Last August the Department of An Taoiseach published the national risk assessment 2019 to map looming change and prepare strategies to manage that successfully.
Our ageing population was recognised as a major issue, one that will strain public finances, social welfare and health systems, and economic competitiveness.
Unless our current services are expanded and improved, a greying Ireland will also put huge emotional and financial strains on individuals and families.
Demographic change means the proportion of the population aged over 65 will increase from one in eight last year to one in six by 2030. The cohort 85 or older will double. This increased dependency ratio will have consequences for education, health, and social welfare budgets.
The area most directly affected will be the State pension budget, with the Social Insurance Fund forecast to generate a deficit of €335bn within 50 years.
The ESRI predicts that by the end of this decade, demand for public hospital services will increase by up to 37% for inpatient bed days and demand for GP visits will jump by up to 27% because the increased demand generated by to an ageing population.
Despite those challenging figures — and despite around 500 people waiting on hospital trolleys yesterday — it could be worse. Ireland’s old-age dependency ratio is expected to be one of the lowest in the EU27 by 2050, and the lowest in 2070.
The issue is already having an impact. Last year, health watchdog Hiqa received over 700 complaints about the care, or rather the poor care, of elderly patients.
Complaints included allegations of financial, verbal, and physical abuse, along with vulnerable residents avoiding supervision. Hiqa warns that these complaints are unsubstantiated but a good number of them are probably justified.
Especially as the agency published a report last year that found almost half of nursing homes it inspected were not up to standard because of issues around protection, record-keeping, staffing, and infection control.
It is hard not to think that because we entrust this vital service to the market’s appetite for profit that priorities other than the care of older people take precedence.
The relevant businesses will of course argue this point but the body of evidence suggesting we need to treat care of the old as a vocation rather than a profit generator is substantial and growing.
There is an immediate opportunity — not the election — to underline that expectation. The Law Reform Commission today publishes its issues paper on a regulatory framework for adult safeguarding.
The commission acknowledges that there is a pressing need for a clear statutory framework to address risks of physical, psychological, and financial abuse.
The commission will examine what form that regulatory framework might take, building on existing arrangements and parallel policy and legislative developments.
It also wants the public’s view on these issues, which will intrude in all our lives sooner or later.
This is an opportunity to engage, in an apolitical way, on one of the issues of the day. An important opportunity not to be missed.