Older people in Northern Ireland feel cheated out of the healthcare they have paid their whole lives for, a new report has found.
Since taking up her post as Commissioner for Older People last year, Siobhan Casey has conducted an extensive survey of more than 1,200 people aged over 60.
She told the Irish News she was shocked by the level of fear and vulnerability older people felt about accessing services.
This included a very real concern they would die on lengthy waiting lists, struggling to get GP appointments and feeling terrified at the thought of sitting for days in emergency departments.
Ms Casey also hit back at negative stereotypes of wealthy older people expecting too much from public services and whether she expected her report to do anything more than gather dust.
One older person in the report described the current system as “torture,” while another said: “It is immoral and inhumane to expect older, frail and sick people to have to ring a GP practice 100 times in order to get an appointment or home visit.”
A third said: “I worked in the NHS for 40 years and now when I need it most it is disappearing before my eyes.”
With longer life expectancies and a plummeting birth rate, Northern Ireland is on course to become the UK’s oldest region by 2050.
Even with health service funding increasing from £6.2bn to £8.4bn in the last five years (over half Stormont’s annual budget), Ms Casey said that without reform it would not be enough to cope with the “irreversible demographic change.”
As an example, the report states that Northern Ireland had 22,700 people living with dementia in 2020 at a cost of around £800m – from both the public budget and families providing unpaid care.
By 2040, twice as many people are expected to need dementia care with the cost rising to £2.3bn.
More people will also have reached retirement age than those entering the workforce, placing even greater pressure on health service funding and staffing.
“Older people are telling us that they do feel shut out of a system and unprotected,” Ms Casey said.
“Some are giving up on trying to get an appointment or don’t feel that they’re worthy.
“That’s not a good thing if they have a condition which is getting worse. What I didn’t predict from the survey was the scale of this particular issue, in terms of accessing health and social care.
“So we had to come out and publish this report, because my job is to make sure the voices of older people are heard.”
She said witnessing the impact on health workers unable to provide the proper care for older people was especially difficult.
“I think what stopped me in my tracks was a staff team at an A&E in Belfast, they were fully committed,” she said.
“But it was the fact of the moral dilemma they had about treating older people in corridors and the impact it was having on them as individuals.”
One section of the report quotes a press article criticising benefits for older people like the triple lock pension and free public transport.
It states: “If boomers cannot bring themselves to act collectively and patriotically for the greater good” then the government “should pursue their lottery winnings” with higher property and pension taxes.
Ms Casey said: “That’s a narrative that we need to challenge because older people are not to blame for the pressures in the health system at the minute, in fact they’re the group that are most affected by them.”
The report adds that it is “fundamentally mistaken” to suggest giving less to older people as it is not their individual care needs that have changed, but the amount of people.”
This is demonstrated by a drop in nursing beds and care packages in the last decade.
In 2014, there were over 381,000 older people with 28 nursing beds and 26 care packages per 1,000.
By 2014, an older population of 470,000 must compete for a lower 22 nursing beds and 20 care packages per 1,000.
Ms Casey acknowledges the issues are not new, with the 2016 Bengoa report already setting out the solutions needed to fix “the burning platform” of the health service.
“I do have hope, I see the commitment from the teams in the Department of Health who are putting a great emphasis on working with older people,” she said.
“They’re looking at addressing winter pressures so I think the narrative of moving more care into community services is very hopeful for me.
“That’s undermined by the lack of funding that we’re seeing at the minute, but this is an all-government issue.
“Because if we want to shift left into the community then things like transport to help get people to appointments, housing and legal protections are really important as well.”
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