28 Nov 2005

A major new study comparing the health needs and service use of older people in the Republic of Ireland (ROI) with their counterparts in Northern Ireland (NI) was launched at a Dublin conference held by the National Council on Ageing and Older People (NCAOP) and the Institute of Public Health in Ireland today. 

The report ‘One Island-Two Systems’ – A Comparison of Health and Social Services Need and Use by Older People in the Republic and Northern Ireland was compiled by the Healthy Ageing Research Programme (HARP) Team at the Royal College of Surgeons in Ireland (RCSI), Trinity College Dublin (TCD), the Economic and Social Research Institute (ESRI), and Queen’s University of Belfast (QUB).

Lead author Professor Hannah McGee, Director of the Health Services Research Centre at the Dept of Psychology, Royal College of Surgeons in Ireland (RCSI) said “while we are inclined to think of older people as those needing care and who simply draw on the services and resources of the State, in fact they provide a high level of care to other (mainly older) people. This does not count their key roles in other areas such as care of grandchildren so in fact older people are also net contributors which is often not acknowledged.”

Director of the Institute of Public Health in Ireland, Dr Jane Wilde commented on the report. “This report is a good example of all Ireland research involving several organisations.  Significant differences exist in policy, structures and funding between the healthcare systems in the Republic of Ireland and Northern Ireland, yet many of the older people interviewed described similar challenges and opportunities across both jurisdictions.

Dr Wilde continued “Many older people are living on a low income, have a disability and are living by themselves and because of these circumstances are finding themselves on the margins of society. We urge those involved in policy-making to consider the findings of the report and explore the development of approaches to make the experience of ageing on the island of Ireland a positive one.”

Over 2,000 people aged 65+ were extensively interviewed in their own homes throughout Ireland. Dispelling the view that older people are simply service users, it found most older people lived independent healthy lives with twelve per cent of those surveyed being the primary caregiver for others, many of whom would themselves be other older people. 

Participants in Northern Ireland were more likely than those in the Republic to be caregivers (17 per cent vs. 8 per cent) with a higher proportion of carers being women in both regions. Northern Ireland had a higher proportion of men in caring roles than in the Republic of Ireland.

The report also found that the majority of those surveyed expressed very strong preferences to live at home with outside support if needed rather than living in institutional care (89 per cent in the Republic and 81 per cent in Northern Ireland). However, Professor McGee warned that the danger was that community based services were “not sufficiently developed” to provide for the desire of older people to stay at home on a longer term.

Significant North/South differences were found for a range of services, including use of home helps, meals on wheels, chiropody, and services from opticians, dentists and social workers. Of 15 services compared, 9 were used by a higher proportion of older people in Northern Ireland - “there seemed to be a better developed primary care service in Northern Ireland than the Republic of Ireland.”

Satisfaction ratings for aspects of GP care, i.e. with the quality of information received, concerns taken seriously, and the availability of the GP were very high with almost 90 per cent satisfaction in each area.  

“The levels of hospitalization were about equivalent as were the levels of GP care, but from the year 2000 to 2004 you do see a significant increase in the number of people over 70 attending GPs in the Republic, almost certainly linked to the free medical card for the over 70s which was introduced in 2001,” Professor McGee stated

Among the other key findings of the report were that NI participants were seen more quickly in A&E by a doctor than those in the Republic of Ireland (81 per cent of NI vs. 46 per cent of Republic of Ireland participants reported being seen by a doctor within an hour of arrival. However, hospitals in the Republic may have been seeing more complex cases as more of the their patients attending A&E were admitted to hospital (40 per cent vs. 17 per cent).

Participants in the Republic of Ireland rated their current health much more positively than those in Northern Ireland (64 per cent vs. 44 per cent rating current health as good/excellent). In parallel, and in support of their own ratings, those in Northern Ireland were much more likely to report problems with routine activities off daily living such as walking, shopping and personal care. About one in three in Northern Ireland had some difficulty and one in ten in the Republic of Ireland. This was despite similar age profiles in the two groups. These North/South differences are significant and have not come to public attention before this study. The study concludes by reminding us that ensuring good health and social services for older people is in all our interests – we all want to live to a point where we can enjoy these services in our own old age.

ENDS

For further information please contact Stephen O’Hare, NCAOP at +353(0)1 676 6484 or +353 (0)85 711 2635. Email: stephen@ncaop.ie

 Notes to Editors:

HARP
The Healthy Ageing Research Programme (HARP) is a five-year project aiming to document ageing and health and their interaction with health care and social services in Ireland. HARP commenced in 2003 and is funded by the Health Research Board. It is a cross-institutional, cross-border project involving the Royal College of Surgeons in Ireland (RCSI), Trinity College Dublin (TCD) (Department of Gerontology), the Economic and Social Research Institute (ESRI) and the Queen’s University of Belfast (QUB) (Department of Geriatric Medicine). Institutional research leaders are Professor Hannah McGee (RCSI), Professsor Des O’Neill (TCD), Dr Richard Layte (ESRI) and Professor Bob Stout (QUB).

The Institute of Public Health in Ireland
The Institute of Public Health has been set up to identify and develop practical advantages from building greater co-operation for public health between Northern Ireland and the Republic of Ireland.  We work in four areas; policy advice, information surveillance, research and capacity building and our objective is to tackle inequalities in health and improve the health of the public.