When public policies backfire, Ministers end up hiring costly consultants who inevitably point to the need for a more “joined-up” Government.
So, when policymakers try to figure out why so many people are languishing on hospital trolleys, we can at least save them the expense of another investigation.
They need look no further than the current controversy.
Grants aimed at helping older people and those with disabilities to continue living in their own homes are being reduced and will end up impacting on those who need them most.
On its own, these changes may not have a major impact. But taken alongside wider cuts to home-help support, homecare packages and reductions in planned supports for early discharge from hospital, they will surely end up in more people requiring admission to residential care.
Meanwhile, the number of nursing home beds receiving a subvention is being cut and access to the Fair Deal scheme for older people is being restricted.
Is it any wonder, then, that so many older people end up in hospital with nowhere to go?
The Government has insisted there are no cuts to the scheme of grants for home adaptations. Technically, it is correct. It is increasing the amount of money available for the schemes this year by €3 million over last year.
Demand soaring
But overall funding for these grants has been cut by almost two-thirds over recent years, at a time when demand for assistance has been soaring.
In 2010, for example, almost 14,000 people received grant aid totalling just under €100 million. This year, about 10,000 are likely to receive grant aid which will total €38 million.
Jan O’Sullivan, the Minister with responsibility for housing, yesterday said the Government was trying to “ spread the benefits as widely as possible” and to ensure fairness and value for money in the operation of the grant schemes. But doing more with less is another way of saying more people will get less – and the poorest of all will end up paying more.
From now on, the income of all adult household members will be included in the assessment for all three schemes. Until now, only spousal income was included. The eligibility cut-off has been reduced to €60,000. Even the poorest will be required to contribute towards the cost of any housing or mobility adaptation.
The maximum grant payable reduces on a sliding scale as household income increases. Even those earning less than €30,000 will receive 95 per cent of the grant, rather than the full amount.
The grants being affected by these changes have allowed some of the most vulnerable members of the community to make simple, but highly significant, changes which have allowed them remain in their own homes.
The housing adaptation grant for people with disabilities provides funding for access ramps, accessible showers or adaptations to facilitate wheelchair access. The mobility aids grant scheme helps to cover the cost of basic works to address mobility problems, primarily – but not exclusively – associated with ageing.
The housing aid for older people is available to assist older people to have repairs or improvements carried out to cold or damp homes.
'Warehousing'
These grant cuts can save money in the short term, but they can lead to the more expensive prospect of more older people in nursing homes or acute hospitals.
It’s a theme the former ombudsman Emily O’Reilly emphasised over recent months, hitting out at policies that promoted what she called the “warehousing” of elderly people in private nursing homes that were designed “primarily for commercial profit”.
The greatest irony is so many cuts that promote independent or supported living undermine Government policy aimed at assisting people to live at home.
One that stands out is a 1988 policy document commissioned by the Department of Health, The Years Ahead, which set out an ambitious blueprint. It stated that "it is fundamental to the welfare of the elderly that every elderly person has an opportunity to live in accommodation suited to his or her needs".
It’s a laudable vision, but one we’re still struggling to meet.
Who knows – maybe some joined-up thinking might see us realise it one day?
