Pre-Budget Submission 2008

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• PRIORITY ISSUES
• INTRODUCTION
• BUDGET 2008 OBJECTIVES
• RECOMMENDATIONS
  • Recommendation 1
  • Recommendation 2
  • Recommendation 3
  • Recommendation 4
  • Recommendation 5
• BIBLIOGRAPHY

PRIORITY ISSUES

• Link the Old Age Contributory Pension to Public Service Pay and increase by one half of a percentage point per annum.
• Introduce a new Tax Credit for over 65s of €1,000 (worth €200) for expenditure on bona fide repairs by approved craftspeople.
• Provide adequate funding for CARELOCAL to ensure the continued provision of much needed visitation and support services.
• Enact legislation to create a statutory basis for the provision of home help and meals services to older people.
• Increase funding of community-based services for older people.

INTRODUCTION

CARELOCAL is an organisation whose mission is to provide companionship to older people living alone throughout the Dublin City Council area. We operate on the basis of recruiting volunteers who give freely of their time to visit frail and housebound older people in their homes, to extend the hand of friendship, and to provide them with a link to the outside world.

Services include one-to-one visitation in the community and in nursing homes, provision of day trips and social outings, live musical entertainment in Community Centres and residential homes, home repairs and financial assistance, and advocacy. All volunteers are screened and trained before embarking on any visiting. We are gratified that we have succeeded in attracting increased numbers of volunteers over the last number of years, and our year-end target of 115 volunteers will be achieved. We have a target of having over 150 visiting volunteers by the end of 2008.

As CARELOCAL has been providing these services for over 30 years, on an almost entirely voluntary basis, we are well positioned to understand the needs of older people.

Why the service?

In the National Development Plan 2007-2013, the government states that

'Older people are recognised as one of the main groups who may be at risk of social exclusion.' (NDP p. 228).

With the changing demographics and lifestyles in Ireland, many older people are now living in communities where very few of their original neighbours live. As property prices have increased, their neighbourhoods have become more attractive to a wealthier, younger population. This section of society tends to be time-poor, and the result is a breakdown of the original sense of community in which the older people now live, leading to an increased sense of social isolation. Further, as the extended family becomes more dispersed away from the city, the links with family are weakened, and personal physical contact opportunities are reduced in number.
Residents of Dublin City Council sheltered housing complexes, and of private and HSE nursing homes, can also tend to be isolated from the wider community. Pro-active measures are required to ensure the continued integration of older people in their local areas; CARELOCAL provides the structure and vehicle for younger people who want to reach out to their older neighbours, in a safe and supported way.

The National Action Plan for Social Inclusion 2007-2016 states that “Most [older people] would prefer support services to be delivered in ways that enable them to stay in their own homes and communities for as long as possible” (NAPSI, p.49). A major benefit of providing a visiting/companion service is that it contributes to the extension of an older person’s period of self-sufficiency and independence. The benefits to the Exchequer are that people who might otherwise become dependent on the State remain independent for a longer period. International research has demonstrated the strong link between social connectedness on the one hand, and health and personal well-being on the other (OECD, 2001). Regular social contact has shown to be buffer against mental and physical illness for all age groups.

Into the future

As the population of older people increases due to greater longevity, there is a corresponding need to expand community-based services, both statutory and voluntary, in order to meet government commitments to supporting older people to live independently at home, and to participate in the life of their communities.

The Social Partnership Agreement “Towards 2016” sets out a vision in which:

• Every older person would be encouraged and supported to participate to the greatest extent possible in social and civic life;
• Every older person would have access to an income which is sufficient to sustain an acceptable standard of living;
• Every older person would have adequate support to enable them to remain living independently in their own homes for as long as possible. This will involve access to good quality services in the community, including: health, education, transport, housing and security, and;
• Every older person would, in conformity with their needs and conscious of the high level of disability and disabling conditions amongst this group, have access to a spectrum of care services stretching from support for self-care through support for family and informal carers to formal care in the home, the community or in residential settings. Such care services should ensure the person has opportunities for civic and social engagement at community level. (T16 p. 61)

CARELOCAL acknowledges that the budgetary framework in 2008 will be relatively challenging, due to changing economic circumstances. However, even if the gloomiest economic predictions come to pass, the situation in 2008 will still be far better than it was in the many years that our older people worked, for relatively low pay, and were taxed at extraordinarily high rates. Thus, we argue that somewhat reduced economic circumstances cannot absolve the current taxpayer from responsibility for payback time for the older people. We also believe that those same taxpayers would accept that responsibility generously.

BUDGET 2008 OBJECTIVES

Our proposals for Budget 2008 are framed with 2 objectives in mind:

• To ensure that older people are guaranteed a proportionate and fair share of the nation’s wealth.
• To ensure that older people are adequately supported with a portfolio of services to allow them to live in independently and safely at home.

RECOMMENDATIONS

Recommendation 1:

Link the Old Age Contributory Pension to Public Service Pay and increase by one half of a percentage point per annum.

The growth of the economy in recent years is well documented. We would argue that as a basic principle, older people should enjoy a proportionate share of national wealth. Our analysis, on at least one key indicator, shows the opposite to be the case.

Comparing the increases in the Old Age Contributory Pension (OACP) in recent years with the growth in Public Service Pay, and with GNP, makes the point. Table 1 compares growth in Public Sector Pay, GNP, and OACP from 2000 to 2006. It is clear that the OACP growth has lagged behind Public Sector Pay & Pensions, and GNP.

What this means is that the pensioners are receiving a reducing share of the wealth of the country, and are particularly disadvantaged vs. the Public Sector. These inequities we believe can be remedied with low cost to the Exchequer.

D

Index OACP

Year	Amount €
2000	100
2001	110
2002	120
2003	130
2004	137
2005	147
2006	160

Index Public Service Pay & Pensions

Year	Amount €
2000	100
2001	121
2002	133
2003	147
2004	158
2005	172
2006	188A

Index GNP

Year	Amount €
2000	100
2001	111
2002	120
2003	134
2004	141
2005	153
2006	164

It is not the role of CARELOCAL to comment on the level of Public Service remuneration. However, if the pensioner community are receiving proportionately less than the Public Sector, it means that the share being given to pensioners is falling.

We also acknowledge that the OACP has increased substantially over the last six years. The problem is that despite the increases, the OACP has not kept pace.

In order to arrest the decline in share of national wealth available to pensioners, pensions payments should be automatically linked to an appropriate grade in the Public Service. For the foreseeable future, the share available for pensioners should be increased by agreeing to raise the OACP by a half percentage point p.a. above the appropriate grade mentioned in point 1. Thus, if that pay grade moves up by 5%, the OACP should move by a minimum of 5.5%

To do otherwise is to say to those in our society who made sacrifices down through the years to provide the wealth we have today – thanks, but we take the spoils from your efforts.

Recommendation 2:

Introduce a new Tax Credit for over 65s of €1,000 (worth €200) for expenditure on bona fide repairs by approved craftspeople.
Home maintenance and home security are issues of major concern for older people living alone.

Many older people are not confident in bringing tradespeople whom they do not know into their homes, and costs of essential home repairs are often prohibitive. Providing supports for older people to maintain their homes is central to facilitating independent living, and also contributes to maintaining the housing stock.

Creating a list of approved craftspeople will encourage older people to avail of home repair services with confidence. These measures will allow older people to modify their homes as required with advancing age, help towards the upkeep of homes, and facilitate the installation of necessary security measures.

Recommendation 3:

Provide adequate funding for CARELOCAL to ensure the continued provision of much needed visitation and support services.

CARELOCAL is experiencing a continuing increase in demand for our services. Many of our referrals come from HSE Public Health Nurses, hospital Social Workers, Community Mental Health Social Workers, and Dublin City Council personnel. The unique value of volunteer visitation is increasingly being recognised by service providers as an integral and essential element of community-based care for older people.

Without any Core Funding from government, CARELOCAL is entirely dependent on donations, once-off grants and fundraising to continue to provide and develop our unique services to older people in the community.
To ensure the continued development of CARELOCAL as a Dublin-wide voluntary organisation dedicated to providing support to older people living alone, a realistic level of multi-annual Core Funding is required, year-on-year, to sustain and reflect the growing need for support services. As community-based support for older people functions as an effective preventative measure against physical and mental health problems, funding CARELOCAL will contribute to lessening the demand on over-stretched health services, and to maintaining the health of this vulnerable population.

Across the Community and Voluntary Sector, chronic underfunding is seriously impeding the delivery of essential services, with fundraising activities accounting for a disproportionate percentage of income. As partners in service delivery, it is unacceptable that the Community and Voluntary sector is expected to generate income, as well as deliver high-quality, targeted and tailored services on behalf of the State.

Recommendation 4:

Enact legislation to create a statutory basis for the provision of home help and meals services to older people.

Home Help Service: Research to date has highlighted the need for guaranteeing a sound legislative basis for community care service provision for older people. At present, the Home Help service is discretionary. Under Section 61 of the Health Act 1970, health boards are empowered, but not obliged, to provide Home Help. In the absence of a legal obligation to provide this service, it is vulnerable to underfunding, budgetary constraints, and lack of investment in training and the simple infrastructure needed to develop it further (Lundström and McKeown, 1994).

The Home Help service contributes to the greater independence and dignity of older people, better community spirit and is an extremely cost-effective method of delaying the need for residential care. The Home Help service has to compete for a share of the health budget against service providers who are guaranteed funding because their service is legally mandated. There should be a clear mandatory responsibility for the provision of a Home Help service, based on a detailed needs assessment, and included in an integrated care package which supports the older person remaining in their own home.

Meals Provision: The nutritional and social benefits of community meals services have been well established. For example, the nutritional status of those availing of the Elderly Nutrition Programme (ENP) in the United States is significantly higher than that of non-participants (CSOP, 2007).

At present there is no standardisation of meals provision for older people, largely because this service is discretionary. Meals provision is dependent on partnerships between voluntary groups and the HSE, and often these arrangements are ad hoc and dependent on individual goodwill of HSE personnel and volunteers. A framework needs to be drawn up which ensures an effective interface between voluntary agencies and the statutory sector, ensuring consistency, continuity and transparency of service provision (Donoghue, 2002). Legislation should be enacted as a matter of urgency to ensure that statutory entitlement underpins the provision of meals services to older people. This should include the provision of meals at weekends, bank holidays, Christmas and Easter, as the current unavailability of meals services means these are the loneliest times for older people already experiencing isolation.

Recommendation 5:

Increase funding of community-based services for older people.

Community services such as Public Health Nurses, Meals on Wheels, home helps and day care centres continue to be the Cinderella of service provision for older people. The number of public health nurses in Dublin has fallen in recent years, despite an increase in births and an aging population (www.irishhealth.com).

CARELOCAL is aware of many older people on waiting lists for day care services. These relatively low-cost services are vital in providing opportunities for socialization, companionship and access to nutritious meals to older people.

CARELOCAL calls for increases in funding for these essential services to ensure that the likelihood of older people maintaining good health and independence as they age is maximized.

BIBLIOGRAPHY

Council for Services for Older People in the North West Inner City (CSOP), Review of Meals Services to Older People in the North West Inner City of Dublin, (due for publication 2007).

Donoghue, F. Reflecting the Relationships: An Exploration of the Relationships between the former Eastern Health Board and Voluntary Organisations in the Eastern Region. Dublin: Eastern Regional Health Authority, 2002.

Government of Ireland, National Development Plan 2007-2013. Dublin:The Stationary Office, 2006.

Government of Ireland, Towards 2016 – Ten Year Framework Social Partnership Agreement. Dublin:The Stationary Office, 2006.

Government of Ireland, The National Action Plan for Social Inclusion 2007-2016 Dublin:The Stationary Office, 2007.

Organisation for Economic Co-operation and Development (OECD), The Well-being of Nations: The Role of Human and Social Capital, Paris:OECD, 2001.

Lundström, F and McKeown, K. Home Help Services for Elderly People in Ireland. Dublin: National Council for the Elderly, 1994.

http://www.irishhealth.com/index.html?level=4&id=9634