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Seanad debates

Tuesday, 4 July 2017

Report on Dying, Death and Bereavement: Statements

 

2:30 pm

Photo of Diarmuid WilsonDiarmuid Wilson (Fianna Fail)
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I welcome the newly-appointed Minister for Social Protection, Deputy Regina Doherty.

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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I thank the Acting Chairman. This is my second time in the Seanad since my appointment. So far, I have not been anywhere else yet. It is a pleasure to be back in the House again.

I welcome the publication of the important report, Finite Lives, Dying Death and Bereavement: An Examination of State Services in Ireland, and thank the Seanad for the opportunity afforded to me to discuss its findings and extensive recommendations. It is fair to say the report would not have come about without the impetus provided by Senator Marie-Louise O’Donnell. It was kick-started by her initial motion on end of life care and bereavement carried in the Seanad in April 2014. The motion called on the Government to explore the components of an overarching strategy on end of life and bereavement which would examine wider societal issues, including legal issues, finance, economics, education and culture. In response to the motion, the then Taoiseach invited the Senator, in a letter of 26 March 2015, to examine Departments' policies, services and procedures around dying, death and bereavement and consider how they could be improved. A report on how the various Departments support their staff was completed in 2015 and, following the 2016 general election, work commenced on reviewing Departments' support to the public. This report is the outcome of this large body of work.

Dying, death and bereavement affects each and every one of us. It is a traumatic experience, although sometimes we do not fully acknowledge this. I was reminded of the final lines of a poem by Francis Ledwidge,To One Dead:

The silence for you

And the sorrow for me.

Ledwidge was no stranger to death. While Senators will be aware of the poet's early death, it is worth bearing in mind that his father died when he was five years old and his mother and he himself, as a teenager, had to go out to work to support the family.

Irish people are well aware of the sorrow of bereavement. We provide huge support to family members, relations, neighbours and friends when a bereavement is imminent and occurs. This is one of the very positive aspects of our society. However, we also need to identify the State's role surrounding end of life supports for those approaching death and their survivors. This was essentially the remit given to the Senator, namely, to establish the policies, services and procedures around dying, death and bereavement provided by the State and how they could be improved or developed.

Senator O'Donnell and her research team sent questionnaires to the Secretaries General of Departments, surveyed Deputies and Senators, carried out interviews with academics and practitioners and conducted desk research. I commend her on producing such an impressive body of work in such a short time.

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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The main recommendations of the report include developing an integrated strategy on dying, death and bereavement by an interdepartmental committee following a process of consultation. It seeks to improve access to information about end of life services and make life easier for people at a time when they should feel supported by the State. Practical recommendations include the establishment of a dedicated website on end of life services offered by the State and the introduction of a bereavement services helpline which would inform people of the steps they need to take following a bereavement and their rights and entitlements.

The report also recommends adopting a planning tool developed by the Irish Hospice Foundation, known as Think Ahead, which allows people to make preparations for their future care and to put their affairs in order. Many of these recommendations are straightforward, common-sense and useful measures that should be examined by Government and introduced where possible. Apart from the general overarching proposals, the report also makes specific recommendations for each Department. It is a tremendous starting point for discussion, consideration and debate.

Recommendations relevant to the Department of Social Protection include ensuring staff receive ongoing communications skills training. There have been significant improvements in the provision of staff training in recent years. My Department currently provides a customer service course to its staff that emphasises the Civil Service code of conduct, including dealing with customers sympathetically, efficiently and promptly. The course also emphasises best practice in communications skills. This is particularly beneficial for front-line staff dealing with end of life issues, including bereavement. All new entrants to the Department receive this programme and customer service training was also provided to front-line staff as part of the suite of training delivered during the roll-out of the Intreo service.

The report recommends that the Department consider introducing a service similar to the Tell Us Once service in place in the United Kingdom, whereby a bereaved person tells one point of contact on the death of a loved one and this information is disseminated to other departments. In my Department, when a date of death is recorded by one area of the Department, including the General Register Office, this information is disseminated within the Department via notifications through various information technology platforms. While this approach does not currently extend to other Departments or local authorities, this option could certainly be explored.

I draw attention to the citizens information website operated by an agency of my Department, the Citizens Information Board. The website includes a section on death and bereavement and provides information on the steps to be taken immediately following a death, registering a death, how to access income supports and legal issues that may arise. It is an excellent source of practical information. It also includes material on planning in terms of making a will, advance health directives and links to the Irish Hospice Foundation's Think Ahead tool, as well as general information on the State services available.

The two main recommendations for my Department are to reinstate the bereavement grant, which was abolished in 2014, and to increase the living alone allowance. The programme for Government includes a commitment to increase the living alone allowance. In this regard, a €2 increase in the allowance, from €9 per week to €11 per week, paid to pensioners and people with disabilities who live alone would cost €21 million. Introducing a once-off €850 bereavement grant would cost €25 million. As I am sure Senators will appreciate, there are many competing demands in the run-up to the budget between programme for Government commitments, my personal priorities, various pre-budget submissions and ensuring the social impact of the budget measures we introduce helps the most vulnerable. This does not mean anything has been ruled out. The bereavement grant is an issue that is consistently raised in my office, as I expect it is frequently raised with Senators. It was one of the first issues I inquired about on my appointment. The Department, through community welfare officers, continues to pay an average of €2,000 to people who present seeking assistance with bereavement costs. No one will be turned away.

Many of the recommendations in the report relate to other Departments. I am sure other Ministers and their officials will examine the recommendations relevant to their Departments and give them as much consideration as I am giving those that pertain to my Department. In conclusion, I thank Senator Marie-Louise O'Donnell for her time, effort and most particularly for her commitment to this issue. As anybody who knows her will attest she is eloquent in her description of things. Her passion for this topic knows no beginning and no end. She is really committed to the issue. One can see that every time she stands up to speak. I pay particular tribute to her for the amount of work she has done. I thank her for the huge service that she has done for us in providing us with this report and to ensure that Government takes it seriously and that we will all act on the recommendations in so far as Government finances allow.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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I welcome the Minister and wish her luck in her new job. I know that she will do it well and articulately. I thank her for being here today and for taking this debate.

My report is an examination of end-of-life issues outside the health arena. My remit was to establish through 15 Departments and two State agencies policies, services and procedures around dying, death and bereavement and how they could be improved, enlarged or developed. My report is the first comprehensive analysis of end-of-life issues across all Departments. I learned an awful lot during the research. It did not come out of the ether and did not appear from the back of my head. In fact, I had always thought about dying, death and bereavement as something personal, private and associated with family. That is true but experts have taught me to think about them politically. This is the one life event that Government can plan for as it is inevitable that all citizens and residents of the State will eventually die. One hundred per cent of us will die and dying is 100% guaranteed. The cost to the State is estimated to be €1.4 billion so this needs thought, planning, services, human rights, respect, acknowledgement, policies, reviews, communication, clear information, supports, creative practices, newly unmet needs and a national conversation.

As the Minister has said, my report originated from a meeting of the Oireachtas Joint Committee on Health and Children that was chaired by the former Deputy and now Leader of the Seanad, Senator Jerry Buttimer. He chaired the meeting beautifully and he fuelled the idea of this report with meaning and value. Following the hearings I tabled a motion on end-of-life care and bereavement in the Seanad that was accepted by the Government. The Taoiseach at the time then invited me to review the end-of-life services provided by Departments and my report is the result.

I stand on the shoulders of giants this evening because nobody ever does anything on their own in politics. They may think they do but they do not. In the Visitors Gallery sit representatives of the Irish Hospice Foundation, McAuley Place in Naas, the Turning Point Institute, architects, the Alice Leahy Trust, Anam Cara, funeral directors, active retirement organisations, Sage, the National Safeguarding Committee, the Citizens Advice Bureau, Irish Rural Link, psychologists, philosophers, writers, psychometricians and the lead researcher, Ms Caroline Lynch.

Most of our knowledge, as politicians and Senators, is gained at committees. Great, informed, respected and objective people who work on the ground attend committees and tell us what we need to know. We become the conduit to change and alter things, and create legislation to protect, develop and make life better for the common good. That is where my report has come from.

The report has three elements. Part 1 features indepth research compiled by 15 Departments and two State agencies, namely, the OPW and the Revenue Commissioners. Part 2 contains 34 qualitative interviews from diverse disciplines that range from the arts, law, psychology, ethics, philosophy, specialist palliative care, sociology, social work, funeral services, industry, criminology, the coronial service and architecture. Part 3 contains a survey conducted on Deputies and Senators.

Dying, death and bereavement are very profound subjects. This is a very serious report on how we, as politicians, and a new Minister of the State can improve services and, therefore, the lives of people facing mortality. End-of-life services cost the health budget €1.4 billion a year. Eighty people die every day and 800 people are directly affected by their deaths. Does the State measure up when people face their most challenging time? I have tried to answer that question in my report. It is not accusative but challenging. What is the State’s role in dying, death and bereavement? Does it support, enable, encourage and recognise? In some ways it does but in some ways it does not. The State does not prioritise the issues. There is little account taken of the signals the State sends out to people who are approaching the end of their lives or those whose lives will be changed forever by the loss of a loved one. A glaring example of this was the abolition of the bereavement grant, as mentioned by the Minister. The bereavement grant was rebranded as exceptional needs. Removing the word "bereavement" from the State’s lexicon has had a social and psychological impact. Bereavement is an acknowledgement of loss and we, as citizens, have a right for that to be acknowledged. "Exceptional needs" is a label of poverty and people do not like it.

The Government rarely mentions death in its reports. Death is mentioned in Government statistics and where compensation is paid. The State counts us in and it counts us out. The State encourages us to plan for education, employment and retirement. However, it does not encourage us to plan for the end of life.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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The State must encourage, support and enable people to think ahead and not to do so through one Department. One of the main recommendations was that the Department of the Taoiseach would take the lead and help people to think ahead.

Throughout the report, surveys and research the centrality of all arguments, and I have spent six years as a Senator, always comes back to the decency and dignity of how we are acknowledged and how our self-worth and self-respect is regarded, especially when human frailty, illness and life loss comes to our door. We need comfort, food, financial security, communication, warmth, transport, community care, the arts, lack of anxiety around loneliness, education, funeral and fuel surety, adaptive home environments, human rights, and living well with value and meaning until one dies. These are the issues that kept cropping up - living well until we die.

Why did the State second rate the power of community? I do not know why. The State continues to do so. It does not mean to do so but continues to do so. We live communally and locally. We do not live nationally. We die communally and locally. We do not die nationally. We want to die in our own homes. We talk about rural regeneration but at the same time strip away services. Planning permission is given carte blancheto globalisation within small towns and villages. We do not prioritise the human being as the core of all creativity and communication. We are now not likely to die at home or even live in our homes as we age because the State’s policy is geared towards building nursing homes. Community care is what people want not nursing homes. Despite our greatest and most hoped for final wish we keep building more nursing homes. Do Members know what that does? It teaches people how to be frail. That is what it does.

We have no such thing as architectural expectations. We do not expect the environment in which we live to be beautiful. We have no power over our houses. We have no power over trees, shrubs, where we can sit or what we can look at. We have no power but the banks have the power to decide how much interest one pays over one's lifetime.

It is everybody's right to be around environmental beauty. It is health particularly when one faces one's own mortality. That right has been eroded. When politics does not prioritise the human being as the core of all creation and communication in heart and head, when it ceases to understand the human need for a qualitative way of life, a good death and a compassionate place for those who are left behind, then politics ceases to be of value. That is why politics has become valueless. People do not trust politicians. Throughout all of my research, and all of the days and nights I spent with Ms Caroline Lynch, Dr. John Weafer and Angela Edghill, the following constantly arose - the need for a human being to have value and meaning.

The second thing that arose was the power of the arts. Music, drama, poetry and visual arts were platforms for hope, courage and joy. There is also the transformative effects of the power of personal conversation, private feeling and public expression. All of this acted as a way to navigate through the most appalling times of our lives. However, at the same time the Department of Education and Skills gave 25 points to mathematics but did not do the same for visual art.When I am at the worst time in my life, I will not be looking to algebra to help me out. NGOs are exhausted asking for help, making suggestions, doing things creatively and doing things imaginatively. They are constantly ignored because good practice is consistently and constantly subsumed by territory. That is what happens in politics. We have lost the landscape vision. I am offering the Minister a platform because I know she has ability. I do not believe in gender quotas but I believe in the truth that women can impart at times. I believe the Minister has a unique facility to take on aspects of this, run with it and see what she can do. Human beings are called to meaning. We are called to do more than function. We are value-giving people and meaning has collapsed.

I am nearly finished and I thank the Acting Chairman for his indulgence. The report on dying, death and bereavement informs us across all the Departments about isolation, fuel poverty, community care cutbacks, funeral costs and depression. The director of the safeguarding committee, Patricia Rickard-Clarke, is in the Gallery. Financial fraud is being perpetrated on the elderly. The Minister should carry out a spot check on whether pension payments that are being collected for our elders or for people who cannot collect them themselves are being used for the right reason. That has never been done. The previous Minister, now Taoiseach, was talking about a different kind of fraud. Is the money given to older people being used for the right reasons when they cannot collect it themselves? We have the ignoring and burying of elder ethics and rights. Questions must be asked and changes must be made.

The idea of the wicker weave on the front cover was to weave the concept of dying, death and bereavement across all Departments, not in a joyless or macabre way but in a way that Departments would see it as relevant and that it was their business. It is all of our businesses and central to how we think and develop all our policy. It could chart a way forward for all Departments - a life course, living well until one dies, and the right to a good death, a landscape vision of the whole life within a whole State. It is the reason I am a Senator.

How we die is as important as the irrefutable fact that we will. This report is the beginning of a national conversation. It is difficult and challenging but it is timely. It is one that may mark us out as a Republic which is 100 years old. I recommend the report to the House and to each Department to see where their relevance lies and what they can do.

It is an irrefutable fact that we will leave this planet and we should leave it well. We are always talking about how great it is to be born, become educated, get married and have a life here, but it must be a good place from which to leave. Those who are left behind should not be traumatised for the rest of their lives because of their leaving and how it was brought about when things could have been better.

I recommend the report to the House.

Photo of Gerry HorkanGerry Horkan (Fianna Fail)
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It will be hard to try to follow that. I congratulate Senator Marie-Louise O'Donnell; it is a fantastic publication. It is not my area of expertise normally, but I am delighted to be asked to speak on behalf of my colleague. It is a very fine 256-page report. I cannot say I have read every page and all the details, but I have read and absorbed a considerable amount of it. As it happens, my mother lectured in UCD for many years in social science. She lectured in gerontology, elder abuse and many of those areas over her 33 years in that department. Therefore, I have a bit more exposure to this topic than many people might think I do.

I welcome the opportunity to speak on the report. I support every aspect of it that I have read. I congratulate the Minister and wish her well in her new role. I also congratulate Senator Marie-Louise O’Donnell on the report which examines how the State and Departments - with the exception of the Department of Health which understandably is being dealt with in a different way - support people who are facing dying, death and bereavement. As an accountant, one might say there is nothing more certain than death and taxes. Unfortunately it comes to us all.

The report illustrates that dying and death cannot be looked at in isolation or as primarily the remit of one Department and that those facing death or those who have been bereaved will often encounter the Department of Social Protection and the Revenue Commissioners, but also many other Departments. We must therefore recognise that the State plays a role in dying and bereavement and how it responds can greatly affect individuals' and families’ experience at what is a difficult and sensitive time.

More than 30,000 deaths were registered in 2016 and almost 30,000 in 2015. This comprises people of all ages and people who died from multiple causes - natural, accidental, suicide and illness. For example, 151 neonatal deaths of children under four weeks were registered in 2015. Diseases of the circulatory system accounted for 9,249 deaths, almost one third of the total.

While these are not easy or comfortable subjects to discuss, the report underscores that we will all face dying and bereavement and we need to start a conversation about end of life. By doing so, the State will be better equipped to respond holistically and with compassion to the challenges associated with dying, death and bereavement.

The recommendations of this report, including the need for the State to develop a whole-of-Government strategy on end-of-life care, a review of income supports and allowances, and also developing quality standards for bereavement, should be acted upon.

We must face the reality that dying, death and bereavement come to us all and as the report encourages us to do, we must think and plan ahead for the inevitable.

The report examined the work of Departments in supporting citizens at end of life and in bereavement. The Department of Health was doing its own review and was excluded. Fifteen Departments along with the OPW and the Office of the Revenue Commissioners were part of this research. Based on the findings of the research, the report makes a number of overarching recommendations, as well as recommendations for each Department. Some of these have been covered already but it is worth highlighting them again.

These recommendations include developing an integrated strategy on dying, death and bereavement for Ireland. This is the primary recommendation of the report. Such a strategy should be wider than health care and extend across the spectrum. In order to conduct a national dialogue on end-of-life issues, the report recommends the State should engage in a consultation and listening exercise to inform the new strategy. The report recommends that the State conduct a socioeconomic review of costs linked to end of life, not as a cost saving exercise, but to determine the most appropriate, effective and efficient services for the dying, the dead and the bereaved. As Senator Marie-Louise O'Donnell said, most people would prefer to die in the community, in their homes with their families where possible, rather than in a nursing home or a hospital.

The report proposed the development of a dedicated website on end-of-life services offered by the State, providing a comprehensive outline of all State services that are available to support people at the end of life. It is essential that people are able to access comprehensive, accurate and up-to-date information on the relevant supports and services offered by each Department.

The report recommended that each Department review its services from an end-of-life perspective and develop a plan of action including a bereavement policy. This review should include ensuring that front-line staff receive training in communications. Each Department should also develop a bereavement policy and a range of supports for its own staff.

To reduce the administrative burden the report recommended developing a "call us once" service and a bereavement service helpline. The "call us once" service that operates in the UK allows a person to make a phone call on the death of a loved one and this information is disseminated to most affected Departments. The report recommends that a similar system should be considered in Ireland. That would be a very simple process when set up. It would relieve much of the burden.

I helped out an elderly neighbour of mine whose husband had died. People are required to go through an amount of organisations and agencies, and it is very upsetting to get letters and polling cards. If someone dies outside the State, the death certificate does not get to the places it would reach for those who die in Ireland. They remain on registers and continue to get letters sent to them which can be quite distressing even though it is understandable that it happens.

The report recommends the Government should review the income supports available to people who are bereaved, including an analysis of the telephone allowance, fuel allowance and living-alone allowance. We have discussed things. I understand the pressure the Minister is and will be under as we approach budget time. The telephone allowance did not cost much and gave people certainty. Equally with the fuel allowance, people are far more worried about fuel than many other things.With the amount of extra cost involved, the Minister could give a lot of people peace of mind.

The report also recommends that we support people to live and die in the community. It is important to ensure that the supports and services are in place allowing those at the end of life to have access to multidisciplinary teams of professionals within their own communities. It is recommended that the bereavement grant be reinstated. For many people, this was a very important grant at a very difficult time. It helped meet some of the financial costs that follow in the aftermath of a death. Funerals and the simple process of burial are extremely expensive, most of all in Dublin but also across the country. It is a huge burden for many families. The report recommends that we adopt the Think Ahead planning tool and encourage people to plan ahead. Developed by the Irish Hospice Association, Think Ahead allows people to make preparations for their future care and to put their affairs in order. The report argues that the State should adopt this tool and make it available to every citizen free of charge.

The report recommends that the Government should use its global influence to support the development of palliative care services internationally into the future. It recommends the development of quality standards for bereavement. There is currently no statutory policy or standard in respect of bereavement services in Ireland for adults or children. The report recommends that the State should ensure that all bereavement supports, including counselling, provide a consistently high standard of service. There is a recommendation to set up a working group in the Department of Education and Skills to develop guidelines and education programmes for teachers - involving civil society and teachers - to examine ways in which to support grieving children. Government Departments and agencies must recognise their role in these matters. The report challenges the State to build dying and death into policy and practice across all Departments and agencies. Whether death is sudden or prolonged and whether the person involved is young or old, it is at this time that we most need to be treated with courtesy and civility by the State and to feel that we have been so treated.

I congratulate Senator Marie-Louise O'Donnell and the big team behind her. I recognise a number of their names of those involved, for example, Jane Lehane, Denis Murphy, who was in college at the same time as me and is now the principal of St. Mary's, Ita Mangan, who lives in my former electoral area, Seamus Boland, whom I have met before, and John O'Keeffe. I did not even know all these people were involved in producing the report until I began reading it. I commend the report to the House. It is a fantastic publication and I hope many of its recommendations will be implemented sooner rather than later. Well done.

Photo of Victor BoyhanVictor Boyhan (Independent)
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I warmly welcome the new Minister, Deputy Regina Doherty, and wish her well in her role. I thank Senator Marie-Louise O'Donnell for this brilliant piece of work. It is a really important document. However, important documents are no good unless we take them on board and implement them. The report is 256 pages long and contains 86 key recommendations. The Senator engaged in 34 comprehensive interviews with people from diverse disciplines. Out of those interviews came 112 suggestions and these are listed in the report. I will not rehash what is said in the report. As the great old expression goes, "Do not teach your mother to suck eggs."

The report is not all gloom and doom. What strikes me most is the statement on page 14 to the effect that "the regenerative and joyous power of the Arts through music, drama, poetry, visual art, poetry and dance were cited as platforms for hope, courage and joy." What a lovely line. The report alludes to the overarching capacity of the arts to enrich us all.

While reading the report, I was reminded of Maslow's hierarchy of needs. The latter fits in nicely with this piece of work and describes the psychological need for food, water, warmth and rest, the need for security and safety and the need for belonging and love. Whatever age we are, we all long for, yearn for and require these things. It also includes the need for esteem, prestige and a feeling of accomplishment, as well as the need for acceptance, love, belonging and a sense of purpose. Then there is the need for self-actualisation and the achievement of one's full potential, capacity and ability. Each and every one of us needs that affirmation.

While the report deals with issues concerning death, it is also relevant to life and how we live all of our lives. We never know when our time will be called and we must leave this world. That is the fact of life. The report sets out clearly all the Departments and their objectives. There are 85 key recommendations, as I said. It behoves all Ministers and politicians in these Houses to keep those items on the agenda and drive them forward. Many people facing death at the other end of the age spectrum may be alone, vulnerable, concerned and isolated. They may have to struggle with officialdom for home care packages or community services, including meals on wheels, an amazing movement that is mentioned in the report. People in rural areas may have difficulty accessing the post office. They may have limited opportunities to meet someone for a chat, to feel recognised or to have a sense of belonging to a community. That is important.

For me, the biggest thing coming out of the report is that we are a people of art. One little quote on page 231 resonated with me. It is captioned "We are artistic people" and is attributed to Margharita Solon. It reads:

I am much more than a physical being. I am an emotional, psychological and spiritual being and it is the arts that will make me feel better. My hearing, my touch, my taste, my sight and my thoughts. These are really the things that make a difference into how I live my day. The whole area of the arts is huge.

What an important thing - making someone's day - what an important aspect of anyone's life. This is a really important piece of work. I acknowledge the people in the Gallery who no doubt have been involved. I know some of their faces. However, this fine work will mean nothing and come to nothing unless we keep it on our desks and our agendas, politically and personally, and drive each and every one of these 85 recommendations, heed the 256 pages and drive forward the 112 suggestions offered by the 34 interviewees. I congratulate the Senator on a wonderful legacy - not that she is going anywhere. She has a lot more to do.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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They have me dead and buried at the moment.

Photo of Victor BoyhanVictor Boyhan (Independent)
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It is an exceptional piece of work and it will be more relevant if we put it to use.

Photo of Colm BurkeColm Burke (Fine Gael)
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I welcome the Minister and wish her every success. I had the pleasure of working with her on the Joint Oireachtas Committee on Health for five years and I certainly learned a lot from working with her. I look forward to working with her in her new role as Minister. I thank Senator O'Donnell and all who have helped her in producing this publication. There is a lot of research in it and it is a super publication in that it sets out a range of extremely important ideas. As Emily Dickinson wrote:

Because I could not stop for Death -

He kindly stopped for me -

The Carriage held but just Ourselves -

And Immortality.

We need to look at the challenges we now face in this country. Death affects people of all ages, from as young as a day old to as old as 102 or 103. The one challenge we have is that, at present, there are over 600,000 people over 65 in Ireland. Within ten years there will be 1 million such individuals.That is the challenge we now face.

The level of support for old people are not the same as they were before. Families are smaller and many families have emigrated, leaving their parents at home. I know of a lady aged in her 90s who has lived in the same house since 1959. Her son and daughter work in the UK and are now retired. She is selling her house in order to move to England because that is the only way she can access the services she wants and have the support of her family. She could not expect her son and daughter, who have been working in England for over 40 years, to return to Ireland to look after her in her final years of life. That is the challenge she faces.

The report raises many issues, such as the living alone allowance. I was in a house in a rural area recently. I spoke to a man who, when his wife was alive, received a pension of over €400 a week, but when she died the payment was reduced to €240 a week. It is a significant amount of money, but those living in urban areas have access to bus services which makes things slightly easier. Those living in rural areas with no access to public transport are dependent on neighbours and friends to provide transport to shops, doctors and hospitals. That is the challenge faced by this man. The cost of heating his house has not changed since the death of his wife. The cost of food has not significantly changed. He lives on a narrow road on which only one vehicle can travel. If one met an ongoing vehicle one would have to pull in. There is no public transport. That is the challenge in rural areas.

I recently spoke to someone who is working with a farming organisation. She calls into farms to help them comply with safety regulations. She was amazed at the number of farmers to whom she called who have been living on their own for quite a number of years. When one is working on a farm and living alone, one does not necessarily have the same level of contact because one is occupied with the work one is doing. She came across people in their aged 70s and 80s who are still working. Rural areas need supports for people who want to continue to live and work there. The report highlights a number of key issues in that regard.

I met Senator O'Donnell when she was preparing this report. She is involved with me on the Bill relating to missing persons. The State could take immediate action. If a person goes missing, and the body is not found families cannot get a death certificate and face significant problems with simple things. There was a tragedy off the west coast in the past few months. The families faced face major obstacles in trying to access the supports to which they are entitled.

I met a gentleman whose daughter went missing over two and a half years ago. Her car and clothes were found near a beach, but her body was not found and a death certificate has not been issued. He is facing major challenges and wants closure. We can bring closure to such cases through the missing persons Bill. That man would be entitled to go to the courts and apply for a presumption of death order because all of the evidence indicates that the person who is missing has died. Such a system has operated in Scotland for the past ten years. Only five applications a year are made in Scotland, but they are important for the people affected because they want closure.

As a solicitor I deal with wills. People sometimes take short cuts or no cuts at all. For example, a will was made by a person who owned a farm in Ireland and house in England. He owned the farm in Ireland because the person who was going to run it had a drink problem. The parents did not leave the farm to the son who was running the farm but instead gave it to a daughter who was teaching in England. She died and the question of the location of the will and who should continue to work the farm arose. We could not find a will, but found a carbon copy of a will in an old handbag in a wardrobe in a house in England. I spent four days in the High Court trying to get the will approved. They are the kind of things we deal with in respect of planning, wills and administration.

Some people want to leave things until tomorrow, but tomorrow may come far more quickly than they think. We do not do enough to advise people. The great thing about wills is that one can write them today and change them tomorrow. We need to provide more information on wills.

I refer to planning for housing. One area I represent is the north side of Cork city where great estates were built. Every house has five, six or seven steps. That was fine when people first moved to the houses when they were young, but they are now aged in their 70s and 80s and it is impossible to install wheelchair ramps. We need proper planning. We plan for people aged 25, 30 and 35 years, but we are not planning for when they are aged 70 or 80 and want to stay in the same house.

The report has highlighted a significant number of issues which would not be costly to implement but could improve people's lives substantially. We face major challenges in terms of making sure an adequate number of people are available to provide home support. Of a cohort of more than 600,000, more than 23,500 are in the fair deal scheme . The same ratio would mean 40,000 people would be nursing homes in ten years time. We need to plan for that because if 40,000 people do not want to be in nursing homes in ten years time we needed to make sure there is enough support at local and community level to ensure people can continue to live in their homes.

I again thank Senator O'Donnell for bringing forward the report and all of those involved in it. It has made a significant contribution to the debate and I hope each Government Department will examine it carefully and bring about the changes that are required.

Photo of Maire DevineMaire Devine (Sinn Fein)
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I welcome the Minister and those in the Gallery. I received the questionnaire on death, dying and bereavement, and shuddered and stayed away from it for a while. Given the tenacity of Senator O'Donnell, I managed to fill it in. I am delighted that the report has been presented to the Seanad. I wish to continue the poetic sense which is probably right for the end of life. In his insightful book, A Grief Observed, CS Lewis wrote, "My temple was but a house of cards".

As Sinn Féin spokesperson on health and well-being and social protection, this research makes very interesting reading from many different perspectives. Much of our energies, legislation and debate in the Seanad and Dáil Chambers involve the act of living with dignity and quality of life. This report examines the act of dying with dignity and equality.

It is an in-depth piece of research. A lot of time and resources have gone into it and I offer a special thanks to all of the groups in the Gallery which have contributed their time and energy to it. The second recommendation in the report is to conduct a national dialogue on end-of-life issues. It is fair to say Senator O'Donnell has begun the process very well.

The former Taoiseach, Deputy Enda Kenny, was specifically thanked for his support of the work. I question the legitimacy of that endorsement, given the track record of the Government in terms of the cuts and austerity measures which targeted the most vulnerable. Austerity dismissed aging as burdensome and not valued, and treated it with disrespect.

Will the 86 key recommendations in the report to be taken seriously by the new Taoiseach and the Minister of State? This report and all of its recommendations within it cannot end up on a shelf gathering dust.

There is much to say about the report, but I have some point of note from my particular portfolios, namely, end of life issues and social protection. Recommendation 9 of the report is to reinstate the bereavement grant.In 2014, the bereavement grant was cut and it was possibly one of the most heartless austerity measures carried out by Fine Gael. The cost of funerals is enormous, not just financially but emotionally, and the grant was only an aid, yet it was taken away from the most vulnerable. The research in the chapter on social protection details funeral poverty, a concept which should never be allowed to exist. Perhaps the Government thought this cut fair to taxpayers, which is exactly and unfortunately how Theresa May has defended the cut of the bereavement grant in the UK this year. She is learning tips from our Government. Last year, Sinn Féin’s alternative budget included a €600 bereavement grant as a first step to re-introducing it. It is a relatively low cost to society but goes a long way towards looking after those suffering the aftermath of a loss and attempting to grapple with huge distress, grief and the challenges of life becoming so changed and different.

Health care is also my portfolio and I am well aware that the Joint Committee on Health is drawing up its own report on this area. Recommendation 8 is to support people to live and die in their

As a nurse, my task was mostly to fight to preserve life but, at times, I have held the hands of the dying in the darkness of the night when no relative was available or to be found. Frightened people often know that they are dying. It was a privilege to be there and to hold their hands. There was a beauty about it as well before the sun rose. We had small tasks, one of which I remember well. I do not know if it is done today. When someone died, we would open the window to allow his or her spirit roam free. There was a sense of being there for someone and watching his or her spirit leave, and we hoped that we offered them something if they were alone and did not have family around.

I see many similarities between the recommendations here and what Sinn Féin and I would push for. We would hold Government Departments accountable for the findings. This document should not be another dust collector on the shelf, particularly because of the expert input from the NGO sector, the public and all carers. Let us not allow this wonderful and respectful report go to waste. Let us do as we mean to and let us care enough and let us be reactive to the needs that this document addresses.

Gabhaim mo bhuíochas leis an Seanadóir Marie Louise O'Donnell. Well done to her. Let us progress the report.

Photo of Colette KelleherColette Kelleher (Independent)
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I join others in commending Senator O'Donnell. This is a significant, thorough and necessary piece of work and, might I say, a very beautiful document. Senator Grace O'Sullivan and I were looking at the photographs. It is unusual in a report to look at it and be visually stimulated rather than daunted by the volume of the words. We can all join in paying tribute to Senator O'Donnell for the way that she has painstakingly examined the issue and produced a comprehensive report. I was lucky enough to be present at the deaths of my mother and of my sister and, more recently, of my mother in law. One of the things one learns is that not all deaths are equal. Some are much better and nicer than others. The Senator's report highlights the conditions that we can make for us to live well, but also for us to die well and with dignity.

The report has 16 key recommendations that I think we can all endorse. I particularly welcome the call for the full commencement of the Assisted Decision-making Capacity Act. The Citizens' Assembly is currently examining the challenge and opportunities of ageing. On behalf of the all-party Oireachtas group examining dementia, of which my colleague, Senator Devine, is an active member, I made a submission to the assembly. Many of our calls in that submission directly link as they are about ageing and dying as peacefully as possible. They directly talk to this report.

As Senator O'Donnell said, people who are old and dying want to live at home for as long as possible. We must do all that we can to facilitate people's wishes. I always think that, even if my mobility changes and I could not move, I would love to be near a French door, feel the wind on my face and be able to see the little birds, smell the grass, see the mountains and listen to some music. We need to appreciate all of those things when people are at home or in nursing homes so that we can make the environments that Senator O'Donnell speaks so passionately about fit for people. We know from the Irish Association of Social Workers, Age Action, the Alzheimer Society of Ireland and UCD that people with dementia want to live in a familiar environment. In fact, it can be a terribly disorientating and dreadful state of affairs if people are in a non-familiar environment. Therefore, home care is particularly key to that group of people.

In the submission to the Citizens' Assembly, we called for the creation of a national network of dementia advisers so that there is not only at least one dementia adviser in at least every county but one in each primary care network. We also called for dementia to be recognised as a chronic disease within the new GP contract. In every community, both urban and rural, there should be a dementia friendly community. This will involve education and awareness among those in An Post and shops as well as gardaí. Those can be the people that are available in a rural area when doctors, nurses or a hospital are not available.

As well as improving the community environment, we need to enhance the home environment. The Department of Health acknowledges that home care support can be a cost-effective alternative to long-term residential care for some older people and it has just produced a consultation paper. The consultation is fine but we kind of know what we need to do. Last year, 25,000 people signed the Alzheimer Society of Ireland's pre-budget call but we did not act on it. I am sure an equal number will sign it this year. We know that we need home care and a home care infrastructure. We have it in many other countries. We need resources for home care so that it does not disappear in the middle of the year or disappear for those living in one part of the country or another. It needs to be adequately resourced. We need the regulation that Senator Burke has been fighting for in this House and we need the right to it so that it is not just for residential care. Senator Devine spoke about the focus that we have on residential care to the expense of everything else. In Denmark, they have not built a nursing home since 1987 because they have a mixed provision. They have some nursing homes - we do need some - but they have alternatives because they looked ahead and did the joined-up thinking that Senator Marie Louise O'Donnell recommends in her report.

A campaign by NGOs, many of whom are represented here tonight, is calling for a proper home care infrastructure. We need to do it. I do not really believe that we need a consultation. We will all participate in it but we know what we need to do. This year, I also proposed a Bill to safeguard adults at risk of abuse, for which I thank my colleagues Patricia Rickard-Clarke, Mervyn Taylor and others. This Bill proposes additional protections to protect all adults, particularly but not exclusively as we come to the end of our lives.

A recent RED C poll commissioned by the National Safeguarding Committee found that one in three people believe that abuse of vulnerable adults is widespread. Some 80% of people are unclear about what constitutes psychological or financial abuse. While we do not have comprehensive statistics on abuse and neglect, the data we have paints a bleak picture. Last year, the HSE received nearly 8,000 reports of adult abuse.The National Study of Elder Abuse and Neglect in 2010 estimated that 10,000 older people are mistreated or neglected each year, with 6,000 cases of financial abuse. The study also showed that the only income of many people who were financially abused was the State pension, and this will be of particular interest to the Minister of State. The State pays in excess of €7 billion in pension payments and more than €3 billion in illness, disability and carers' payments, and again we need to be sure the people who are entitled to that money are getting it and are not being taken advantage of by unscrupulous people, some of whom can even be in their own families. The Department of Social Protection has a big challenge to give adequate protection to people. This is the aim of my Bill.

The Bill does two main things. It establishes a national safeguarding authority and mandatory reporting. We need these to uncover the scale of abuse we have. I hope to bring the Bill back before the Seanad before the end of the year. An ombudsman for older people would also be very helpful. While the Ombudsman and Information Commissioner for Ireland deals with complaints from or on behalf of older people relating to public bodies, there may be a need for an office solely focused on complaints made by older people which has the responsibility for promoting the rights and welfare of older people.

As highlighted by Senator O'Donnell, we need joined-up thinking. We need assistive technologies. We have wonderful technologies. I saw this while working among children with disabilities. Eyegaze is one example. Why can we not have this for people suffering from strokes or people who have communication difficulties? We should have assistive technology in our homes, for example, lights that turn on automatically in bathrooms. This does not cost a fortune when we get into it. We should have technologies that will remind us to take our medications. There is a world and an internet of things out there. We need to make the end of life as comfortable as possible for people. I believe enhanced home care, new rights and protections via a safeguarding Act and an ombudsman and the use of new technologies would do just that.

I congratulate once again my fellow Taoiseach's nominee, conduit - I recognise that word - and Independent Senator on her extensive and very detailed report. I have no doubt that the proposed changes will make the very difficult but inevitable process of death and dying easier for us all.

Photo of Gabrielle McFaddenGabrielle McFadden (Fine Gael)
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I welcome the Minister of State to the Chamber and the guests in the Public Gallery. This study was designed to be an examination of end of life issues outside of health. I admire the fact it has begun a conversation between the State and the citizen about these issues. I commend Senator Marie-Louise O'Donnell on the great work that went into this study. I also acknowledge the former Taoiseach, Deputy Enda Kenny, for having requested this study and support and respect his motives for having done so. As Senator Kelleher has said already, it is truly an amazing and beautiful publication. To be honest, I was not going to speak in this debate because I do not find the topic of death an easy one to discuss but, having looked at the publication, read it a few times and picked it up and put it down a few times, I felt compelled to come to the House and voice what I have to say. For a report like this, it is very beautiful.

Dying and bereavement are inevitable. Each year, 29,000 of us die in this country, which leaves about 290,000 bereaved people in the country each year. Helen Keller said:

We bereaved are not alone. We belong to the largest company in all the world - the company of those who have known suffering.

When we are dying or caring for someone we love who is dying, the State should be there to support us. The State must do better to support us when we are in our hour of need. This report asks, and I believe rightly so, that where State services are required, they be put in place or that the State help and support communities to respond to the needs of their citizens who are dying or bereaved. The report recognises the need for comfort, financial security, warmth and community care when one is facing end of life issues - in the words of the report, "living well until we die". The time when one is dying and one's family is dealing with the trauma of a loved one dying is a time when we most need to be treated with courtesy and respect.

I am helping at present a family facing the death of a loved one while trying to care for a very sick person and continuing to work and rear children. One Department is seeking forms, birth certificates and bank statements from this man. In my mind, the carer has enough to be doing living day to day, rearing young children in a house and caring for a terminally ill loved one without having to try to look for things the Department needs. The Department should be more compassionate and allow them to live the last few months of their lives comfortably as a family. Worrying about forms and certificates can be done later. When a family is at this stage, they need to spend every minute they have as a family making great memories and not worrying about forms. My family and I know this only too well. Departments need to be sensitive and helpful to families. I have personal experience of this, both positive and negative. On one occasion, my family received a letter from the HSE asking us whether our family member still had a terminal illness. It is unbelievable.

This report, as I said, starts the much-needed conversation about what the State can do to make life easier for someone who is dying in order that the family left behind have memories of a lovely, serene time, not a stressful time of hardship. One must not regret that one's final time with one's loved ones was spent filling out forms and getting bank statements and certificates together. Each Department has a responsibility to take this report on board and see what can be done to build death and dying and bereavement into policy and practice across all Departments. I commend the report to the Minister of State.

Photo of Joan FreemanJoan Freeman (Independent)
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I wish to share my speaking time with Senator McDowell.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Is that agreed? Agreed.

Photo of Joan FreemanJoan Freeman (Independent)
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I am here more than anything to support Senator O'Donnell. She is marvellous. Her passion comes through every time she speaks, and what she has produced reflects exactly the kind of person she is. She is committed and has such enormous love of humanity, and it shows in her report. I was not going to speak either but I really wanted to say a few things.

I watched my mother and my mother-in-law live and die at home. They were in a very fortunate position because they had a large family and we did all the minding and caring. We forget such efforts all the time. I have two very good friends, one of whom travels down to Kerry every weekend. Her whole weekend is spent looking after an elderly parent while her sister looks after the parent during the week. I have another friend who does the same thing in Longford. They are saving the State many thousands of euro. They have lost much of their own lives doing this. They have put their own lives on hold. One of them does not get any carer's allowance. Any carer's allowance would never be adequate anyway for the amount of work and the hardship they go through, not that it is hard to mind a parent, but one's life stops and there are no two ways about it. In my case, I had to leave my children every Tuesday night to stay with my mother. I found this terribly stressful but there was no way under the sun we would have allowed our parents to go into a nursing home. This should be the main focus. Deputy Enda Kenny said this is a wonderful place in which to grow old. It is not a wonderful place in which to die. Furthermore, when I had two parents, a mother-in-law and a mother, die within months of each other, it was at enormous financial cost and there was no bereavement grant. Again, because we are a big family, we were able to club together and pay for it, but do we all remember how older people are always terrified of not having enough money to have themselves buried? What a terrible thing to have to think about and worry about. The removal of the bereavement grant was an insult to the people who worked for our country and made it what it is.I congratulate the Minister on her new job and it is lovely to meet her. I know she has probably already organised her budget but I ask her to consider reinstating it.

Photo of Michael McDowellMichael McDowell (Independent)
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I congratulate Senator Marie-Louise O'Donnell on this report. I attended its launch on what was an auspicious day. I welcome the Minister, I congratulate her on her appointment and I wish her well in the discharge of her functions.

I have become increasingly aware of a delay in the holding of inquests. People may die after a fall at home but it is now quite frequent, in the Dublin area at any rate, for an inquest to take a year or 18 months. It is difficult and unnecessary to leave that hanging over a family, especially when there is no suggestion of foul play. In the Constitution there is a general right to inherit or bequeath property by will but the legal profession and the Judiciary have somehow created a new idea that any challenge to a will gets paid for out of the estate, unless it is brought recklessly or in bad faith. This means people who are trying to administer estates in accordance with the intentions of the deceased are effectively blackmailed into surrendering to any case unless they can establish that the will is being challenged in bad faith or there is no real hope or prospect of challenging it successfully. Legal costs are very significant in these cases.

As regards getting older and approaching death, people are living a lot longer and, from time to time, it is tentatively stated that the pensionable age will go up by a year in 15, 12 or two years' time but we have not grasped the nettle of compulsory pensionability and bringing people's working lives to an end well in advance of the end of their natural lives. This applies particularly in the public sector, where so many people face getting their marching orders at 65 and living in an economic twilight zone thereafter until the onset of extreme old age. In the context of implementing all the suggestions made in Senator Marie-Louise O'Donnell's report, we have to face up to the fact that when Bismarck introduced the old age pension in Germany, it was available, on average, for about two years. However, we now live in a world where pensionability will be 15 or 25 years for may people. The implications, economically and socially, for those who are marginalised, out of employment or not playing an active part in the community are very significant and we have to face up to them.

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Senators are entitled to five minutes each but three Senators remain and there are only ten minutes left. Can they agree to stick to three minutes each? Agreed.

Photo of Paul GavanPaul Gavan (Sinn Fein)
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I congratulate Senator Marie-Louise O'Donnell on an excellent report. It is not every day that we get agreement in this Chamber but the Senator's report has achieved that and she is to be commended. It is a fine and timely piece of work. I welcome the Minister and congratulate her on her recent appointment. I have been through the bereavement grant process and it means a lot to families. Now that we seem to have some additional fiscal space, and maybe even some hidden fiscal space, it is high time for the Government to look at the issue and see if it can give people some reassurance.

A colleague of mine has been told he will lose his weekly heating grant because he has savings. However, those savings are destined to pay for his funeral. That seems to be a terrible way to punish someone after a lifetime of work. It is wrong and I think we all agree on that. I note that the grant is being phased out but that is not the point and somebody in their 70s should not be faced with the choice. It is an example of the State at its worst.

We need to look at standards because there is a huge gap in home care services. Senator Kelleher said we should try to keep people in their homes for as long as possible but there are a number of private sector operators which pay their staff as little as €9.50 and have them on precarious work contracts. One cannot have high-quality standards of care and continuity of care if such companies lose staff every six months because it does not pay them to work. It does not pay them if they do not get money while travelling from one person's home to another. There is exploitation in this area. We should look at bring in a sectoral employment order to ensure that high standards of pay and training exist throughout the sector. The same applies to nursing homes. We seem to have drifted into a situation where care for the elderly has been effectively privatised in the past two decades, which is a retrograde step.

Photo of Michelle MulherinMichelle Mulherin (Fine Gael)
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I also compliment Senator Marie-Louise O'Donnell. I was also at the launch and it was a very interesting and different experience. I also compliment all the people who supported the Senator in delivering this document, which is broad-ranging and far-reaching in nature. I also agree that it is timely.

We would not have had this debate 100 years ago as people would not have been living so long. People are having fewer children and the demographic profile of society has changed. The only way we are sustaining population growth in the West is by living longer, unlike in developing countries where people produce more children. We should consider ourselves blessed that we have the space to have this type of conversation because in many countries they do not have it. It is also challenging because 60 is the new 40. We want to have quality of life. People work hard and have built up the country and the society that we enjoy. We have to look at housing and where people have mobility issues they should, if at all possible, stay at home and be supported, which is the cheaper option anyway. Senator McDowell spoke of pensions but who will pay for them if our younger people have gone? This leads me to the issue of migration, which is a massive topic for us as we grow older. Hopefully, we will enjoy good health as we do so.

I congratulate the Minister. I know she has empathy with this topic. I wish to raise one issue, however. At the moment, people get carer's benefit for two years. If they have a dependent child who is terminally ill, one parent can stay at home for two years until the payment stops, after which they are means tested for carer's benefit. If the other parent continues to work they can avail of the carer's benefit if they take two years out but that may not suit the set-up. There needs to be some accommodation when there is a dependent child or adult involved so that spouses or civil partners can share their PRSI credits to maximise the amount of benefit. If the other spouse stayed at home, the State would still have to pay carer's benefit. It is just transferring credits to somebody else. I am involved with such a case and I will bring it to the attention of the Minister. It would bring fairness all around. I welcome this debate.

Photo of Alice Mary HigginsAlice Mary Higgins (Independent)
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I welcome the Minister, Deputy Regina Doherty, to the House and congratulate her on her appointment. I commend Senator Marie-Louise O'Donnell on her report. This is an incredibly important conversation. She is correct to say that the arts have been able to have this conversation in the past, going right back to the ancient Greek writers and to Irish writers such as Michael Longley and others who have drawn inspiration from it and who recognised that when we look to the essence of what it is to be human, we also need to look to the essence of what it is to live and die and our duty to the dead as well.

Having worked with Older and Bolder, campaigned on the national positive ageing strategy and talked about the demographic dividend, it was an interesting read and a challenging read to go to the next step and to consider death and bereavement. I commend Senator O'Donnell on making this conversation happen, not just between the State and citizen but within the State. Each of us who read the report was given pause for thought. One can see that in the correspondence the Senator has had with Departments such as the Department of Public Expenditure and Reform, and the Department of Finance. She showed them how they have a relationship and responsibility in respect of death. I was really struck, for example, by the Department of Defence and the view it had following the experience of those who have seen the thousands of migrants who have died in the Mediterranean Sea. It is now considered that they might need training in cultural norms to understand the different experiences of death that are happening with those around them. There was a huge sensitivity and detail in all those areas. Another area of note was the role of educators and, in terms of childhood bereavement, the need for psychologists. In the area of health we must consider the Assisted Decision-Making (Capacity) Act and the advance care directives. We have an anomaly in the State where pregnant women are, unfortunately, excluded from some of that advance care protection.

Given the limited two minutes I have I must abandon most of my points and focus specifically on social protection because I am a member of the Joint Committee on Social Protection. The proposals in this regard are concrete and solid. They include the gender pension gap, the very real and concrete issues identified by Age Action and others and the real problems for women in particular who tend to become distant from the system. I refer to qualified adults, people who are dependent on a spousal pension who often find themselves in a real limbo and disconnect from the system itself.

I highlight again the importance of the bereavement grant, even as a point of reconnection with the system and something people can access because an exceptional needs payment, which is means tested, is not something someone who has been outside the system will be able to access at that time of urgent need. The bereavement grant has had a very crucial role. Senator Marie-Louise O'Donnell has called on the Minister to look at the issue of funeral poverty. Reference has been made to Scotland in this regard. We have seen the impact of funeral debt in the UK. This is an important issue.

It is a key moment when a person finds himself or herself living alone. The living alone allowance is important in terms of how people are supported to make that possible and allowing them to continue to contribute to society and their community while living in their home for as long as possible.

Others have spoken about home care and quality care but it is crucial that there is recognition of care in our system with the care credit. It is vital in terms of the pension and the long-term security of people to ensure we do not penalise those who have delivered care, as is currently the case. Reintegration is an important issue. People in their 50s, for example, might have cared for five or ten years and they want to re-enter and re-engage with the system. A care credit would be important to allow someone who is coming out of a bereavement to re-enter or retrain and come back into his or her own life having generously contributed and supported the State through his or her work of care.

Assisted technologies were mentioned but I wish to-----

Photo of Catherine NooneCatherine Noone (Fine Gael)
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Acting Chairman, I ask Senator Higgins to conclude.

Photo of Alice Mary HigginsAlice Mary Higgins (Independent)
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I will finish. I wish to refer to public funding support for public research. Very often it is not a case of a product that is going to be on sale but it is a social process we can invest in, and public research can often identify that in a way that perhaps commodity-based research might not. This can transform experiences.

Photo of Martin ConwayMartin Conway (Fine Gael)
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Our wonderful colleague, Senator Marie-Louise O'Donnell, has done a phenomenal service to the State in terms of this report. I had indicated to the Fine Gael group that I would like to speak but, unfortunately, others got in before me. I welcome the Minister, Deputy Doherty, to the House and congratulate her on her appointment. The great thing about this report is that it took so much from the report we did on farm safety.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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Well, I read it.

Photo of Martin ConwayMartin Conway (Fine Gael)
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The Senator took so much from that report. I refer to the practical suggestions and solutions such as the one-stop-shop in the Department of Agriculture, Food and the Marine which all bereft people could access as opposed to having to ring one Department for one payment and another Department for another problem. The Senator addressed issues of concern to families who find themselves bereaved, something that was highlighted in our report. I applaud the phenomenal programme of work Senator Marie-Louise O'Donnell has done. I sincerely hope this report will percolate down into Government policy and that the Government will take note of the recommendations within it because, as others have said, we are all going to die and we hope we will do so with dignity and that the State will provide us with that dignity. I commend the recommendations in the report. I sincerely hope the Minister, along with her Government colleagues, will implement as many of the recommendations as is practicable and possible.

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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I thank Senators for all their contributions. They are exceptionally valuable to me. If I was able to do all the things I want to do, in particular for vulnerable people, older people and those who care for vulnerable people, I would probably use up every penny of the fiscal space no matter how big or small it is. Members know that will not be possible but we will fight as well as we can for it.

Without going into individual contributions, I have heard loud and clear about the need for quality home care based in our homes and communities. Probably every single person mentioned it today. I do not remember if it was Senator Kelleher who said we do not need a consultative process but I disagree with that. We do need one, in particular on the issue of how we will pay for it. We all know what we need to do, but it is not as simple as switching on a button and for it to be there next week. The review needs to be very small and time limited.

Photo of Colette KelleherColette Kelleher (Independent)
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It must be quick.

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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Yes, it must be done quickly in order that we can get to the focus of knowing what we need, which is a service that is of a high quality and is well paid in the community in order that parents and vulnerable citizens can stay in their own homes and enjoy the beauty of those around them, namely, their grandchildren, children, friends, and birds in the back garden such as the robins who come up and eat the bread. We all know what it is like to have a good quality experience in our older years and we must be aspirational in terms of providing people who are in their dying months to have that time at home where they want to be.

I wish to refer to one or two minor issues that were raised where a response was sought. Senator Marie-Louise O'Donnell spoke about making sure people who are entitled to payments are getting them and that they are not being misused by others. There are arrangements in place currently and there are audits. We could probably step that up but I will have a look at the issue and come back to the Senator.

First, I must correct the record on the bereavement grant. I think I said we spent €250 million on it before we got rid of it but we did not. I got that wrong. It was €25 million. It is something everyone would like to see come back, but when we come to making such decisions, we will only have a very small amount of money and we do not want to exclude anyone. Reference was made to the hidden fiscal space but I have not managed to find any of it yet. It is not the case that one set of people is more vulnerable than the next set of people because we all know that all the citizens for whom we provide require help. My Department is a payments Department so therefore everyone is relying on the money they get every week. What is important is to make sure we reach the most vulnerable people. People who are in the dying days of their lives, along with their families who are left behind, are very vulnerable, and the last thing we want is any pensioner worrying about the money he or she has in the post office to pay for his or her funeral.

I assure Members that community welfare officers do not refuse anyone. That is one of the first things I asked when I became Minister. We are delivering an average of €1,700 for every claim that is made. We genuinely do not refuse people. If anyone has any knowledge of that, they should please bring it to me and I will certainly follow it up. That is not to say the reinstatement of the bereavement grant has been ruled out in the budget deliberations this year. It is just that there are a lot of competing issues.

Various topics have been handed to me with regard to the various payments my Department makes.That is what it is there to do. It is for people who are either vulnerable, living alone or parenting alone. There are 140 different types of payments. They are not competing, although they are competing. My role and aspiration is to make sure that we look after our ageing population.

We must make sure that we look after them financially and consider the compulsory retirement age. We must recognise that 60 years is probably the new 40. I look forward to my retirement and having time to do stuff that we do not have time to do today. We need to recognise the gap between when people lose their jobs and, realistically, from about 58 to 59 years probably will not secure full-time employment. We must have something for people that is socially inclusive as opposed to putting them on something like a jobseeker's payment and leaving them sit there until retirement age. That is one project that we will consider. More importantly, we should encourage people to stay in work. We must remove that bar, whether it is just anecdotal by practice in the private sector or legislatively in the public sector. We must let people know that they do not have to remain working if they do not want to do so, but we must allow people to defer their pensions if they so choose. We must allow people to continue to work and remain active if they feel they want to do so. An actuarial review is under way. I expect it will give us all food for thought and I ask Senators to come on that journey with me.

Since my promotion, people have told me that pensions and social insurance are complex issues. I believe that things are only as complex as we make them.

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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The idea of the State, and the money that we have to spend in the State, is to provide people with a certain standard of living in their vulnerable or old years. That work should not be as complex as people make it out to be. We must consider how much money the Social Insurance Fund will yield over the next couple of years. We must recognise that far more people will reach pension age than younger people who pay for those pensions. We must analyse how we manage the Social Insurance Find over the next ten, 20, 30 and 40 years and ensure we provide for the older generation who are living longer and healthier lives. We must ensure that they enjoy their lives by having a few bob in their back pockets every week. We must ensure that they experience a good old age.

We must consider all the numerous and worthwhile recommendations in the report. I will make sure that every Department reports to me on a six monthly basis on where they are with specific objectives that have been set for them. I can manage this work because only two Departments are specific to me. We must make sure that we consider that experience. As a State, we must ensure that our interactions with people, whether they are in their dying days or the bereaved who have lost loved ones, are dealt with as compassionately and with as much care and consideration as possible.

Senator McFadden was here earlier. I know the Department she talked about and it is mine. Unfortunately, many of the payments are governed by legislation and certain boxes must be ticked. On Monday of last week or the week before, a wonderful gentleman was brave enough to go on "Liveline" to tell us about his experience at the hands of the State. As a result we must all go to every Department to say that while something might be set in statute, there must be wriggle room for compassion. We are all people and not one of us would want our mother, father, grandmother, grandchild or anybody we love and care for to be treated sometimes by Departments in a cold and clinical manner. If nothing else, today's report should make every Department think about their interactions with citizens. We are here to serve citizens and we are lucky to have the privilege to do so.

I will come back with recommendations on a twice yearly basis. The initiative will help us to analyse where we are now and we might have a review to ensure that we are doing what we are supposed to do. I commend Senator O'Donnell on a beautiful piece of work, as many people have said here tonight. The report is a testament to her positive view of what growing old and dying should be like, and how the bereaved should be treated by the State thereafter. I thank Senators for the courtesy that they have extended to me tonight.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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I know I am not allowed to speak.

Photo of Maire DevineMaire Devine (Sinn Fein)
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That fact never stopped the Senator before.

Photo of Marie Louise O'DonnellMarie Louise O'Donnell (Independent)
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Yes, but I wish to recognise the various CEOs of organisations who are seated in the Visitors Gallery. Earlier, I omitted to mention Ms Mai Quaid, CEO, Active Retirement Ireland. She is an extraordinary woman and an extraordinary CEO of an extraordinary organisation.

I thank the Minister for her comments. I thank all of my colleagues for their support.

(Interruptions).

Photo of Catherine NooneCatherine Noone (Fine Gael)
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That concludes statements. When is it proposed to sit again?

Photo of Colm BurkeColm Burke (Fine Gael)
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At 10.30 a.m. tomorrow.

The Seanad adjourned at 8.35 p.m. until 10.30 a.m. on Wednesday, 5 July 2017.