In the field of economy, we always come across the concept of demand and supply. On the one hand we picture what the consumers need and demand to have, while on the other, we have to consider what can be given, hence the supply. This applies to all market economies where manufacturers and producers keep a close watch on market trends and demands in order to build up or regulate their stocks and production lines.

The principle applies mostly in the vast areas of selling and buying an infinite range of products. When it comes to the provision of services, the old principle of demand and supply is better qualified when we seek to strike a balance. This is even more vital when providing public services intended for those who really need them, rather than those who would just like to have them.

The challenge lies in the fact that, in recent decades, the nation has been facing the new reality of an ever-increasing ageing population. With such a fast growth in life expectancy, the demand for elderly care and residential services is a constant issue that demands continuous planning. Past administrations lacked the impetus to be pro-active, which posed a major challenge to this government in March 2013. It was no sudden discovery: it was there – written on the wall – with little or no concrete action being taken on either a long or short-term basis. We had to immediately roll up our sleeves in order to update established policies, if any, upgrade all services and, most importantly, introduce new provisions in a fairer, more reasonable and structured manner – targeting best quality levels as a major goal.

The outgoing limping government had grown used to depicting all problems as a perception, followed by a long nap, pretending that challenges could be met by painting them over with colourful and expensive slogans. Little did they bother that real problems could not be erased but would erupt at any time. On taking office, Labour took up the challenge and faced reality on a myriad of national issues, not least the fast growth in our ageing population. We went a step further: not merely seeking remedies for accommodation in terms of numbers, but injecting the long-overdue principles of giving our elderly the degree of dignity they deserved. For our government, a haphazard whitewash was never on its books, nor in its actions.

We immediately embarked on a long-term plan to face the real challenge of never-ending waiting lists of applications for admission to residential homes. This was no mean task, as we found out that very little or no structures were in place to tackle the problem. Fairness was hardly visible in what we found and that was a major challenge, hence establishing good practices of transparency and just processes. We never expected miracles to happen without feasible plans and tangible steps in attempting to solve problems. 

The very first step had to be taking stock of the quantitative reality, dismantling the convenient perception covers. What is striking about the health and social circumstances of older people in society is how variable the picture is, ranging from a rather depressing stereotype of dependency to that of vigorous septuagenarians, economically and socially independent, rising above any sign of disability, with wide social and cultural interests to contribute to society.

In our fast-ageing world, older people are increasingly playing a crucial role – through voluntary work, transmitting experience and knowledge, helping their families with caring responsibilities or in paid work, even if on a part-time basis. These contributions rely on a balance of older people enjoying good health and society addressing their needs – creating the necessary space and structures to enable them to stay active.

The whole scenario, however, brought us face-to-face with a wider reality of older people who need to take up residence away from the family home where they had lived most of their life. However sad and traumatic it may be, we all know that old age can bring with it problems of health, mobility and the need for constant attention, hence the requirement for long-term care. All these considerations presented me, as Parliamentary Secretary, with an opportunity to serve my country in the vast field of providing solutions to what almost a quarter of our population immediately required and rightfully deserved.  

The introduction of multi-disciplinary professional teams to assess and evaluate each case on the long waiting lists was a first step towards instilling proficiency and fairness. It also gave us a clearer picture of what we had to handle, establishing a step-by-step classification of all cases. All evaluations are based on health and social individual situations. Our teams also consider any family-related difficulties, given that admission into residential homes can intimately involve those who have cared for the older relative who now has to leave home.

It gives me pride to note that, in real terms, the number of people waiting for such an assessment has fallen by 34.5 per cent, when compared to last month. By the end of the year, the assessment waiting list will be completely cleared and by the beginning of January, all applications will be assessed in a pre-determined timeframe. Such positive results could only have been achieved through the efficient input on the part of our multi-disciplinary teams and the constant coordination of my Parliamentary Secretariat, particularly so because this achievement is coupled with better figures regarding waiting lists for admission. Since October 2014, we have managed to reduce the number of people on waiting lists for long-term residential care by almost 30 per cent. This means that approximately 1,400 people are now on these waiting lists, a significantly smaller number than the 2,000 registered last year. It is pertinent to note that, on average, five new applications for residential care are received by the Department every day.

Statistical data can be encouraging, but for us it is indicative that we are on the right track – meaning that we have to work harder and faster. Knowing that supply of accommodation in the government’s homes for the elderly is never sufficient for meeting the fast increase in our ageing population, we have used other ways of to meeting the challenge. Public-private partnerships have proved to be one way of resolving the issue, together with government-church agreements also providing night shelters. In addition to this are the various understandings entered into in tandem with local councils and other local entities to create more day learning centres and active ageing programmes. 

All such tasks are, of course, complemented by continuous projects for the upgrading and refurbishing of existing homes all over the island, not to mention the vast revamping programme at St Vincent de Paule long-term care facility. Focusing on specific projects does not prevent us from proceeding with ongoing projects for extensions and upgrading, also bearing in mind everything that we are doing in other related sectors, such as tackling the increasing challenges regarding dementia. 

Such a positive account of work-in-progress is encouraging, but it is never, in itself, sufficient to meet demand. I am fully aware that – despite our progress and the shortening of waiting lists – it means next to nothing to those who are still waiting for the service. However, our progress means that we are addressing the issue in a rapid manner. It is pointless to be over-optimistic and say that we will eliminate waiting lists, because this will never happen. However, we have a plan – for the short, medium and long term – and it is yielding results. We know that the challenges ahead are constant but so is our determination to face them and take immediate action!

 

Dr Caruana is Parliamentary Secretary for the Rights of People with Disability and Active Ageing