Speech By Minister Brady At The National Federation Of Pensioners’ Associations Autumn Conference

Good morning ladies and gentlemen. I am delighted to be here today to open your Autumn Conference and I would like to thank Seamus O’Donohoe for inviting me to address you. I had the pleasure of meeting Seamus in Leinster House last week, along with John Hartigan, Jim Keegan, and Peter Dunne. During the course of our interesting and informative discussion, we covered a range of important issues, and I would like to touch on a few of them this morning.

National Positive Ageing Strategy

My over-arching priority at present is to progress the National Positive Ageing Strategy and work on this is now well underway.

The Programme for Government 2007-2012 contained a commitment to prepare such a Strategy, to better recognise the position of older people in Irish society. This process will set the strategic direction for future policies, programmes and services for older people, and is to be modelled on policy-making for disability and for children.

The Strategy is being developed within the constraints posed by the present fiscal situation. It is not the intention that it will propose specific new service developments – rather it will set strategic direction for all future policies, programmes, and services for older people.

A major factor underlying the Government’s decision to prepare such a strategy is recognition that, like many other countries across the globe, our population over age 65 will increase rapidly in the years ahead – from about 500,000 in 2009 to around 775,000 in little more than a decade.

The Government is keenly aware that the expected rise in the number of older people in our population will pose both challenges and opportunities. These challenges can be successfully met, and such opportunities fully exploited, by planning now for a society in which there will be unprecedented numbers of older people. Appropriate responses will be required from all sectors of Irish society – public, private, community and voluntary. Consequently, the National Positive Ageing Strategy will have a much wider focus than any previous consultation between Government and older people about matters that affect them.

In the past, policy relating to older people tended to deal almost exclusively with health and social care issues. A range of factors, however, impact on an older person’s health and quality of life – including socio-economic status, housing, transport, education, employment and broader social interactions. Consequently, the new Strategy will focus attention on issues relevant to older people that span the public policy process, and will ensure more coherence and integration in planning across the various programmes and services.

The Strategy is being developed by a Cross-Departmental Group, chaired by the Director of the Office for Older People. There is an Expert Advisory Panel, and a Liaison Group (composed of key Non-Governmental Organisations representing older people), advising on the process.

The Strategy’s wide-ranging consultation process aims to ensure that all interested parties can express their views. A call for submissions on the Strategy was made in June of this year. We have had a most encouraging response, receiving over 170 submissions to date from a very broad range of agencies and organisations covering the public, private and voluntary sectors, as well as from individual members of the public. We have already begun the task of analysing the submissions received, including from your own Federation. Given the overall high quality of the submissions, we expect that these will play a key role in informing the Strategy.

It is intended that the National Positive Ageing Strategy will encourage people of all ages to think positively about their own ageing, enable them to plan sensibly for their later years, and facilitate them in adopting lifestyle practices that will have the effect of ‘adding years to life and life to years’.

Fair Deal

I am sure you are all aware by now that, last week, my colleague, Minister Mary Harney, announced that the Nursing Homes Support Scheme, “A Fair Deal”, will commence on 27 October 2009. Budget 2009 provided €55 million for the introduction of the Fair Deal this year.

The introduction of this scheme will provide peace of mind to one of the most vulnerable groups in society – those in need of long-term nursing home care – that such care will be affordable, and will remain affordable, for as long as they need it.

The Fair Deal will equalise State support for public and private long-term care recipients. It will ensure that there is one, transparent system of support towards the cost of care that will be fair to all, irrespective of whether they are in public, private or voluntary nursing homes. It also aims to render long-term care affordable and anxiety-free, and ensure that no-one has to sell their home during their lifetime to pay for their care.

The application form and information booklet for the scheme are already available to the public. This means that people can start doing the groundwork for applying for the scheme so that they are ready to submit the form when the scheme commences on 27 October.

Anyone looking for an application form should go to the HSE website or contact their local Nursing Homes Support Office.

Minister Harney also announced last week that the new care representative appointment process has commenced. This allows people to apply to the Circuit Court for appointment as a care representative, when they wish to apply for the Nursing Home Loan on behalf of an applicant with reduced capacity.

Patient Safety

Patient safety is everyone’s concern, and needs to drive all our decisions when formulating future health policy. Safety is a fundamental aspect of quality healthcare. To improve safety, the healthcare system must develop, maintain, and nurture a culture of safety.

Patient safety is a particular issue that has recently been focused on globally, but also has taken precedence within the Department of Health and Children, and as such has become a priority for the Irish government.

In 2007 Minister Harney established a Commission on Patient Safety and Quality Assurance. Its remit was to develop clear and practical recommendations to ensure that safety and quality of care for patients is paramount throughout the entire healthcare system.

Their Report – Building a Culture of Patient Safety – was published in August 2008 and subsequently approved by Government in January 2009.

The brief to the Commission was to think radically and creatively, not merely to improve on what was already in place, but to also be mindful of what is realistic and practical.

The Commission’s report is the first of its kind and it makes far reaching recommendations which, when implemented, will impact very positively on patients and their families.

Those recommendations include proposals on legislation on licensing of all public and private healthcare providers; mandatory adverse event reporting; and clinical audits – to name but a few.

In many ways this was the easiest part of the process. The challenge now is to drive the implementation of the recommendations. I am happy to tell you that this important work is well underway: the Implementation Steering Group (ISG), chaired by Dr. Tony Holohan, the Department’s Chief Medical Officer, has been established and is well advanced in progressing implementation.

The role of the ISG is to oversee the implementation of all the recommendations in the Commission’s Report, and to ensure that they are implemented as effectively and efficiently as possible in an appropriate timeframe. It is expected that the ISG will issue their first progress report to Minister Harney shortly.

Cardiovascular Health, including Stroke

One of the items on the agenda for my recent meeting with your Federation was developments in relation to stroke. Stroke is one of the leading causes of death in most developed countries, and it is estimated that in Ireland more than 10,000 acute strokes occur each year. Thankfully, mortality rates from stroke have fallen considerably in recent decades, but there are now about 30,000 people and their families living with the effects of residual disability from strokes. With longer life expectancy after strokes, and an aging population, strokes will continue to pose challenges for individuals, families, communities and the health service for years to come.

It is impossible to talk about strokes without considering cardiovascular health as a whole. Ireland’s first Cardiovascular Health Strategy, Building Healthier Hearts, was launched in 1999, and since then over €60 million additional funding has been allocated to its implementation, supporting a wide range of new services and initiatives.

Since the publication of Building Healthier Hearts, there have been many changes. The structure of the health service has changed. Ireland has changed. Lifestyles have changed, and technology has changed.

The National Audit of Stroke Care, published in April 2008, provided the country’s first overview of stroke services in hospitals and in the community. It highlighted a number of areas where clinical care and the organisation of stroke services should be developed and improved.

It was clear that we needed to plan for the future, taking these factors into account. It was for these reasons that Minister Harney established the Cardiovascular Policy Group to develop a new policy framework for the prevention, detection and treatment of cardiovascular disease, including stroke.

The policy group considered the Stroke Audit findings and addressed the issues raised, including prevention in the primary care setting, rapid access to diagnostic services, the configuration of stroke services which includes stroke units, the provision of thrombolysis – otherwise known as clot-busters – as well as models for rehabilitation and discharge planning. Its report, which will be published shortly, subject to Government approval, addresses the spectrum of cardiovascular disease, including prevention and management, and how these are integrated to reduce the burden of these medical conditions.

The cardiovascular policy is being launched in a challenging economic climate with little prospect of additional resources. It is my view, however, that much can be done to advance the cardiovascular policy in tandem with other policies and current and planned service delivery frameworks. The policy will provide for safe, effective and equitable services, within an over arching commitment to prevention and early management of cardiovascular health problems.


In conclusion, I would like to reiterate that the topics I have touched on here this morning are of mutual concern to us all. I appreciate from my recent meeting that other issues such as Cancer Services, Rural Transport, and Social Welfare Allowances are also high on your agenda. You will be pleased to know that I have arranged a meeting for 26 October next, between representatives of your Federation and the Cancer Policy Unit of the Department, to discuss issues such as Prostrate Cancer and BreastCheck services.

I see that you have a very interesting and useful programme of talks ahead of you today. I’m told that the Older and Bolder Group will be talking on their campaign for the Positive Ageing Strategy; that there will be a presentation concerning first-aid in general and swine flu; and a talk from Martha Doyle on politicians and the influence of certain groups. I’m sure that her paper will interest us all!

I hope that you all have a most enjoyable conference, and I thank you once again for your warm welcome this morning. I wish you all an interesting and productive day. Thank you.