Tuesday, 15 April 2003
Government Policy and the Provision of Services for the Elderly: Statements.
I am pleased to have an opportunity to speak on issues relating to the provision of services for older people and to outline what the Government is doing to meet the needs identified for this group. Significant progress has been made in terms of the growth in funding available for this sector in recent years, which is indicative of the Government's commitment to the ongoing development of health funded services for older people.
I want to demonstrate the Government's commitment to the development of a comprehensive range of services for older people. I am full of admiration and greatly impressed by the range of activities of older people networks, activities of which promote positive ageing in many different ways in our communities. I also wish to acknowledge the extraordinary contribution that older people make to society. While old age has been associated with dependency, the vast majority of older people are healthy and independent for whom mature age can offer a new lease of life. They are no different from other age groups in so far as we all need to have a sense of control over our lives and the means to participate in society.
There has been an enormous sea change in the level and provision of services and additional resources made available in recent years. My priority, as Minister of State with responsibility for services for older people, is to ensure the issues facing older people are addressed with a view to providing improved services benefiting an older population whose contribution to Irish society is fully acknowledged by the Government.
Since my appointment as Minister of State with responsibility for services for older people, I am pleased to indicate to the House that I have established an interdepartmental group made up of senior officials whose objective is to ensure services for older people are delivered in an integrated and co-ordinated manner. It is my intention to engage in widespread consultation with all the key stakeholders in the area over the coming months with the objective of producing a mission statement which will define our approach to the topic for the future.
I want to focus on the additional revenue and capital that has been allocated. Additional revenue funding for the development of services for older people has increased significantly from €12.7 million in 1997 to an additional €87.8 million in 2002, totalling €100.5 million. In excess of €270 million additional funding has been provided for services for older people from 1997 to date. This has resulted in over 1,000 additional staff being recruited. Between 1998 and 2001 over 550 additional beds were provided in new community nursing units while over 1,250 day places per week have been provided in new day care centres.
Additional funding of over €87 million made available in 2002 was allocated for the provision of the home help service; community support structures; support for carers; the Alzheimer's Society of Ireland; voluntary groups; improvements in staff ratios; improvements in the nursing home subvention scheme, and implementation of the new health strategy. Additional moneys were used for the improvement and enhancement of existing services. For example, additional funding was provided for community nursing units, day care centres, community services while a contribution was made towards improvements in home help pay and innovative approaches to the delivery of services for older people at local level.
In 2003 a total of €23.6 million in additional revenue funding was allocated to services for older people. This funding will be used for a variety of services, including the home help service; the nursing home subvention scheme; support for carers; commencement of the elder abuse programme which I am delighted to indicate; support for voluntary organisations; the opening of new community nursing units; aids and appliances; the development of dementia services; funding of day care centres, and the development of consultant-led services.
Since 1993, there has been an unprecedented level of investment in the nursing home subvention scheme and €5 million was allocated for the scheme when it was introduced in 1993. However, due to a range of factors such as demographics, increasing levels of dependency, economic circumstances, etc., the costs of the scheme have risen significantly. In 1994, the first full year in which the scheme operated, the cost was €15.2 million. The total expenditure on the scheme in 2003 will be almost €110 million. The most recent information available indicates that approximately 455 nursing homes have been registered, with 7,580 people in receipt of subvention.
In line with a Government decision, an expenditure review of the nursing home subvention scheme has also been undertaken by my Department in association with the Department of Finance. The objectives of the review of the scheme were, inter alia, to examine the objectives of the scheme and the extent to which they remain valid and to assess the service delivered and to establish what scope, if any, exists for achieving the programme objectives by other more efficient and effective means. The review raises some key questions in relation to the scheme and it is intended to publish it shortly.
A root and branch review of the scheme is underway in my Department. This review will look at all aspects of the scheme, including the allowances given for assets, assessment procedures for means and dependency and all other elements of the scheme. I am concerned that there seems to be ambiguity in the manner in which certain health boards and officials interpret the scheme. The interpretation and criteria should be more streamlined. There is scope for development of the scheme and we hope to give more details in this regard as time passes.
My Department is also in the process of consulting all stakeholders with an interest in the scheme for their views on how it might be improved to benefit the most important person involved, namely, the patient. It is planned to bring forward proposals in respect of whatever additional measures may be necessary arising from the expenditure review of the nursing home subvention scheme and the Ombudsman's report, together with experience gained from the operation of the scheme since its inception in 1993. The review of the scheme will also need to be looked at in the wider context of how we, as a society, will fund long-term care in the future.
It is acknowledged that there is insufficient provision of public long-term care beds to cater for our growing elderly population, with a resultant over-reliance on the private nursing home sector. The Eastern Regional Health Authority and the Southern Health Board areas are particularly affected because of a lack of public long-term care beds. This was acknowledged when my Department was preparing the national health strategy, which contains a commitment to provide 1,370 additional assessment and rehabilitation beds and 600 extra day hospital beds, with facilities encompassing specialist areas such as fracture prevention, Parkinson's Disease, stroke prevention, heart failure and continence promotion clinics. The strategy also proposed the provision of an extra 800 extended care/community nursing unit places per year over a seven year period that will include the provision of long-term care beds for people with dementia.
Public private partnerships or PPPs are currently being piloted in the health sector. PPP is based on the concept that better value for money for the Exchequer may be achieved through the exploitation of private sector competencies to capture innovation and the allocation of risk to the party best able to manage it. Initially, the focus will be mainly in the area of community nursing units CNUs for older people.
It is anticipated that 17 new CNUs will be created when the initial pilot programmes are complete, providing up to a maximum of 850 new beds in Dublin and Cork. The services offered in these units will include assessment/rehabilitation, respite, extended care and convalescence. If the PPP pilot demonstrates success, it is the intention to use it as a means of providing additional community nursing units in other locations throughout the country. The current position in relation to the project is that the two agencies involved, the ERHA and the Southern Health Board, have recruited business advisers who will assist in the development of the project. The next stage in the process will be the development of an outline business case.
Indicative funding for services for older people under the National Development Plan 2001-2006 showed a sum of just over €36 million to be made available in 2001 and 2002 combined. Just under €55 million was actually spent and this funding helped to construct or equip new community nursing units in a number of locations. Substantial money was spent on facilities for older people at the Royal Hospital, Donnybrook, Mercy Hospital, Cork, and the South Infirmary/Victoria Hospital, Cork. The capital funding was also used to construct new day care centres in locations such as Killorglin, Finglas and Mallow. In addition, money was spent on badly needed upgrading/refurbishment of a number of community and district hospitals.
The publication of the report, Protecting Our Future, towards the end of last year, was a momentous occasion for older people. They were being given a blueprint to deal with the scourge of elder abuse and a pledge that this blueprint will be implemented. Until recently, there was a feeling that elder abuse did not exist in Ireland. However, the report confirms what a number of us would suspect, namely, that a problem – the extent and nature of which remains to be identified – exists. This report, in starting with a definition of elder abuse and recommending the putting in place of structures to deal with suspected cases, will hopefully give older people who feel they are the subject of abuse in any shape or form, the confidence to report their anxieties, as appropriate, to a social worker, a public health nurse, a member of the Garda or indeed any professional or care worker.
The report is a first, but important, attempt to deal with elder abuse. Abuse can come in many shapes and forms – physical, psychological, financial, or through neglect. I accept the need to make the general public more aware of the problem of elder abuse. However, even more important is the need to target relevant service providers so that they become aware of the steps being taken to respond to elder abuse and the procedures that will be available.
As the saying goes, "prevention is the best policy" and I hope that greater awareness of the problem will lead to a lessening of the incidence of elder abuse. I note the recommendation to establish a national centre for research and training and obviously such a centre will play a role in prevention. I will have to give careful consideration to where such a centre might be based. I also note the recommendation that a national implementation group be established.
A number of the recommendations in the report are based on experience gained from two pilot projects. The outcomes of the pilot projects are not contained in the body of the main report. However, a separate evaluation report was commissioned and I understand that without any major publicity, sufficient cases, both in terms of numbers and seriousness, have come to light to justify this whole process. Financial abuse seems to loom large and this trend is corroborated by statistics produced by the National Help Line for Senior Citizens, which receives many of calls from older people in distress.
I am determined to press ahead with gradual implementation of the report, starting in 2003. Despite the difficult financial situation we face, I have made €800,000 available in 2003 to commence this process. I concur with the broad thrust of the report, which recommends that the response to elder abuse be placed in the wider context of health and social care services for older people. As Ireland's population of older people rises, we should not forget that they have been instrumental in building the State up to the level that we enjoy today. Their contribution to the economy is widely acknowledged, and the Government is fully committed to improving all aspects of their lives by focusing on issues that affect their well-being. I am pleased to tell the House that I have also met the Garda Commissioner to discuss the elder abuse report and have initiated consideration of structural changes to focus specifically on community support and appropriate liaison structures for older people.
From a health perspective, the cornerstone of policy is to keep older people living in their own homes for as long as possible, and research has shown that to be the choice of older people themselves. Older people have a fundamental right to be treated with respect in their twilight years, and the implementation of the recommendations contained in this report will help bring that about. They are often reluctant to report abuse, and I urge the various voluntary organisations that represent them to encourage them to come forward.
The starting point for making the changes called for in the report may well be for each of us to reflect on our individual attitude to older people. I am in no doubt that, if we are to make an impact on the problem, it must involve major cultural change on the part of us all. We must begin to question our attitude to older people to satisfy ourselves that we do not harbour in-built negative feelings towards them, for they can often be the source of unintentional abuse of older people. We must now proceed on a journey during which we will have to absorb much and learn to cope with what may be considerable fallout.
It will be clear to the House from what I have outlined that the Government's commitment to older people is undeniable. We acknowledge that we must continue to develop services to meet a growing need and that we cannot be complacent. While it cannot be denied that the Government and its predecessor can be proud of their records, there is no room for complacency and we must continue our efforts.
I look forward to the contributions of Members of this House regarding what I have outlined, which is only some of the work that we have undertaken to date. I intend, as I continue in this office, to which I was appointed only in June 2002, to achieve a marked improvement in all that affects older people and in the provision of the appropriate services.
I am pleased to have set up the interdepartmental group, which focuses on older people's needs, and I believe that it provides an opportunity to bring positive influence to bear on the various services provided to them. The group is taking a cross-cutting approach to its work, with members speaking with authority on behalf of their Departments. To date we have met around seven Departments, and those who have participated have influence over their Departments' policies regarding services for older people. A number of agencies and interested groups have also made submissions to the interdepartmental group, and we have made great progress. Pilot studies are under way and, arising from their positive effects, I hope to roll out the interdepartmental group's beneficial work nationally.
I welcome the Minister and his statement on Government policy and provision of services for the elderly. He has certainly given a broad outline of the services and the methods by which he intends to assist the home help service and the nursing home subvention scheme and support carers. Much has been done, but there anomalies in the report. Prevention may be the best cure.
I am involved in the county council, the VEC and adult education. My brief includes involvement with active age groups, which attempt to give back to older people a sense that they belong and have as good a purpose as that of any other group. Over the years I have seen the local group provide self-sufficiency, self-fulfilment, self-confidence, self-esteem, self-reliance and, most importantly, independence.
The budget has come partly from the VEC community education budget, but often it is up to the relevant vocational education committees whether to give those supports. In County Roscommon, supports are exceptional. It is incredible to see an elderly population being catered for, but unfortunately that comes out of a VEC budget. Some vocational education committees are not as active in providing the service, and that is one area in which we can make a difference. The VEC budget must be ring-fenced so that vocational education committees have to spend the money in the area, for some do not do so.
The groups have annual magazines and the Bealtaine festival. They meet each other and are affiliated to national organisations. It gets them around the country, and I had the privilege of bringing my local active age group to Leinster House. They were not all supporters of my party, but they certainly enjoyed themselves. They would never have been together but for the VEC co-ordinating elderly people in the group. That is one area that we should examine.
The Minister spoke about the health boards. In my own area we had a problem with physiotherapists. The Western Health Board runs the Plunkett Home in my town, and it took a year and a half to appoint a physiotherapist there. The lack of physiotherapy for elderly people caused serious stress and many problems for them. Such cases are unacceptable breakdowns in the system. Thankfully, we now have a physiotherapist, who has come from South Africa, but the problem was not merely in Boyle but all around the country. Physiotherapists were not available to work for the health boards, and that was a serious problem for a year and a half.
We must restore independence to older people at home who become ill or dependent, and we should encourage and support the care of older people in their own community by family, neighbours, voluntary bodies and in every way possible, also providing high-quality hospital residential care for older people. They need dignity and independence at home. Limerick Regional Hospital has separate admissions procedures for the elderly, and most hospitals around the country should consider that. It is unfair that elderly people should have to compete with younger people for admission.
I do not know if active retirement comes under the Minister of State's brief, but more people are choosing to continue working after 65 years of age, often in a different capacity to that which they previously occupied. My mother, who is over 70 years of age, still carries on our family business. Without working in the family shop, she would be a drain on health services. In the aftermath of the economic consequences of the Celtic tiger, it is almost impossible to hire part-time staff. There are many retired people who would like to work in shops for two or three hours a day or three days a week because it would get them out of their homes. These people represent a major source of prospective employees for employers. It makes good sense to bring them into the part-time workforce.
The peak-hour ban on elderly people with free travel passes should be removed for those attending hospital appointments. An expansion of community access and travel initiatives – such as the active age initiative – should be promoted to allow elderly people to travel and the rules regarding those who accompany them should be relaxed. We should seek additional agreements with other member states in order to allow elderly people to travel through the EU.
I welcome the rural initiative, but there was an anomaly with it to which I referred previously in the House. A pilot scheme commenced in rural areas, but elderly people who live there do not have the benefit of public transport. The scheme was good, but, unless the transport operator was registered, elderly people on free travel passes could not use the scheme. The scheme, which operated on a pilot basis, was doomed before it could take effect. Anomalies of this nature can only be dealt with by someone appointed to act as a liaison in respect of such schemes.
Carers for the elderly are not getting a good deal. Approximately 85% of all care provided for dependent elderly people is provided by non-professional carers. Caring is often done on a 24 hours a day, seven days a week basis, with little help or respite. Carers should be receiving a better deal. If a son or daughter, a niece or nephew is prepared to care for an elderly person, it is much better for that individual and it provides better value for the State than would otherwise be the case if they had to be placed in a nursing home and a subvention had to be paid.
One of the greatest achievements of the 20th century is the fact that people now live longer. By 2030, the proportion the population aged 65 years and over will have grown to 16% in comparison to just 11% today. The issue of an elderly population will not go away and additional resources must be provided. The major implication for the health services will be dependent ratios. We discussed health insurance – that provided by BUPA and the VHI – previously and I supported the equalisation initiative. If there are too many voluntary health insurance companies, some will be able to cherry-pick their clients. This could be dangerous. I am happy with the new Bill, but we cannot allow cherry-picking to proceed because the elderly would be neglected as a result.
In the area of promoting active retirement, there should be an emphasis on preventative rather than reactive measures. I have already referred to this matter in the context of the vocational education committees and the active age groups. The organisation Alone estimates that 88,000 people over 65 years of age spend Christmas Day on their own. That is a scandalous indictment of our society. Government services must lead the way in showing respect and support for older people.
I welcome the Minister of State and commend him on his excellent contribution, which says much about the kind of person he is and the amount of hard work he invests in his brief. I do not say that lightly, because I have heard similar comments from nurses and doctors who hold the Minister of State in high esteem.
Senator Feighan concluded with a quote and I will commence by doing likewise. I do not know who originally uttered the words, "Those who drink the water should remember those who dug the well," but I rather like them. As the number of older people in Ireland rises, we should never forget the role they played in building the economy from which we benefit today. The Minister of State has recognised that contribution and is fully committed to improving their lot now that they have come to the autumn of their lives. He is determined to ensure that they enjoy their latter years.
From a health perspective, the cornerstone of policy is to keep older people living in their own homes for as long as possible. Research has shown that this is the preferred choice of older people. When researching this matter, I spoke with a person from the North Western Health Board who referred to the CHOICE programme. The latter offers a choice to older people to decide where and how they want to be cared for. The North Western Health Board runs this programme very successfully and increasing numbers of aged and elderly people in its area are staying at home. There are not concerned about nursing homes or subventions. All they want is to be left in peace and quiet in their homes, whether they are large, medium or small.
It has been found that these people are more independent and retain a greater sense of dignity by staying in their own homes. What impresses me most is that the health board has built up the home base for elderly clients. Development money has been invested in the provision of home help and day care centres. We are all familiar with day care centres. I grew up in Tullamore in the midlands and each day we passed the county home on our way to school. One would dread seeing the high wall and being told that was where old people would end their days. However, the care administered in day care centres is second to none.
Like everybody here, I have been at any amount of day care centre openings, particularly in County Sligo, from Skreen, Easkey and Tubbercurry to the one in my own town, Sligo – St. Anne's, which is a wonderful success story, about which I would like to tell the Minister of State. It is set up in St. Anne's Youth Centre in the middle of a corporation housing estate but the elderly have services of which they can avail every day. They can also walk to the church, the post office and the hospital. They have access to all the amenities that are important to them, which we take for granted, to which we can drive or walk or which we can visit every few months but to which they find it important to get to every few days, or perhaps on a weekly basis. They can now do this from the day care centre.
While I recognise and appreciate the wonderful funding the Minister of State has provided for respite care, I ask him not to take his eye off the ball and continue to fund respite care for the elderly. I look at people who go into the day care centre and will then hear they are spending perhaps a week or two in hospital. The carer looking after them at home is getting the break and their problems are being picked up in the day care centre. They may not be picked up if they were left at home with somebody elderly looking after them.
I received correspondence from the office of the Minister of State with responsibility for housing and urban renewal yesterday and was interested to see the figures for the essential repairs grant which can now cover up to 90% of the approved cost of the work to be done. The maximum grant currently stands at €8,467 compared to a figure of €1,143 in 1998. That is a wonderful incentive and great initiative. In 2000 we extended the special housing aids for the elderly to make provision for suitable heating for the elderly. These are administered from the community care section of the health board.
Without ignoring another health board, I have great ties with the Midland Health Board. While I have to support my own in the north-west, I never forget where I came from. I was delighted to hear the Minister of State talk about innovative measures and ideas taken on by health boards. When I went home at the weekend, I had received a copy of Senior Times in the post, which I am sure all my colleagues also received. I was delighted to read an article about the Midland Health Board and Music Network, which operates out of Dublin Castle, which have come together to plan for the future in what they see as an innovative way to provide not just health care but also social care for elderly clients. They do this through music, dance and art. When I spoke to somebody there today, they said theirs was a pilot scheme but they had now incorporated it into the day-to-day running of the service. This is the third phase of the scheme. We talked about elderly people suffering from dementia. Apparently, when they hear a piece of music, whether it be set dancing or traditional ballroom dancing, the men and women involved immediately get up, are activated and encouraged. The music brings them back. They may not have spoken or been active, yet something like a piece of music can trigger whatever it is in their minds that brings them back to where they might have been ten, 20, 30 years ago. There is nothing as emotional as to see an elderly person who may be confined to a chair wanting to get up and move. It gives them great dignity if they can enjoy something they enjoyed many years ago and which can now come back into their lives. While it enhances their lives, the right environment has to be created. I heard a lovely story, also about the Midland Health Board, in which Hugh Tinney came to Mullingar with a piano that cost €75,000 and entertained, free of charge, elderly clients.
I was particularly touched when the Minister of State talked about elder abuse. I say, "Well done." I am glad the interdepartmental group has highlighted elder abuse and made it one of its key issues. I was very touched last week when, like many of my colleagues, I heard the Marian Finucane radio programme in which an elderly lady talked about being being duped by con men in her house. We are all very familiar with this. Those of us living in the west would be no different from those on the east coast. I am glad the Minister of State met the Garda Commissioner. These are horrible crimes against people who have served the State well and should be living their final years in tranquillity but instead are almost prisoners in their own homes because of people like this. I would like to think that the Minister of State will keep whatever it is going that will eventually get rid of such crimes.
I liked the language the Minister of State used. He talked about "positive ageing", "maturity", bringing a "new lease of life". That is very important and the message we need to send to the elderly. We welcome the allocation of €100.5 million to date that the Minister of State has provided for services. While I hope I have many years to go before I will be elderly, I also hope the structures the Minister of State is trying to put into place today will still be in place for him and me when we are in the chair with a little blanket over us, and that wherever we might be we can enjoy some of this. Again, I say, "Well done" to the Minister of State and the Government for the commitment they are making to the elderly.
I was referring to her recent election to the Seanad.
I understand Senators Feeney and Feighan began with a quote. I think it was Kofi Annan who said about two years ago, "We will all be old some day, with a bit of luck." The elderly are a particular category to whom we owe a massive debt of gratitude for what they have done for us and for the way in which they have contributed to what we know now as a civilised society, one that obviously needs improvements in many areas. We would not have what we have today without them. They established many years ago the standards, fundamentals and principles of our health care and educational systems. It is particularly important that we, as legislators and public representatives, should not forget them.
The population trends show that the number of older people in our society is increasing rapidly for which there are a number of supporting demographic figures. European figures show that by 2050 over half the population of Europe will be above retirement age. The Central Statistics Office estimates that by 2031 over 200,000 Irish people will be over the age of 80 years. All of these figures point to the need for immediate planning, not just for the present cohort of the elderly population but for future levels. This requires good planning and a long vision for which we can hope to prepare by putting in place systems that will be of assistance to elderly people in catering for their needs.
There are a number of other issues to which we have to face up, apart from the ageing population. First, there is the fact that people are living much longer and, second, the number of full-time family carers is diminishing. The costs of long-term care are escalating at a rate which is alarming to say the least. It is also essential to bear in mind that serious staff shortages in the health service have a detrimental effect on the health of elderly people, in particular. When we mention waiting lists, for example, we tend to think of ourselves but we should not forget that these failings impact most seriously on our elderly population.
I did some minor research, because this is not my area, and found some interesting articles and statistics in an insightful publication, Ageing Matters, published by Age Action Ireland. One of the more alarming findings came from a SIPTU nursing conference held recently in Limerick. It related to the Society of St. Vincent Paul paying for private medical care for a person in south Dublin. This person would have had to wait a long time for a public bed, but the local branch of St. Vincent de Paul came to the rescue and paid for this elderly person's private treatment.
Another case involved an elderly person with gangrene and other ailments who had applied to the local authority for a special bathroom. This person, whom I assume had a terminal illness, had a life expectancy at the time of one year, and was told by the local authority that the provision of the required bathroom would take at least 12 months. The Society of St. Vincent de Paul came to the rescue, and that was wonderful.
These are very serious issues, reflective perhaps of the current financial situation and the priorities of the Government collectively in terms of where funding is going and where cutbacks are being made. We recently had a debate in this House on the carer's allowance, and I believe the Minister for Social and Family Affairs, Deputy Coughlan, was in the House that evening. The figures and statistics were there for all to see. There are over 200,000 carers in this country, and if the Government is seriously committed to services for elderly people, this is a fundamental area which must be looked at. My own party and other political parties have campaigned for the abolition of the means test for the carer's allowance. If it were abolished, potential carers would take up the role and help those who need their services. Some organs of the health service are being propped up by carers, and in order to maintain the numbers of those taking on the job, a root-and-branch reform of the scheme is essential. Innovative measures should be taken by the Government to ensure that older people have carers as they get on in years.
One of the more interesting ministerial titles is "Minister for Health and Children". The title speaks volumes. The Government might look at the idea of having a Minister for the Elderly. This would show it is seriously committed to this section of society and would also ensure that a special Department would be set up to look at their needs and put the provision of services for elderly people on a statutory footing. That is not an easy thing to do, but it would highlight a serious commitment by the Government.
EUROSTAT findings indicate that Irish people fare worse than Europeans in terms of poverty among older people, with poverty for older single people the worst in Europe. The findings show that the general risk of poverty for single older people in Europe is 27%, while in Ireland it is 62%. During my research for this debate I found that, in particular, single older women were more likely to be poverty-stricken than single older men. That is a worrying feature.
We are all aware of the current situation in the health services. It is essential that when the people who built this State, who put together what we now enjoy today, need to call on health services, there is a decent service available for them. It will be a damning indictment not only of Government but of society in general if this is not the case.
There have been many debates relating to levels of pension payments to elderly people and a watchful eye needs to be kept on the area. Elderly people need to be looked after by the State and I urge the Government and the Minister responsible to continue this approach. The next time we are approaching a budget, let us dig in there. When Champagne Charlie wants to initiate cutbacks again, let the Minister of the relevant Department for once stand up and say that this will not happen, because these particular demands for funding are for the elderly people in our society.
I welcome the Minister of State to the House and congratulate him on his elevation. There is no doubt he is a hands-on Minister and is making improvements and changes.
The policy of Fianna Fáil in Government is to maintain older people in dignity and independence at home in accordance with the wishes of older people themselves, as expressed in many research studies. The policy is to restore to independence at home those older people who become ill or dependent, to encourage and support the care of older people in their own community by family, neighbours and voluntary bodies, and to provide a high quality of hospital and residential care for older people when they can no longer be maintained in dignity and independence at home.
In Ireland there are more than 900,000 people aged 50 or over, 11,000 in county Sligo. In the past the growth in the number of older people has been referred to in negative terms. While old age has been associated with dependency, the vast majority of older people are healthy and independent. Our aim in Fianna Fáil is to provide improved services benefiting an older population whose contribution to Irish society is fully acknowledged by this Government.
Additional revenue funding of more than €26 million has been announced for 2003 for services for older people, including palliative care services. Between 1997 and 2001, total additional funding allocated was €168 million, which has enabled over 1,300 additional staff being recruited for these services.
From 1998 to 2001, over 550 additional beds have been provided in new community nursing units and over 1,250 day places per week have been provided in new day care centres. The Minister for Health and Children, Deputy Coughlan, recently announced that work on the development of pilot public private partnership programmes for community nursing units for older people has begun in the Eastern Regional Health Authority and the Southern Health Board areas. These developments will ultimately provide about 850 additional public long-term care beds for older people in such units and thereby take some of the pressure off the acute hospital sector where older people who are fit for discharge are sometimes inappropriately placed in acute hospital beds because of shortage of community nursing unit beds.
Together with considerable investment in health board facilities and community care, substantial additional resources have also been made available for the nursing home subvention scheme. As Members will be aware, the Health (Nursing Homes) Act 1990, under which subvention regulations were made, has two principal objectives: first to ensure high standards of accommodation and care in all nursing homes registered under the Act, and second to provide a new system of nursing home subvention so that dependent persons most in need of nursing home care will have access to such care. Additional funding of €87.8 million was made available in 2002 for further development of the services, including enhancement of the nursing home subvention scheme, provision of additional home helps, improving community based services and other services provided in community hospitals and day care centres, additional respite care and support for carers.
It is expected that 4,500 people will benefit from changes in the carer's allowance coming into effect this week. Changes in income disregards will see 1,700 new carers qualifying for a payment and 2,800 existing carers receiving an increased payment. A single person can now have an income of €210 per week and a couple can have €420 per week, without affecting their payment. These improvements will make a real difference to carers. For example, as a result of the changes, a couple with two children and earning €24,000 can qualify for the maximum rate of carer's allowance. Such a couple, earning nearly €40,000, will still get a payment, including the respite care grant.
I acknowledge the valuable and unheralded work done by carers whom this Government has committed itself to helping. In the programme for Government, it pledged to expand the income limits for the carer's allowance so that all those on average industrial incomes could qualify. These improvements are in line with that promise and are welcome. While any Minister would like to raise the income limits further, that has to be done at a rate the country can afford.
The task force on special housing aid for the elderly, under the aegis of the Department of the Environment and Local Government, has made an initial allocation of grants totalling €11 million to health boards for essential repairs to houses occupied by elderly persons living on their own. In 1997, the allocation for the task force was a little over €5 million, with approximately 3,000 jobs completed in that year. In 1998 and 1999, with allocations increased to over €6.3 million and €7.6 million respectively, a further 6,500 jobs were undertaken.
As adequate heating was considered to be a key requirement for the health and well-being of elderly persons, the scope of the scheme was extended to include the provision of suitable heating systems in 2000 and, with an allocation of over €10 million, some 3,600 jobs were carried out. In 2001, funding of €10.99 million was provided and over 5,200 jobs were completed. In 2002, €11.9 million was provided and, by end of June, the latest date for which figures are available, over 2,500 jobs were carried out. Over 47,000 applicants have had repairs carried out to their homes under the scheme since its introduction. I am delighted with the effectiveness of the scheme in helping elderly people to continue to live in their own homes in as much comfort as possible.
A few years ago, I had the privilege of being a member of my local branch of the Society of St. Vincent de Paul. At that time, elderly people were being assaulted and robbed in their homes. There was a voluntary housing scheme, which I believe is still there, under which we applied initially for 12 houses and, a year later, 16 houses. In my home town, there are now 32 houses which were grant aided under that scheme to the extent of 80% for the first scheme and 90% for the second scheme. That includes 16 one bedroom houses and 16 two bedroom houses in this development, Cuan Íosa. Approximately 48 people are now living in this haven of peace. We were very fortunate in obtaining a site close to the local nursing home, church and railway station. The occupants of those houses were previously living alone, in terrible housing conditions in very isolated places. I believe that scheme should be more widely promoted. I know from experience the difference it has made to the residents of that estate. I invite the Minister of State to visit the estate whenever he is in Sligo. It is well worth seeing.
I welcome the Minister of State to the House. I am glad of the opportunity to make a few points on this important issue. As the Minister of State may be aware, there is no designated home for the elderly in Kilkenny city, although it is an issue which has been used by political parties over the course of many elections, with repeated promises being made. The last election was no exception, when outgoing Members on the Government side committed to the provision in Kilkenny city of a home for the elderly. Currently elderly people from that city are accommodated either in Castlecomer or Thomastown, in the absence of any facility within the immediate catchment area. That situation has dragged on for too long. It is an important issue which is liable to affect most people at some stage and it should be finally put to rest.
It is disappointing, to say the least, that the Celtic tiger years have passed without provision being made for a home for the elderly in the city of Kilkenny. I urge the Minister of State, as a new man in the Department, to look at this issue with a view to having action taken on it as a matter of urgency.
Previous speakers have referred to the carer's allowance. It is disappointing that this scheme is still means tested. I believe the role of carers in society is generally acknowledged. They provide a vital service in keeping family members at home rather than in hospital facilities, thereby saving the State substantial sums of money while caring for their loved ones. It is regrettable that better provision was not made during the boom period of the past six years. I acknowledge that improvements were made, as outlined by Senator Scanlon, but the situation is still not good enough. The opportunity existed for the Government to tackle that issue seriously, but it was passed up.
Senators and other public representatives will be familiar with the grant systems available through health boards and local authorities for housing and other schemes. However, there is not enough money available in most local authorities to meet the demand. In Kilkenny, the list of applicants for the disabled person's grant stretches a couple of years into the future. Commitments were entered into last year in anticipation of this year's money, which was already allocated even before we received it. People were in urgent need of funding for essential adjustments to their homes. It is disappointing that funding for such a vital scheme was not beefed up to a much greater extent.
The same can be said of other schemes, including housing aid for the elderly. They are good schemes and serve their purpose up to a point. A few weeks ago, I met a woman who had applied for the disabled person's grant. As she is in her nineties, much as I regret to say so, she may never live to see her grant come through, even though she urgently needs to have essential repairs carried out to her home. That case illustrates the reality and I find it extremely disappointing. No doubt the Minister of State is also disappointed. I urge that something more should be done in terms of allocating funds to those schemes. In the "bread and butter" aspect of politics, it is my view that we should not be in the positions we hold unless we can help people who cannot help themselves.
Kilkenny city and its catchment area include some 20,000 people but there is no health board operated home for the elderly in the city. The issue is continuously booted around as a political football by all parties. I would like the elderly of Kilkenny city and surrounding areas to have a facility close to where they live. There are few public transport links between Kilkenny, Castlecomer and Thomastown. Therefore, it is not easy for relatives to visit elderly people in the homes. Public transport for the elderly must be prioritised. Other Senators have also referred to this issue. Great work has been undertaken by rural transport groups in conjunction with local authorities to provide improved public transport within villages and districts to local towns. There had not been a public rural transport service in recent years, yet it is vital for elderly people who do not have access to a car because it provides them with a facility whereby they can do their shopping, collect their pensions or meet their friends. Good work has been done in Kilkenny which is important for the future of the rights of elderly people. While improvements have been made, I urge that continued efforts be made.
I welcome the Minister of State and compliment him on his speech and the excellent work he is doing in this area in such a short space of time.
A number of ancient cultures held their elderly in great esteem. In times of difficulty it was the elderly of various communities who were asked to guide their people through. During the years the position of respect that the elderly occupied has been diminished in the eyes of society, which is to our shame. At times it seems that at least some aspects of society view the elderly as a burden. Instead of taking advantage of their vast skills and talents, certain sections of society are more likely to ignore them.
Whether this section of society is ignored, the fact remains that, as a group, elderly people are going to increase as a proportion of society over the next few decades. As matters stand, there are more than 900,000 people aged over 50 years. With advances in medical science in the provision of health services, Irish society will soon have more elderly people than ever before. With this in mind, we can be thankful that the Government has not shared this negative view of the elderly. The present and previous Governments have rightly cherished the role the elderly have played in making this country what it is and the role they continue to play as it develops further.
The Government has put more money than ever before into projects devoted to the elderly. Funding for services for older people increased from €12.7 million in 1997 to €87 million in 2002, including nursing home subvention. In addition, over €270 million has been provided for services for older people during that period covering a wide range of services, including home help services, nursing home subvention schemes, support for carers and voluntary organisations, the opening of new community nursing units, aids and appliances, development of dementia services and funding of day care centres. Senator Scanlon referred to the successes of voluntary housing and housing for the elderly. In Rathdowney, County Laois, a 28 unit scheme, Cuan Bhríde, has been an enormous success and helped to sell the scheme throughout the county in Ballinakill, Portlaoise and Mountmellick.
The Government has also been responsible for ensuring equal treatment for the elderly through the introduction of the Equal Status Act 2000. It is fair to say no other Government has been as concerned about the rights of the elderly and their place in Irish society as a whole. Senator Feeney described some of the more recent developments and initiatives taken by the Government in greater detail. The healthy ageing programme should provide an even greater level of support for those who may no longer be in the prime of their life but who are also adding considerably to the State. The National Council of Ageing and Older People will also help to identify and address more of the problems that the elderly face.
Under the Government, there has also been a change in focus from long-term care to community care which has had a huge beneficial effect on the lives of a large number of our elderly citizens, enriched their lives and boosted their esteem a great deal. This was only possible because of the extra funding made available, which facilitated aids and appliances for older people and allowed them greater freedom of choice. We need to respect the dignity of elderly people. We should not be content with those sections of society who would like to lock elderly people away in nursing homes, content to let them wilt away as age continues its relentless march. We must put in place even more measures that will ensure the elderly are maintained as pillars of our community and that we encourage their involvement in all aspects of society at every level. It is for this reason that I am glad the Government has put in place the measures it has. We have ensured more and more focus is put on innovative measures that will be of benefit not only to the elderly but also the country as a whole.
I welcome the Minister of State and I am glad the Seanad has devoted time to discuss this important matter. The Minister of State will be aware that the Western Health Board area has the highest percentage of ageing population of any area in the State. This creates huge problems for the health board, in particular, which has to deliver services for the elderly and whose responsibility is greatest. The most important thing the Government could do is recognise – as the Minister of State suggested – that this is an interdepartmental problem and that all units of government must work together to ensure a decent quality of life for elderly people.
One of the greatest problems elderly people experience is isolation. While we might identify isolation as a rural problem, it affects urban areas, too. Many in our towns and cities are terrified and prisoners in their own homes. Likewise, in rural Ireland, gone are the days when relatives and neighbours provided transport for the elderly to town, the shops or the post office because society is geared up for the occupants of most houses to be working. Children are in care like the elderly.
One of the difficulties to which the Government must face up sooner rather than later is the fact that when relatives offer themselves to care for their elderly family member, neighbour or friend, no impediment should be put in their way to provide such care. The sooner we tackle this problem and all that goes with it in terms of carer's allowance the better. We must be conscious of the fact that many people who provide care in the community are doing so an a voluntary basis because they are afraid to accept payment owing to the fact that they will be taxed on it or it may render them over the limit in relation to other entitlements.
The Minister of State must ensure that the Department of Justice, Equality and Law Reform rows in behind him on this. I pay tribute to the work of the Garda Síochána in rural areas in particular in providing a service to many elderly people on a community watch basis. No other scheme deserves more support. Elderly people who apply for alarm and safety systems should be granted them automatically. Unfortunately, that is not the case. Elderly people applying for alarm systems which would provide them with security and safety in their homes encounter a great deal of red tape in doing so.
The Minister for Justice, Equality and Law Reform has changed the system of policing in rural areas in that there is no longer an identifiable presence of gardaí on the beat in the community. They are patrolling areas in cars and are not in the local Garda stations, something to which the elderly had become accustomed. That scheme needs the Minister of State's financing and support.
I agree with the remarks made by Senator Ulick Burke regarding threats of crime in rural areas. This is a major issue. I visited an elderly person the other night and had to wait at least half an hour until they removed the barricades from the door to allow me into their house.
I received representations to go and see them. I telephoned to say I would be arriving half an hour earlier than expected. On arrival, I had to wait for them to remove the barricades from the door in order to get into the house. They live this way because of the threat of crime in rural communities. There are fewer gardaí on the beat and elderly people are afraid in their homes. We have witnessed, time and again, elderly people being attacked in their homes. This situation is grossly unfair. No just society would allow this to happen. The Government should be called to order by everybody in the country.
Those who worked through the awful years to build this State are now, in their declining years, forced to worry on a daily basis about the cost of living, repairs to their homes and the frightening level of service charges. Years of plenty, when Champagne Charlie—
I will take note of it. Politicians living their lives to the full did not do anything to make an impact on the conditions and lifestyles of these disadvantaged people. It does not take much to notice that the Minister continues to party while these people make up the shortfall.
Society's most vulnerable are paying for the Government's wasteful mismanagement of the economy, which has led to the funding in the budget for essential community projects – such as day care services for the elderly who, in many cases, are effectively confined to their homes – being slashed. Shame on the Government parties – Fianna Fáil and the Progressive Democrats – which are not willing to take on the real issues of elderly and disabled people living in inaccessible or inappropriate surroundings.
We cannot tolerate blatant discrimination against our elderly and disabled citizens. Exchequer shortfalls are not the problem of these people and should not be rectified at their expense. It is time that the Government stopped expecting the disadvantaged to bear the brunt of its mismanagement. It is a tragedy that there are considerable shortfalls in funding for essential repairs and disabled persons grants, which add to the lengthy waiting lists for nursing home subvention. I raised this issue three weeks ago and on the Order of Business last week.
Many county councils have run out of money for the disabled person's grant and are currently, instigating reviews of the scheme, if they have not already done so. This means that people with disabilities are disadvantaged even further. What is happening is a blatant failure of the Government to cater for and properly manage facilities for our elderly and disabled. Carers are expected to work around the clock taking care of elderly or disabled relatives while the Government has the audacity to means test the carer's allowance. We were promised that allowance would not be means tested yet it remains so. To allow this to continue is a shame on society. In a country experiencing cutbacks across the board, many of which impact on the elderly, is it not obscene that a steel spire has been erected at a cost of €4.6 million? Where are our priorities? In a damning indictment of the Government – allied to the lack of care for the elderly and disadvantaged – that, seven days a week, there are more homeless people in Dublin than in London. Homelessness is at an all time high, with 6,000 people on the homeless list. Eradication of waiting lists is a priority.
Following the recently experienced and most prosperous period in our nation's history, we should be able to say that the weakest and most needy benefited to the greatest degree. I plead with the Minister of State to do his best on behalf of the elderly and to rectify the situation whereby the Government is failing to allocated funding to local authorities. Directors of services are notifying public representatives that there is no funding available. This issue must be rectified.
I welcome the Minister of State. I welcome the opportunity to contribute to this debate. Before I take any lectures on discrimination from any side of the House, I must state that other parties were given opportunities to increase old age pensions and to make facilities available to the elderly. They failed dismally when they had those opportunities. Let the record speak for itself, the facts are there and I do not have to reiterate them. Not only do I recognise that those parties failed dismally, but the Irish people recognised it also when they practically scuttled the total Opposition in the last general election.
By 2020, one in four of all European Union citizens will be aged 60 or over. Sharp increases in life expectancy have been followed by substantial falls in fertility rates. This means that fewer people will be working to generate resources to meet the needs of an ageing population. This has caused panic and scaremongering in some quarters regarding society's ability to cope with the change.
In developing any policy, we need consultation and education. There are concerns that people of all ages need to be aware of issues and policies related to ageing. We need to build a stronger older peoples' movement and recognise that people have competing priorities. In this regard, I congratulate the Senior Citizens' Parliament, representatives of which I have met on a number of occasions, on the work it has done.
Absence of consultation with older people by policy-makers and service providers is a recurring theme. Consultation should be considered an integral part of any service or policy initiative. This lack of consultation has had a serious negative impact on the quality of provision of services. In the process of consultation, providers of services need to be sensitive to the fact that older people are women but that most decision-makers are men.
Older people identify good health as their top priority. The EU supports the importance of promoting preventative approaches, stating that it will minimise the need to expand clinical and care services and will be more advantageous financially than medical technologies, which paradoxically tend to increase overall spending. We need increased commitment for ageing well. Mental health of older people needs increased resources and further research, supporting the integration of mental health services and primary health care using a holistic multi-disciplinary approach.
Carers have been mentioned and I too want to put on record how valued carers are in society. Carers need access to good quality information and advice as well as flexible support services and respite care. There is a perception among older people that there have been substantial reductions in the level of domiciliary care provision. That the perception may be explained in part by the fact that resources do not meet demand, even though real expenditure has increased in the last decade. With an ageing population the demand has also increased. The delivery of services by different health boards is uneven, and to maintain high standards of care in residential homes an even more rigorous inspection system is essential.
Carers, as Senators stated, save the health service millions of euro each year, yet support for them is seen to be grossly inadequate. The burden of care has fallen largely on women who often receive little support from their own extended family. To promote the role of the carer, health services should work in partnership with families, the needs of carers should always be assessed at the same time as the person being cared for, and carers should receive appropriate support to develop stay-at-home care.
It is commonly recognised that, for a variety of reasons, less family support will be available in the future. The issue of whether the State will be able, or willing, to compensate fully for such a change is of vital importance to succeeding generations of older people. Research and appropriate planning for such an eventuality are crucial.
Available, affordable and accessible public transport is what members of the older community require and there is almost universal dissatisfaction with the present provision, particularly in rural areas. Greater partnership in identifying the transport needs of older people is required. Unused resources such as school buses should be looked at.
Senators have referred to the many worthwhile housing schemes for the elderly which are better in some areas than in others. Currently housing is not being designed properly for older people, giving them the right to retain the choice of where they live. Future planning needs to take account of the divorce rate, with its consequence of there being more single older people.
We also need to look at the area of security and of older people living in large houses, which are normally their main asset, when in effect schemes should be looked at to transfer this asset into a means for provision of care in their later years. I want to highlight an instance recently where an elderly person wanted to go into a type of sheltered housing. I could not get her on that housing list because she owned her own house, a substantial asset. She wanted to hand over the house to the local authority, which could have accommodated a large family. All she wanted was to be put on a list, but that could not be done until she sold her asset and went into some type of temporary accommodation. We must adopt a degree of flexibility in approach and we must be more serious and pro-active in facilitating people who have a substantial asset and who actually want security.
One of the most striking aspects of the elderly was brought home to me while campaigning before the general election when I engaged in lengthy conversation with a woman at a doorstep. She was very proud of her family, and spoke about them all and how well they had done, and I of course asked where they were living, etc. She would not give away the game as she was so proud of them, but the reality was that these people were so busy with their own lives that she was lonely. The loneliness of elderly people is something which we, as a society, must face up to. It is not only politicians who must face this. This is about the principle of community, of neighbourliness and of supporting those around us.
In some areas initiatives have been developed to provide both practical help and reassurance to older people and a range of possibilities exist such as befriending schemes, which I advocate, home safety information seminars, and identifying individuals who would benefit from regular checks or calls by the community or the police and arranging for these. Community associations should be encouraged to take on specific schemes to deal with the elderly. We must also provide further grants for safety items for the elderly and establishing neighbourhood networks.
The opportunity to enrich their own lives and those of other people is a fundamental priority with many older people. Without volunteers the social fabric would be strained to breaking point, and many who work for and with the elderly are themselves older persons. While Government recognises this, this recognition needs to be translated into more concrete support. Volunteering should complement and support – not replace – statutory services. An agreement between Government and statutory agencies and volunteer groups should be formalised to identify and clarify various responsibilities and obligations.
Life-long learning – LLL – needs to be attractive, accessible, affordable and enjoyable for older people. Its value to the individual and for the wider community is unquestionable. Older people have considerable experience and knowledge, and this wealth of skills remains relatively untapped. Certain questions remain to be answered for LLL to be put into practice in any meaningful way. In the recent past, for example, the older community have been denied access to funding on the grounds that they are not economically active. Older people need to be represented directly on the various bodies which carry forward the LLL proposals such as colleges, third level institutions and institutes of technology. The provision of courses should be drawn up in consultation with the older community.
We all touched on the issue of residential care and the greater demand, not only because of the increase in the numbers of older people but due to changes in our society. Modern living does not allow for families to provide full-time care for their parents. This is a cultural change in Ireland and it is something we must face up to. We have to refrain from promoting residential care for all and try to get a balance with adequate places and supports for those remaining in their homes.
To be consulted is to be valued and consulting the older community makes practical sense. Ageing issues need to be reflected in the school curriculum. This would not only help to change attitudes but also alert people at an early age to the need to think and plan ahead. I would advocate that the Internet, for example, should be used to link students with older experts to facilitate problem solving, and to engage them and provide that sense of friendship and support, giving that sense of being worth something which young people want to communicate with them. Older people need to become more assertive because unfairness, misrepresentation and ageism must be challenged. In addition, the agenda of the aged must be put forward in any future proposed equality legislation.
Greater help for the hospice movement is a cause I fully support. The philosophy of relieving pain in order that people can live until they die is one we should all support. Older people do not want to thrive at the expense of others. They want the opportunity of continuing to share their knowledge, skill and experiences to the benefit of all.
I congratulate the Minister of State on his detailed statement to the House on the many achievements of the Government in recent years. The cornerstone of all our policies is to keep our elderly people living in their own homes and within their own communities. I pay tribute to the elderly for the contribution they have made to the State and also to the carers whose voluntary work makes possible the standards in which our elderly live today.
I am involved with two voluntary housing associations providing 40 units in my area. As many speakers have pointed out, there should be some flexibility in regard to the qualifications for these schemes. People's circumstances may change a number of times throughout their lives. The voluntary housing sector has been a success story over the last 20 years. A partnership between the Minister's Department and local government to deal with issues affecting elderly people living in voluntary housing associations would be welcome. There is a crying need to cater for those who came in at 65 years and are now in their 80s. Voluntary beds for nursing home care could be provided as part of those complexes. They already qualify for grant assistance from the Department of the Environment and Local Government for the provision of these units. Grant assistance from the Department which provides those beds would make it possible for elderly people to live out their lives in housing associations. I ask the Minister of State to consider a pilot scheme in this regard.
I thank the Members of the House for their contributions which were very much appreciated. I greatly appreciate the kind sentiments expressed by a number of Members about my own commitment and level of work. I am taking my brief very seriously. I have hit the ground running and those speakers who listed issues of concern to them should watch this space. As I mentioned, there has been a sea change in the provision and delivery of services for older people in my Department. My outlook is very positive. I have begun to look at elderly people in a different light than heretofore, when they may have been considered a burden on society. We should acknowledge that older people have a tremendous amount to give to society. I also acknowledge that the current economic climate we enjoy in Ireland today was built in no small measure by the people concerned. They have given a full contribution to the country and it is, therefore, appropriate that we ensure support services are in place when they may require them.
I acknowledge the attendance in the House of Mr. Duggan, my principal officer, Mr. Brady, my assistant principal officer and Mr. McCarthy and Mr. Phelan from my office. This indicates the level of interest in the contributions of Senators and the level of commitment in the Department.
Senator Brennan was quite right in that there has been a lot of progress. The issue of voluntary housing is one on which I am working with the Department of the Environment and Local Government and my interdepartmental group. I would like to see more progress in this area. As time passes Senators will be impressed with our progress.
Senator Minihan made a number of suggestions that should be considered. These matters are under consideration: a number of the schemes he mentioned are already under way. The Senator also referred to an incident in which an elderly person wanted to return a house – a valuable asset – to the local authority in lieu of senior citizen accommodation. There is a scheme in place that would meet the needs of the person concerned. If the Senator wants more information, I will be happy to give it to him. He also mentioned the area of transport. The Department of Transport has a number of schemes in which the Senator would be interested. Again, if he would like more information, I would be happy to provide it.
I echo the Senator's sentiments in regard to the need for consultation. A number of the elderly network groups now introduce me as the Minister who has been here before to meet with us. My approach since my appointment has been to engage in widespread consultation and meet every single group. I started with the voluntary sector and moved on to statutory groups such as the NCAOP and then to professional groups working in the area of older people. I have undertaken widespread consultation across the board.
Senator Bannon mentioned a number of issues. I do not want to be political about this but he seems to have a lot of incorrect information. If he wishes to have factual and correct information, my officials will be happy to brief him fully on the tremendous progress made in the delivery of existing and additional services. It is something of which we should be proud. This and the previous Government have been very progressive in the amount of additional services put in place. It is regrettable that there are people who are not aware of how much good work has been done. I offer the Senator an invitation to ask for clarification on any issue. I will be happy to arrange it.
Senator Ulick Burke referred to a number of issues. The security of the elderly is an issue I have taken up with the Garda Commissioner as recently as this week, when I had a very fruitful meeting with him. I do not want to pre-empt what my officials and his will come up with but when I report back to the House, the Senator will be quite impressed. Areas mentioned by him such as community policing will be included. I also remind him of the rural initiative undertaken by my colleague, the Minister for Transport.
Senator Kieran Phelan is correct that there has been a change of focus from the institutional setting to the community. This is of great benefit to the elderly as they can stay in their communities with the appropriate supports and it ensures they are integrated in the manner they desire, most of the time keeping their dignity in their own homes. This is the manner in which I wish to advance, with additional supports for older people. The Senator is quite correct in the number of developments he mentioned.
Senator John Phelan may be aware that I had planned a visit to Kilkenny in the past two or three weeks to undertake part of my consultation process. Unfortunately, because of the death of a senior and long-standing public representative on the day in question and after consultation with some officials I thought it appropriate that the trip should be cancelled. The visit to Kilkenny will come back on the agenda as soon as my officials arrange it.
The rural transport issue was mentioned and earlier I referred to the rural transport initiative. The disabled person's grant for a woman in her 90s is a matter for the local authority, which needs to ensure an appropriate mechanism is in place to deal with priority cases. In answer to a point raised by Senator John Phelan, I have checked with Niall Crowley, chief executive officer of the Equality Authority, who has indicated that discrimination, whether positive or otherwise, should not exist. In the case referred to by Senator John Phelan, it may be appropriate for a statutory authority to have positive measures in place whereby priority can be given to an older person. I would be appalled to think that a local authority would not prioritise a lady in her 90s who requires appropriate alterations to her home and needs to avail of a disabled person's grant. I invite the Senator to bring the case to my attention if he feels it can be of benefit to do so.
I appreciate the kind comment Senator Scanlon made about my hands-on approach to my Department and the additional resources. I will take up the Senator's invitation to visit a voluntary housing scheme. I would ask him to make the necessary arrangements with my office and I look forward to seeing him on his home turf.
Senator McCarthy referred to the disabled person's grant and skills shortages in the health services. Great progress has been made by my interdepartmental group, which is considering streamlining all the grants and looking at areas where skills shortages exist as well as the current process of applications. We are considering innovative and creative ways to remove those obstacles.
Senator McCarthy also paid tribute to the Government for appointing a Minister of State with responsibility for children, an office which has been in existence for a number of years. The good news for the Senator is that, for the first time, the Government has appointed a Minister of State with responsibility for services for older people whose brief spans a number of Departments. What the Senator sought is already in place and much progress has been made.
I thank my good friend and colleague, Senator Feeney, for her kind comments, which are much appreciated. I particularly welcome her comments about respite care and day care. I concur with her view that tremendous work is being carried out by the providers of care at various levels throughout our community. I am delighted to hear the comments about the hospital to which she referred. The points she raised about the essential repair grant and the elder abuse will be considered by my Department.
Senator Feighan referred to a number of issues, particularly those relating to transport, that are under consideration. I am pleased to note his comments about employment, a matter on which I have strong views. It is wrong to tell a garda of 57 years of age that he can no longer continue to work on the force. It is wrong to tell people at 60 or 65 they should not participate further. Of course we should be cautious and indicate that we will accommodate those who wish to continue, at whatever level, to participate in the labour force on reaching normal retirement age.
I intend to consider the feasibility of removing what might be seen to be financial and other obstacles preventing people who may have pensions or secondary benefits from taking up employment which might bring them above the relevant level and result in their losing some of their benefits or bring them into a tax net and result in their being penalised. These matters will be considered by my interdepartmental group. Some progress has been made, but more needs to be done. The good news is that the employment aspect is being actively considered.
Senator Feeney also raised the issue of respite care and I share her concern. We should continue to ensure that adequate respite is in place at all levels. As she stated, it is vital that older people are supported in the home and the carers of older people who occasionally require breaks are able to tap into respite care.
The issue of carers was mentioned. I work closely with a number of the carers' associations. I am also putting in place appropriate funding. As far as I am aware, I have met every group representing older people. I have asked them to work with me in the most appropriate fashion. It is my desire, and that of my officials and the groups we have met to date, to bring about the sea change I mentioned with regard to the provision, delivery and availability of services.
I am looking at demographics and the current age profile. I recognise that the vast majority of older people who have made a tremendous contribution to the country's economic success are independent and have very positive attitude towards ageing. They continue to make extraordinary contributions to our society. There are a number of people who, as they age, may periodically require appropriate supports.
I am pleased to point to the Bealtaine festival organised by the Age and Opportunity network group, which is all about active participation in the community. I support many of the other active retirement associations' participation programmes and projects. While we can focus in a positive way on that aspect, it is important to remember the facts and figures I presented earlier which indicate the level of support we are putting into the appropriate services when they are needed and called upon.