Older people feel ‘shut out’ as NI Facing ‘planned reform or collapse’ in care system, Commissioner says

Pictured with the Commissioner for Older People Siobhan Casey (second right) are from L-R George Bell, Wilma Stewart, Colin Flinn. 

Older people across Northern Ireland say they feel increasingly shut out from the health and social care system they paid into throughout their working lives, according to a new report published by the Commissioner for Older People for Northern Ireland (COPNI).

Voices of Concern: The Reality of Health and Social Care for Older People in Northern Ireland brings together the views of more than 1,200 older people, alongside demographic, workforce and service data, to assess how current pressures are being experienced by those most reliant on the system.

The report, which resulted from an engagement exercise to help Commissioner Siobhan Casey determine priorities for her new corporate plan, found that what are often described as “winter pressures” are now a year-round reality. It states that these challenges are driven not by temporary post-COVID disruption but by irreversible demographic change.

According to the findings, demand for health and social care is growing far faster than the system’s capacity to respond. Many older people described mounting barriers to accessing GP appointments, hospital care, emergency treatment and social care services.

Commissioner Siobhan Casey said:

“Older people are telling us something deeply troubling, that they no longer feel protected by the very system they contributed to all their lives.

“When I first started this role, I began an extensive programme of engagement with older people to help me determine what issues they were facing in a bid to shape and inform my work over the next four years.

“The results of this engagement exercise showed that access to services, in particular accessing healthcare services, was the biggest concern older people had and the current system is failing older people because demand is rising relentlessly while capacity is not keeping pace.”

The report highlights that:

• Older people are the group most impacted by the effects of population ageing, as the highest users of health and social care.

• The number of people reaching retirement age will exceed those entering the workforce by 2040, placing unprecedented pressure on funding and staffing.

• Northern Ireland is on course to become the oldest region in the UK by 2050, intensifying demand for care.

The Commissioner stressed the need for a whole-government approach to mitigate the impact on the welfare model.

She said:

“Demographic ageing is a whole-system challenge, not just a health one. Tackling ageing pressures needs a joined-up, whole-government response. Alongside health reform, action on housing, transport, support for older workers and carers, and strong legal protections for older people is essential to protect the sustainability of our welfare model.”

She added:

“As the rights of older people are at stake, it is my hope that the Department of Health and the Executive set out a clear and credible vision for addressing these challenges in the short, medium and long term. Limited funding, rising demand and workforce shortages are not temporary pressures. Therefore, these issues cannot be used as excuses for inaction but must, in fact, be the spur to act.”

The Commissioner warned that the findings should concern everyone, not just today’s older population.

“Anyone who thinks this doesn’t affect them is wrong. We are all ageing. The system we allow to decline today is the one we will all rely on tomorrow.”

The report concludes that Northern Ireland now faces a clear choice: planned reform or collapse.

Read the report Voices of Concern: The Reality of Health and Social Care for Older People in Northern Ireland