Health & Social Care Position

policy meeting 

“If we don't speak out now, in five, ten years time, it's going to be worse." 

The system of social care in Northern Ireland is broken and fundamental reform is long overdue. The current system is no longer sustainable or capable of meeting the needs of older people today or in the future. It is vital that a coherent strategic policy direction for social care is outlined immediately as relying on ‘People First’ from 1993 is no longer sustainable or meeting the needs of older people and was not designed for the social care crises in which we find ourselves now.

The Caring Conundrum?

Social care services are under growing pressure. Put simply we have two challenges:
  • First, the cost of treating older people is expected to grow by 30% over the next ten years, but the planned funding for the Elderly Programme of Care (POC 4) only grew by £6 million or 1.1% in 2009/104. However, with a real cut in the DHSSPS budget of around 2.7% by 20145, it is unlikely that the funding needed over the next ten years to treat older people will be available.
  • Second, the numbers of older people, especially those over 85 who are most
    likely to need social care will increase. By 2021, it is projected that there will be more than 93,000 people over the age of eighty in Northern Ireland, a 35% increase from 2011, accounting for 5% of the population.

As a result, Health and Social Care Trusts are rationing services by only offering support to people with very high levels of social care needs, e.g. those who need help getting out of bed, going to the toilet, washing and other essential daily tasks. Today people with fewer needs, who might once have received a few hours of ‘home help’ or a visit to a day centre, usually get nothing.

Prevention: Time to Deliver?

Increasing life expectancy is not necessarily being matched by parallel increases in healthy life expectancy. Northern Ireland fares worst of all regions in the UK in this regard. While women in the UK can expect to have 63.9 years of disability free life, women from Northern Ireland can expect just 60.3 years. In other words, a higher level of need for health and social care is anticipated in Northern Ireland than in other regions of the UK.

Age NI believes that with effective treatment, fair and equal access to services, appropriate levels of funding and prevention strategies, older people can continue to experience good health. By staying well and feeling good, older people are more likely to play an active role in their communities, contribute to society and live independently.

The idea that preventing ill health is a way of controlling costs is not new to health and social care; however, there is no evidence of a change in thinking or a shift in resources to give a higher priority to prevention.

Health and Social Care Trusts are failing to view the provision of social care as a preventative measure, thus enabling savings elsewhere in the system. The usual preventative health measures such as alcohol, obesity, exercise and smoking cessation are valued and necessary; however for older people some of these may not be suitable. The provision of ‘that little bit of help’ can result in significant savings and better outcomes for older people. It is important that this message is central in this preventative agenda.

Cross Departmental Working

Age NI is off the view that this is not an issue for the DHSSPS on its own. As aging cuts across all departmental responsibilities and remits, a joined-up approach is needed if weare to achieve a radical and fundamental review of social care. Re-arranging the deck chairs is not an option!

Supported housing, access to benefits such as Attendance Allowance or Pension Credit, transport networks, the built environment, and access to lifelong learning all contribute to the ability of older people to participate in society. Delivering transformational and sustainable reforms with a focus on removing the barriers associated with cross-departmental working can deliver for older people today
and in the future.

Vision for Social Care

Our priorities are clear for review – a radical and fundamental overhaul of the current system of social care. The key question we need to address is what it is that we expect social care to do?

Age NI has a vision of what social care should look like – "quality integrated social care that recognises the rights, aspirations and diversity of us all, and is based on the right to live with dignity, independence, security and choice."

A good understanding of the challenges of an ageing population is therefore vital as the right strategic policy decisions that are sustainable over the long term are needed. Without this type of analysis within health and social care there is a risk that unsustainable polices might be pursued, which require sharp corrective policy
adjustments in the future.

This long overdue review of social care should now be seen as an opportunity to put older people at the heart of a new and better system. We believe political commitment and leadership will be needed to drive through the radical reforms to deliver transformational change in the provision of social care.

Age NI Advice Line:
0808 808 7575

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