I want to concentrate on spending issues in health and social care services. The Alliance Party understands the funding challenges facing the health service and the pressures on social care. Changing demographics, new treatments, more expensive drugs and improvements in technology all contribute to rising costs in our health sector. The Alliance Party is committed to maximising the resources directed to the health sector from within the Northern Ireland Budget. However, given the current financial situation, we have to be realistic.
In parallel, attempts must be made to achieve genuine efficiencies and to make the necessary reforms to address the healthcare needs of the future. We support the health and social care review and its implementation. Of course, it must not only be about managing resources but ensuring better outcomes.
We talk about using our existing resources better, smarter and wiser. We need to look at changing the profile of spending on health and social services in Northern Ireland, which often means benchmarking and comparing ourselves with other countries and regions. There is a commitment in the draft Programme for Government to increase the proportionate spend on public health. The Alliance Party believes that we need a similar commitment to mental health, which has, unfortunately, been the Cinderella of our health service for years.
A number of changes can be made to achieve sensible efficiencies. Many examples of different approaches to delivery could lead to savings in the health sector. Those include reducing the reliance on accident and emergency services, as too many people use A&E as an alternative to visiting their GP, using an out-of-hours doctor or visiting a minor injuries unit because of their lack of awareness; placing a stronger emphasis on prevention, early intervention and the use of the community sector, including the excellent service that our community pharmacies continue to provide; focusing on improving public health through better diet, exercise, reducing smoking, and so on, to ease demand and cost pressures; facilitating the better use of technology, for example, by supporting people in their own homes, monitoring and managing prescriptions, and remote care; seeking a greater emphasis on better home and community services, including a good meals-on-wheels service throughout the country; and the development of an inclusive service on a North/South basis.
The Compton review picked up many of those examples, and if people are to have confidence in its implementation, a number of them must be followed through. There must be better co-operation, because improving public health involves a large number of Departments, such as the Department of Education and the Department for Social Development. It also involves the Department for Regional Development’s continuing to invest in public and rural community transport to ensure that everyone has equal access to acute facilities.
The Alliance Party welcomes the increased emphasis on the community sector. The community and voluntary sector can play a vital role. Indeed, it has already played a significant role, for which we are extremely grateful. I pay tribute to the many volunteers who contribute to making our society a much better place. However, there has to be a clear and serious reinvestment in community-based services. Home-Start, early years provision and the family fund for disabled children, for example, have come under pressure in recent times. I mentioned community meals, which have also come under pressure, yet good nutritional meals every day will keep people out of hospital. Our community pharmacies have also come under pressure, and the reform document emphasises that. Community pharmacies must be properly funded sooner rather than later.
Emphasis must also be placed on the provision of social care. The rapidly increasing and welcome demographic of older people in our society must demand our attention and investment now if we are to be adequately prepared for the future. Social care should be regarded as a preventative tool by providing people with, for example, a little bit of help to allow them to stay in their own homes, thereby saving money further down the line.
For older people, investment in preventative social care is cost-effective and can increase their quality of life. Tackling issues such as social isolation and exclusion and promoting active lifestyles can deliver significant savings by reducing hospital admissions and facilitating early discharge from hospital or institutional care.
I endorse Age NI in saying that, with effective treatment and equal access to services, appropriate levels of funding and prevention strategies, older people can continue to experience good health and a long and enjoyable life. However, that is being undermined by tightening eligibility criteria for domiciliary care, restricting access to care and support and withdrawing low-level services, such as home helps and meals on wheels, which are under pressure at the moment. There have been significant reductions in those services, and in my opinion that should be halted when the need is clearly there.
The recent evaluation in England of the partnerships for older people’s projects demonstrated that those projects lead to cost reductions in secondary, primary and social care. For every £1 spent, for example, hospitals save £1·20 in emergency beds, and there is a 47% reduction in overnight hospital stays.
Overall, low-level practical support initiatives, from simple housing adaptations for safety and security purposes to running older people’s active lifestyle programmes, can have dramatic outcomes for older people and are very important to them.
In conclusion, social care must also be underpinned by rights, entitlements, fairness, dignity, choice and independence for older people. If those issues can be addressed — I hope that they will be — I will be happy to support the Bill.