Belfast Telegraph

NI health crisis: We can no longer avoid changes necessary to make care system fit for purpose

By Des Kelly OBE and John Kennedy

Every day in Northern Ireland tens of thousands of people rely on care and support services such as domiciliary, day, residential and nursing home care. These services help people with activities of daily living that many of us take for granted, and support people to live happier, more fulfilled lives. Thousands of people work to provide this care, and underpinning it all is the huge contribution of family carers.

It is in all our interests: you may not currently be accessing care and support services, you might not be a care worker or a carer. But the chances are, if you aren't now, you will fall within one of these categories in the future, or at least will know someone who does. We will all be impacted in some way by the challenges facing the care and support system, and by the changes that can no longer be avoided. That is why this is an issue for everyone in our society to consider.

In many respects the current system of care and support has been very successful at supporting people in the community rather than in institutions. But, as our society changes - by 2028, for the first time there will be more people over 65 than children - demand increases and we have seen the system falter.

That is why the former Minister for Health Michelle O'Neill MLA (below) commissioned us to form an Expert Advisory Panel on Adult Care and Support, and tasked us with identifying priority areas for reform. With the publication of our report: 'Power to People: proposals to reboot adult care and support in NI' yesterday, our analysis is now complete. During our time here, it has been clear that there are positives to be recognised: an appetite for change, an enthused workforce, examples of innovative services and family carers dedicated to the welfare of their loved ones.

It has also been clear, however, that much of this exists in spite of the system and not because of it, and if we are to build on those positives, fundamental change is necessary.

Our report outlines those areas we think should be the focus of future reform. We believe that citizens should be at the heart of care and support, with the choice and control to determine how best their own needs are met. We also believe that there is room for much improved joined-up working, not just within and across health and social care, but also with housing and community planning.

And, underpinning that, the fundamental building blocks of the system need to be revisited: how we can support family carers without whose contribution the system would collapse; how the key role played by the social care workforce is reflected in its terms and conditions; how we know that we are paying sufficient rates to ensure quality care; and crucially, how we contribute to the costs of care and support to ensure it is sustainable.

This will require not only a new way of doing things, but a new culture. One which, in our view, can only be effectively delivered with a new Concordat: an agreement between citizens, families, carers, communities, providers and government about our respective roles, rights and responsibilities within a reformed system.

No change is easy, and we recognise that some of our proposals are particularly challenging. But we are clear that those who suggest difficult and sometimes controversial choices aren't needed are wrong in that assertion. Nor does inaction lessen the need for reform; in our view the system is already collapsing in slow motion and failure to act will simply accelerate that collapse.

Our report is available on the Department of Health's website. We encourage each of you to consider it, and urge you to engage fully with the department as it considers and responds to our proposals.

It is in all our interests: you may not currently be accessing care and support services, you might not be a care worker or a carer. But the chances are, if you aren't now, you will fall within one of these categories in the future, or at least will know someone who does. We will all be impacted in some way by the challenges facing the care and support system, and by the changes that can no longer be avoided. That is why this is an issue for everyone in our society to consider.

Belfast Telegraph

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