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A Third Way f or The Third Age

D. A Third Way f or The Third Age. Th. Mervyn Taylor March 7 th 2013. Ireland is . Ageing. The l ife c ycle is getting longer. The Troika is getting worried - the impact of ageing on our public finances.

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A Third Way f or The Third Age

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  1. D A Third Way for The Third Age Th • Mervyn Taylor • March 7th 2013

  2. Ireland is Ageing

  3. The life cycle is getting longer

  4. The Troika is getting worried - the impact of ageing on our public finances http://www.finance.gov.ie/documents/publications/other/spuapr2012.pdf

  5. Rising Life Expectancy Requires • New ways of organising pensions, care and mutual support • The allocation of healthcare risks between state and individuals will have to adapt • New models of housing and urban design • New methods for countering isolation • Greater use of technology • A growing political and policy focus on ageing • Turning associated social & economic challenges into opportunities

  6. Older & Colder“…..75% of resources focused on 5%” ‘Fair Deal’ <€1 Billion State funds + €240 M Residents Funds + Costs of Regulation < 5% 15% 80%

  7. Regulation isn’t enough- compliance rather than quality? “Looking back at my experience of Leas Cross…It was abysmal ….lonely and cold…. no one seemed able to care for my father. He was in pain and suffered greatly in his last days” Mary Fletcher-SmithThird Age National Advocacy Programme Consultant. (Her father, Peter, died in Leas Crosss on 6th June 2005)

  8. H-BlockHospital A husband and wife live separately in open wards funded through ‘Fair Deal’. Their home lies empty. Husband Wife

  9. ‘Less of the same’ is not a cause worth fighting for

  10. Private Sector Dominance is Undesirable“Providing care homes for the elderly and disabled should offer one of the safest investments on the stock market”

  11. There has to be a better way!!! “…age is often made to look pathetic and marginal. We cannot escape the picture of the geriatric ward or certain kinds of residential institution. This is ‘warehousing’ – stacking people in containers because we can think of nothing else to do with them”. Rowan Williams. Archbishop of Cantebury. 2012

  12. People Before Premises!!!

  13. ‘Policy Go Leór’ “National health policy in Ireland since 2001 – and even earlier - is underpinned by the idea that health services should be delivered, to the greatest extent possible, in the communities and homes where people live, and should avoid unnecessary admissions to hospitals and other institutions” (McKeown 2012)

  14. Implementation is the issue “..a public service that appears to have the formal aspects of a public interest culture, and yet is demonstrably weak in leadership and implementation capacity” Rhodes and Boyle, 2012:55 IPA

  15. A THIRD WAY FOR THE THIRD AGEAn initiative to improve the range and quality of supports and services available to older people through innovative public interest trusts

  16. National Economic & Social CouncilReview re Quality, Standards & Regulation - 2012 • Lack of trust in the state & pessimism in its capacity to achieve public good • Individual organisations need to be helped to improve • Alternative institutional models of provision (e.g. social enterprise) needed to stimulate wider change in areas such as elder care

  17. ‘SMART REGULATION’Plurality of forms of regulation • No ready-made blueprints to resolve many issues • Solutions have to be developed through an exploratory process with the users themselves • A series of related steps rather than isolated actions involving users at every stage • Getting a range of perspectives, especially with regard to whether the desired outcomes have been attained. • User participation is part of a process of illuminating the outcomes individuals and groups would like

  18. The response to loneliness and insecuritycannot be ‘outsourced’ & regulated

  19. Dependency levels in nursing homes - more people could live at home Source: DoH Long Stay Activities

  20. What a ‘Third Age Trust’ will do • Organise the provision of support and care for older people within the trust area and develop new supports and services based on identification of need. • Contribute to social and economic development by identifying opportunities for innovation and job creation • Attract additional resources through engagement with citizens, community and corporate groups • Contribute to a national process of innovation and learning regarding the design and delivery of public services. • Promote positive attitudes and approaches to ageing and inter-generational solidarity without denial of the inherent challenges.

  21. Four Pillars of the Third Way • Individualisation of supports and services based on needs and preferences and with a strong focus on collective responses focused on home. • Intelligent Networks to respond to and organise needs across defined areas • Innovation regarding the use of resources and attracting new resources • Institutional Learning & Oversight to ensure best use of resources, quality of experience and outcomes, and transfer of learning across public, private and social enterprise sectors.

  22. Individualisation‘‘....how to wrap supports around the individual based on where they are in the lifecycle’ NESC

  23. “There’ll be nothing about us without us”

  24. Intelligent Networkswho needs what, when, where at what time with what resources

  25. INNOVATION - Best Use of ResourcesContinuum of Care & Cost Costs per day

  26. Innovation for Self Directed Support

  27. Europe is focusing on social innovation December 2011 Commissioner LászlóAndor announced plans for the promotion of the social economy and social enterprises through the European Social Fund. Further financial support will also be provided over the period 2014 to 2020 through the Programme for Social Change and Innovation.

  28. Institutional Learning & Oversight At national and at local level new approaches are needed to ensure learning and accountability The OECD & the NESC have suggested a need for ‘performance dialogue’ regarding standards and quality. A variety of providers, the regulator, older peoples’ advocates & wider stakeholder interests need to be able to present their differing perspectives Independent chairing will be crucial

  29. How far have we got?

  30. Analysis of National Datasets • 'Secondary Analysis of Relevant National Datasets on Support & Care Needs of Older People in the Republic of Ireland'. • Census 2011 • TILDA • National Disability Survey • HSE Operational Data

  31. National Business CaseLocal Business Plan

  32. Reference Group

  33. “Arscáth a chéile a mhairimíd” We live (and we die) in each other’s shadow

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