowledge the Minister of State's personal commitment to this issue and echo the sentiments of my colleagues in thanking her for a very comprehensive response to the report put together by the consultation committee. Today's debate, if anything, hopes to inject a sense of urgency into the various issues for older people. I am somewhat disappointed as I do not get a sense of urgency in some of the comments of the Minister of State. Her contribution was comprehensive but I worry about its sense of urgency. I have some questions and comments on the Minister of State's contribution, and I hope she can respond to those questions at the conclusion of these statements.

I will begin with the comments made by Senator Cummins and Senator Conway in acknowledging the statement on the national positive ageing strategy. Work on that strategy has been ongoing since 2006, and the Government programme has promised to complete and implement the strategy for older people so they are recognised, supported and enabled in living independent lives. We need this publication of a national framework which aids effective policy planning sooner rather than later and a co-ordinated and coherent approach is essential so that the rights of a growing number of people in the population are sufficiently protected.

The Minister of State may be aware of an opinion piece in The Irish Times today written on behalf of Older and Bolder which referenced this national positive ageing strategy. It stated that the official approach to the strategy has been lacklustre, and the cross-departmental group of civil servants and non-governmental organisation liaison groups set up to assist the Minister of State and her officials are simply not functioning. I heard the Minister of State indicate she hoped the strategy would be published by the end of the year but I wonder if she can be more specific. Is she certain it will be published before the end of the year and could she specify when it will happen? That is my first question to encourage a sense of urgency in the issue.

In her opening comments the Minister of State referred to the right to home care and community services. In the report we indicated that research has shown that the majority of people wish to remain at home in their older years, and the Minister of State has indicated that as well. Under the Health Act 1970, citizens have a right to an inpatient hospital bed but there is no comparable right to home and community care services available on a discretionary basis.

Our report highlighted the trend towards reducing the supports available to people to remain at home, although these are more cost effective than institutional care. The number of home help hours provided to older people will be cut by 4.5% and the disability services budget will be cut by 3.7%. A number of nursing homes will be shut down, as well as an unspecified number of public hospital beds, meaning there will be a greater emphasis on diverting older people to private nursing homes. We also mentioned that a large number of hospital staff retired from the health service, which makes home care services even more important. We must ask again today how our most vulnerable older people will be protected in the midst of all these cuts. The Minister for Health must make good on the commitment in the programme for Government to provide adequate and effective care in the community.

The Minister of State may also be aware that in 2011, the Ombudsman, Ms Emily O'Reilly, observed that people do not know where they stand in terms of entitlements and HSE obligations to provide services. Our committee heard evidence that it is difficult to obtain information about services and reliable access to them at critical points. An example would be on discharge from hospital or at the onset of a disability. Eligibility criteria for home care services are not published in a coherent way. Our report is simply calling for clarity around the availability of entitlements for older people, and that those entitlements be given a statutory footing. Without the necessary legislation, access to services is difficult, discretionary and unequal.

Furthermore, the report states that the HSE should make more use of the HealthStat performance information system to audit the existing services and provide more information about the HSE services available in the community. An audit of community care services by HealthStat could have helped to identify the deficits and planned for the future of community care. Can the Minister of State indicate if home care entitlements will be placed on a statutory footing and whether the audit we recommend will take place?

The Minister of State and Senator Conway, among others, referred to the UN treaty. It was noted a UN working group is considering the drafting of a United Nations treaty on the rights of older people but that there is little enthusiasm for this. Perhaps there is a lack of enthusiasm at some of the meetings but a man who gave expert evidence to our committee, Professor Gerard Quinn from the centre for disability law and policy in Galway, does not lack enthusiasm, nor does his team. He was one of the main drivers behind the UN Convention on the Rights of People with Disabilities. He highlighted to the committee that older people are seldom explicitly mentioned in existing international human rights treaties and that this lack of explicit mention makes it difficult for universal rights to be equally as effective for older people as for other groups. The main point of a new treaty would be to tailor the general rights to this particular population, as we did with women and disability. The tailoring of a treaty in this case would ensure the rights of older people could be more effectively enforced through the UN system. Will the Minister of State to tell the House whether the Government will support our recommendation to support the drafting of this treaty in light of the comments we have put forward in response to the report? From our perspective, there is a need for this type of treaty, in the same way we need a treaty for women, ethnic minorities and those with a disability.

The Minister of State made some detailed remarks on the legislation relating to mental capacity. Evidence was presented to the committee on the subject of legal capacity and, as the Minister of State pointed out, there is an international trend away from laws or policies based on deficits or what people cannot do towards the concept of support to enable people to maintain independence and to stay in charge of their personal destiny. There is a lack of up-to-date legal capacity legislation and that is one of the barriers to the ratification of the UN Convention on the Rights of People with Disabilities.

I commend the Minister of State on noting that we must be attentive when it comes to language. Perhaps the name of the legislation might be changed to include the phrase "assisted decision making". I like that. "Legal capacity" refers to a person holding and exercising rights with assistance or support if need be. Perhaps legal capacity legislation could be made distinct from mental capacity legislation. I welcome the Minister of State's commitment that the legislation will be published in the current session.