Ageing population means elderly are now 'purpose' of health system — Dr Henry

Dr Colm Henry said the idea over-65s can only be treated by specialist geriatricians must be “openly refuted” as the population in Ireland has changed. File photo: Sam Boal / Photocall Ireland

Older people are now the purpose of healthcare and not the problem, a change which must be acknowledged by everyone in the system, the HSE chief clinical officer has said.

Dr Colm Henry said the idea over-65s can only be treated by specialist geriatricians must be “openly refuted” as the population in Ireland has changed. Central Statistics Office (CSO) data shows the population aged 65 and over is projected to double to 1.6 million by 2051 in Ireland.

Dr Henry said the health system here was designed to treat short episodes of illness, but now people are living longer with chronic life-long conditions. “Frankly, we are badly configured, and badly aligned and culturally not totally prepared for dealing with people as they age and that’s all over the course,” he said.

He described a recent meeting on new HSE plans for emergency care where a hospital consultant said he was not trained to treat older people and who said people over the age of 65 should be treated by specialists.

“This is precisely the kind of argument we need to refute openly and not be afraid to take on,” Dr Henry said.

“Older people are now the purpose of healthcare and not the problem. And it is everybody’s job — be they emergency department consultants, surgeons, physiotherapists in the community, occupational therapists — to ensure that they maintain the skills and the interest necessary to provide older people with the care that is in line with their dignity and expectations.” 

Dr Henry said: 

Anybody saying that it is not their business, bar paediatricians, has no business being in healthcare.

He said it is now a fact of healthcare that older people make up a large proportion of patients, and this needs to be recognized by all healthcare workers. “I think there is a cultural element,” he said of the change needed, pointing to new HSE plans including the three-year plan for emergency care.

“We want to move particularly as a first measure on the experience of people who are over 75 in emergency departments, where a disproportionate amount of them wait for long hours, often over 24 hours, and is frankly unacceptable and we need to say so,” he said.

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He said, in a podcast interview for the Irish Gerontological Society available on Spotify, that public and media perception of older people as ‘blocking’ hospital beds is changing. “We have to show an intolerance of this message,” he said.

“We don’t say, for example, that young people in car accidents are a problem in emergency departments. We’d like to see less accidents but our emergency departments are there to serve whatever urgent and emergency care comes in.” 

Reflecting on the impact of the pandemic, he said the effort to keep anyone out of hospital who did not urgently need admission led to a funding boost for community care.