GROUP 4. Shannen O Connell. Tony O Connor. Gillian Currie. Christine O Halloran. Rasheedat Abdulrasheed

1. BRIEFING NOTE
THE AGEING POPULATION AND THE
DEMANDS ON THE HEALTH SERVICE
PURPOSE
Is our health service prepared for our ageing population?
A more established population presents numerous difficulties to work markets, government
assess, government spending and the more extensive economy. Government Policy in
connection to our ageing population is to help these individuals to live in poise and freedom
in their own homes and communities for whatever length of time that is conceivable and,
where this is unrealistic, to help access to quality long haul private care (Caring for an
Ageing Society, 2013).
The Government has begun to take action to put the ageing population of Ireland on the
National agenda and developed THE NATIONAL POSITIVE AGEING STRATEGY (2013)
which gives clear direction on challenges and opportunities related to our ageing population
at an individual and social level over a full scope of policy areas.
National Policy Support for Integrated Care for Older People currently encompasses:
• Disease prevention & capacity enhancing behaviours
• Integration through enhanced, more accessible primary care
• Development of Home Care
• Support for Independent Living
• Residential Care
• Enhanced health service capacity
• Older People as Rights Holders
Are we doing enough to ensure the older generation in our country are getting adequate
care?
Is there a serious social and emotional cost for those who are of the older generation not
getting the proper treatment or care due to ill access and financial struggle?
Finally, in order to understand how to improve people’s lives as they age the HSE, Health
and Wellbeing Division has published a “Healthy and Positive Ageing for All’ Research
Strategy 2015-2019.

2. More than 26% of matured over 50s have no wage other than what they get from the state
(Irelands Ageing Population, 2015).
This briefing note outlines the impact the current ageing population is having on the health
service. The problems this population face will be delineated, and a set of recommendations
will be outlined within the context of current government policy.
The 2017 census demonstrated a consistant and rapid rise in the average age in Ireland
(Ageing population will increase demands on health service, 2017).
BACKGROUND
The number of people aged 65 and over using residential care will rise to 12,270 by 2021
which is an increase of 59% since 2006 (CARDI,2015). CARDI (2015) suggests that an
additional 880 people will need residential long-term care but there is a shortfall as only 300
places a year are being created. It is projected that by the year 2031 there will be nearly one
million people over 65years of age in Ireland.
Through the last 15 years, there has been a transformation in the provision of nursing home
care with a shift from being largely publicly and voluntary provided to being largely private
for-profit nursing homes. From 2001 private providers were encouraged through tax breaks
to build private hospitals and nursing homes which led to the increased privatization of
health and social care.
Elder abuse has been increasingly recognised as a concern in Ireland. Age action is the
advocacy agency for the ageing population in Ireland. Their aim is to educate and inform the
ageing and the public on how to report abuse, while supporting and following guidelines
under the National Elder Abuse Policy 2014. HSE figures in 2016 reported that the figures of
elder abuse were 8000 cases but only 6% of those cases were reported by the victim or a
family member. Findings reveal that 63% of people had observed poor provision of health
and social care provisions in Ireland, 21% had observed poor homecare services and a
quarter of those surveyed observed physical or emotional abuse with 36% of that abuse
observed in nursing homes. 47% of people observed poor care in public hospitals, 21%
observed poor care in homecare services and 21% observed poor care in nursing homes.
Worringly, many of private hospitals, primary care centres, homecare services are currently
not regulated or monitored independently. Moreover, despite the introduction of
whistleblowing legislation in Ireland in 2014, whistleblowing is not tolerated within the
Health and Social Care sector and this is an issue that needs addressing to tackle the issue of
elder abuse.

3. RECOMMENDATIONS
1. A full implementation of the 2001 Primary Care Strategy, this would improve utilization of
existing essential care assets and direct the effect of populace maturing and change in the
supply of GPs. Thus, more and better use could be made of other medical experts, such as
practice nurses and pharmacists.
2. Even with full usage of the Primary Care Strategy, the quantity of GPs being trained in
Ireland should increase to keep pace with statistic developments. Implementation of a
government strategy of training 150 GPs a year would have a significant effect, however,
should healthcare policy focus on increasing use of primary care this number would need to
increase further.
3. An investigation demonstrates that a considerable extent of assets in Irish outpatient care
are used on observing and keeping up chronic health conditions that could be similar and as
effectively overseen and substantially more efficiently oversaw in essential care. Making this
change, nonetheless, would require more assets in essential care.
4. The HSE would like to diminish dependence on costly intense healing centres by lessening
the persistent normal length of stay by better case administration and more prominent
utilization of day case and especially day surgery. Even though the changing many-sided
quality of the case stack crosswise over healing facilities can prompt contrasts in day case
rates, the present changeability would propose that there is substantial potential to expand
day rates over the Irish clinic framework and in doing as such essentially increase the level
of effectiveness.
5. The normal length of stay is likewise affected by patient characteristics and older age and
chronic ailment specifically. An analysis suggests that the absence of step down services has
an influence in lessening the proficiency of hospitals in Ireland, especially voluntary
hospitals whose patient load tends to be more established and more prone to have
disabling conditions.
6. In achieving the above recommendations, all areas should strive to meet the HIQA
standards set out in 2016 to ensure people availing of services for older persons should
meet their changing needs.
State and other agents of authority have played and pertinent role in designing and
delivering health services to the ageing population, Within the Health Service Executive
(HSE) most healthcare, is provided within this structure.
Supporting structures such as;
•Health Information Equality Authority (HIQA)- HIQA is responsible for residential services
for children, older people and people with disabilities, they drive quality and safety of
healthcare on behalf of patients.

4. •Irish Blood Transfusion Service- This service is responsible for organising and administering
the supply of blood and other blood products.
•Medical Council- Regulates medical Doctors in the Republic of Ireland, their main purpose
is ensuring high standards of professional conduct, education, training and competence
among doctors.
•Mental Health Commission- Ensures high standards in delivering mental health services.
•National Treatment Purchase Fund (NTPF)- Works to support the delivery of scheduled and
unscheduled care in individual hospitals
•Nursing and Midwifery Board of Ireland (NMBI)- Insures registration of nurses in Ireland
and promotes high standards of professional education and training.
•National Council Screening Programme- Has rolled out essential services such as bowel
screen, breast check and diabetic retina screening programmes to ensure early
identification of cancers.
•Health and Social Care Professionals (CORU)- Their role is to protect the public by raising
awareness and issuing high standards in education, training, professional conduct and
competence through registration and regulation of Health and Social Care Professionals
These are agencies under the remit of the Department of Health or supported by the HSE,
the underlining aim of each of the agencies is to ensure high standards of health care,
delivery of safe services and equal access to all. These agencies are also responsible for
driving change providing knowledge and statics to inform our health care system.
FINDINGS
This creates two huge strains on health care finances: elevated use of health services and
lowering revenues. The “working-age” population (15–64 years) in the EU will decrease by
48 million by 2050.Pertinently, the ageing of European populations is the aftermath of
success: an increased life expectancy in which people are often in good health. The Irish
health service is facing an accelerated increase in the number of people over 65 needing
expensive health care and fewer young, working people to pay for it though taxation. The
hospital system – already in crisis – is inapt for chronic care management. The Cancer
Register is the only national record for chronic disease. Clinical recommendations and
procedures for chronic conditions are under augmentation. Unsatisfactory and disjointed
services for chronic illness add to avoidable and costly hospital admissions for patients.
Ireland is collaborating with the WHO to set out the action programmes in support of the
policy to help with chronic care management. The obligation for achieving this strategy lies
with the HSE, along with other organisations including the HIQA, the Institute of Public

5. Health, health professional training bodies, health professionals themselves, will also have a
major part to play in lowering the drain of chronic disease. The Department of Health and
Children will continue to monitor progress and review policy requirements within three
years.
The ramifications of ageing for health care costs are very difficult to inaugurate. Much will
depend on how people age. Nursing Homes Support Scheme is operated by the HSE in
conjunction with the legislation (Nursing Homes Support Scheme Act 2009). Claimants
cannot use State financing for a place in a nursing home before obtaining confirmation of
their Fair Deal application. The National Quality Standards for Residential Care Settings for
Older People have been set out by the HIQA. These Standards equip the service provider
with ways to help with ongoing improvement to support the sustained development and
provision of person-centred, accountable care.
CONCLUSION
The Irish health service is facing an advance increase in the number of people over 65 in
need of expensive health care and fewer young, working people to pay for it though
taxation. The obligation for achieving this strategy lies with the Health Service Executive
(HSE), along with other organizations including the Health Information and Quality Authority
(HIQA), the Institute of Public Health, health professional training bodies and
multidisciplinary team will also have a major part to play in lowering the causes of chronic
disease. Improving the health of older people will lower the number of elderly people who
are prevented from providing care to a spouse, or parent, because of their own health
conditions.
The Government in conjunction with the WHO set out the action programs in support of the
policy to help with chronic care management. The obligation for achieving this strategy lies
with the Health Service Executive (HSE), along with other organizations including the Health
Information and Quality Authority (HIQA) which has been responsible for monitoring the
standard and quality of care giving to children and older people with disabilities in
residential services in other to provide person-centered care and quality care.
The Institute of Public Health, health professional training bodies, the multidisciplinary
team, will also have a major part to play in reducing the causes of chronic disease.
A National Positive Ageing Strategy is a strategy for age related policy and service delivery
across Government and society.
Age action is the advocacy agency for the ageing population in Ireland. Their aim is to
educate and inform the ageing and the public on how to report abuse under the National
Elder Abuse Policy 2014.
The role of The Health and Social Care Professionals (CORU) is to protect the public and
ensure a high standard of care and save services to the ageing population by raising
awareness and issuing high standards in education, training, professional conduct and

6. competence through registration and regulation of Health and Social Care professionals.
The HSE in 2014, implemented its safeguarding policy for older persons or persons with a
disability. The policy is to promote the welfare of vulnerable people and safeguard them
from abuse.
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