Debate contribution: Social Care Reform

Debate contribution by Ms Kellie Armstrong on 8 October 2024.

MLA

Ms Kellie Armstrong

Party at the time

Alliance Party

Date

8 October 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Social Care Reform

Assembly identifier

Official Report component 4581929

Read the official Assembly record

Text

I declare an interest today because I have been a carer for most of my adult life: first, for my brother Michael, who has sadly passed away, and now for my father. My father is in receipt of social care support twice a day. Care in the community depends on an effective social care system, but, from day one, the problem has been that the need for care in the community was set out and the plans were put in place but there was no preparatory work done to ensure that appropriate care was available in the community to support it. Today, I want to talk about the older population. Northern Ireland has an older population, and we will see that demographic increase over the next number of years. While people live longer and many are healthier in old age, an increasing number of people are not in good health in their old age and will need support to continue to live at home. Too many have not received chronic pain support; too many have their mobility severely limited because of hip or knee replacement waiting lists; and the number of older people living with life-changing health conditions has increased. Many live in fear, the fear of how much it will cost in their old age, if they need residential care. That is why we will support the DUP amendment to our motion. I have spoken to many older people who do not believe that their needs are being met by the health service. They feel that they are a problem for the health service. The care that they receive is limited and takes too long to access, and those comments were made specifically in respect of domiciliary care, particularly when the older person lives in a rural area. They have also told me that they apologise regularly to ambulance drivers if they are having to hold up an ambulance, as they see it, outside a hospital while waiting for a bed. That is not good enough. According to the Alzheimer's Association, the social care system is not set up properly to deliver care that meets the needs of people, from the association's point of view, with dementia. In fact, many people living with dementia continue to be reliant on the social care system to help manage their symptoms. They will continue to require accessible, high-quality, affordable, personalised care, and it is therefore vital that the current and future care system is fit for purpose. That could be achieved through a fairly paid and sufficiently resourced workforce that is trained to understand the specialist needs associated with old age and dementia. Social care systems must also recognise the value of unpaid care provided by families and loved ones. Local systems must proactively assess unpaid carers' needs, as per the statutory duty, on, at least, an annual basis and meet those needs through support and access to respite care to allow sufficient breaks from caring. Unpaid carers save the health service an absolute fortune. They prevent the health service from being bankrupt, but the pressure on them is crippling them. Addressing the current insufficient and fragmented funding model must be a priority, and, as Ms Dillon has just mentioned, that fragmented funding model leads to silo working as opposed to joined-up working. It shifts the responsibility of care to individuals and families to achieve the vision of care in the community. As a sector, adult social care contributes significantly to the economy in Northern Ireland. It is estimated to be worth around £1 billion, and that is in Northern Ireland. Cost savings are being met on the backs of unpaid carers, and, as others said earlier, a carers register is definitely needed.

I go back to dementia. People living with dementia make up around 60% of the people who draw on care at home in the UK, and 70% of those in residential care live with dementia. People living with or impacted by dementia often face catastrophic care costs. An individual with dementia spends, on average, around £100,000 on care in their lifetime. Therefore, it is important that we have a long-term social care workforce strategy. It should be mandatory for all GPs and care staff to undertake high-quality dementia training that is mapped to the dementia training standards framework or an equivalent standard. That recommendation was also made in the UK's Skills for Care workforce strategy, which was brought out in July 2024. There needs to be a sustainable funding model for quality personal care that is centred on achieving affordable care for everyone living with dementia and other conditions. There also needs to be improved support for unpaid carers through proactively offered needs assessments and access to appropriate respite care. Today's motion, hopefully, sets out to the Minister the support that there is in the House for an improved social care system.

813 words. Text as published by the Northern Ireland Assembly.

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