Official Report: Minutes of Evidence

The Chairperson (Ms Bradshaw): We have Dr Kellie Turtle, head of policy and engagement with Age NI; Paschal McKeown from Age NI; Evelyn Hoy, chief executive, Commissioner for Older People for Northern Ireland (COPNI); and Conor Tinnelly, from the office of the Commissioner for Older People for Northern Ireland. You are all very welcome. Thank you for coming at such short notice: we are really trying to move on with this Committee inquiry. I am not sure who is going to start, but I invite you to make some opening remarks.

Dr Kellie Turtle (Age NI): Thank you very much, Chair and Committee, for having us to give evidence today. I will present some opening remarks on behalf of Age NI. We are the leading older people's charity in Northern Ireland. Our vision is for a world where we can thrive as we age, and our mission is to help people enjoy later life. We believe that people should be supported to know and understand their rights to remain as independent as possible and to be connected to their communities. That vision of a world where people can thrive as they age is one that we think can only ever be fully realised when older people are valued and treated fairly and have their rights respected. That has to include legal protection from discrimination, not just in employment, where we currently have it, but when older people are going about their day-to-day lives.

Age NI has been campaigning for age discrimination law in the provision of goods, facilities and services (GFS) for a very long time — well over a decade. In our written submission to the Committee, we set out a brief summary of the milestones to date, which, hopefully, has been useful, going back to the first Programme for Government commitment in 2011. I can confidently say that the prolonged failure to deliver on that commitment is a cause of deep frustration and, I would say, hurt for the older people whom we engage with. Age NI works closely with a consultative forum in order to ensure that older people's voices are at the heart of our work. We also support the community-based age sector, and we have delivered three lived experience surveys since 2020. We build relationships with thousands of older people and their families through the day-to-day delivery of all our services. From all that engagement, it is very clear to us that there is a very strong call from older people to have this legislation introduced.

We also see at first hand the impact on older people when they are not afforded the same level of protection as other equality groups. When an individual believes that they have been treated in a discriminatory way because of their age, there is no route to challenge that or to seek accountability or redress. At an event that we hosted yesterday in the Long Gallery, the Equality Commission cited 32 complaints that it received in 2023-24 that would have fallen under the scope of GFS legislation, but, sadly, the commission had to tell those people that there was nothing that it could do because such legislation does not exist here. That lack of protection not only impacts on those individuals, but, in the long term, the wider consequence of that is that ageist attitudes and behaviour become normalised in society. It creates an environment where even many older people do not see themselves as rights holders and come to expect unequal treatment. As society ages at a rapid pace, we cannot continue to allow the normalisation of ageism and discrimination, so we need better protection that will not only benefit older people now but build the kind of world that we all want to grow older in.

I will highlight a couple of key points from our written submission that we think merit further discussion. With regard to the law in Great Britain, Age NI believes that, as a minimum, older people in Northern Ireland should have the same protections as they do elsewhere in the UK, but we have some concerns about the GB law and have outlined those in our submission. Those concerns are particularly around the exemptions. Our colleagues in Age UK have provided evidence to the UK Women and Equalities Committee on this issue and have highlighted three key things that they think the ongoing unjustified discrimination can be attributed to. The first is those individual and systemic barriers that someone might face if they want to bring a case. The second is the broad exemptions, particularly for the financial services industry. The third is general age-based restrictions in healthcare provision. We share those concerns, and we would like to see a law brought in in Northern Ireland that can do better for the people of Northern Ireland.

Older people understand that some exemptions are necessary. Differential treatment is not always discriminatory treatment, but the issues that are connected to this are leading older people to still be treated less favourably because of their age. We need to address that. We have heard from older people who feel that they are not taken seriously when accessing healthcare. We have seen startling information come through the COVID inquiry that older people have, at times, felt that their lives are less valuable than the lives of others, and that really should be a source of shame for us as a society.

We highlighted in our submission the long-term EU project that has been going on since 2008 to develop goods, facilities and services law. We want to stress that it is important that older people do not lose out on any progress that is made at that level. The current protections that we have with regard to employment and education came from an EU directive, so, naturally, we are concerned that any future progress on goods, facilities and services is not missed out on by people here.

We have also set out in our submission the impact on older people that we can observe. We have referenced as much as we can find of the best available data and research, but more research needs to be undertaken. The most startling figure for us is from our own lived experience survey from last year, in which 79% of respondents rated equal access to healthcare as an essential issue. The survey brought that out as the top concern for older people across that whole piece of research. We would like to see, for example, the Department of Health undertaking regular research in that regard as part of its equality duty to older people as a section 75 group. Obviously, there is also the financial sector. We get so many complaints and concerns through our advice line from people who are dealing with insurance companies, and it is clear that, in that area, blanket policies are still being applied that allow people to treat someone differently because of their age. Older people are falling through the cracks of what is admittedly a complex market, but it continues to apply those blanket policies that leave older people with fewer options and higher premiums.

Finally, I will draw attention to indirect discrimination, which is covered in our submission, to highlight the fact that a lot of what we hear from older people is not about direct discrimination but about structural barriers to accessing services that affect them particularly because of their age. Where a service depends entirely on the user being online or having access to a smartphone, older people are excluded. Our future law will need to address that type of discrimination as well.

We are grateful to you and are pleased to be here to speak up for older people, who feel very strongly that the ongoing failure to legislate for their equality and rights reflects very poorly on the extent to which the Northern Ireland Executive value them and their contribution to society. We hope that the Committee's inquiry will provide the necessary spotlight on this issue so that some progress is finally made and the urgent equality gap is closed.

The Chairperson (Ms Bradshaw): Thank you, Kellie.

Ms Evelyn Hoy (Commissioner for Older People for Northern Ireland): Hopefully I will not be too repetitive, although I very much support what Kellie has just said. I am the chief executive of the Commissioner for Older People. Eddie Lynch's term of office ended in June 2024, but he has stayed on in a caretaker capacity for what will be a period of up to six months until a new commissioner is appointed. He has asked me to extend his apologies for being unavailable today.

You will be aware that the most obvious gap in the equality legislation in Northern Ireland is goods, facilities and services on the basis of a person's age. I commend your colleague Claire Sugden on her proposal to introduce a private Member's Bill to plug that gap. Since 2014, the commissioner has advised that there is a need for legislation to protect older people, but really all citizens, from discrimination on the basis of often arbitrary or spurious age limitations. There have been several false dawns for progress on the issue, including the 2015 consultation on proposals for age discrimination legislation and the commitment to age discrimination legislation in the 2020 New Decade, New Approach agreement. It is my fervent hope that your initiative proves to be successful.

It remains contradictory to develop age discrimination legislation to protect older people without also including younger people. No anti-discrimination legislation should exclude any particular group because of perceived complexity. When COPNI consulted older people, many expressed the view that they wanted to see the legislation extended to their children and grandchildren.

The ageing society in Northern Ireland is largely being ignored by the Government here. Despite advice published last year from the Commissioner for Older People to the First Minister and deputy First Minister, the new draft Programme for Government was published less than a month ago with practically no reference to the major demographic changes of an ageing society. I sincerely hope that the Committee will seek to hear from the commissioner and others about the absence of older people in that document and the challenge of an ageing society before the consultation period ends. The commissioner will, of course, respond to that consultation, and will publish that response.

This year, the Commissioner for Older People released a report titled, 'Are you ageist?'. The commissioner engaged widely with older people through a survey, focus groups and specific events to seek their views on the effect that ageism has on their everyday lives. Some 49% of older people reported having directly experienced ageism — within ageism, of course, is the issue of discrimination — and 60% agreed that older people are viewed as being frail, vulnerable or dependent; 63% believed that modern workplaces do not cater to older people's needs; and 95% of older people surveyed agreed that older people have a lot to contribute to the workplace and society. From those figures, it is clear that older people experience ageism, which includes discrimination, in our society widely and in three distinct categories. There is institutional ageism, which is made up of laws, rules, practices and policies that are prejudiced, biased or discriminatory; interpersonal ageism, which is the showing of disrespect and use of patronising language and behaviours in interactions with others; and, sadly, self-directed ageism, whereby societal bias and cultural tropes about ageing are internalised, leading to self-limiting behaviours. Our comprehensive report on ageism in Northern Ireland, 'Are you ageist?', is available on our website. Every member of the Committee and Member of the Assembly should read it.

Why do we care about ageism and the discrimination that derives from it? At its heart, equality legislation is a mechanism of fairness; as well as playing a direct role in tackling specific discriminatory offences, that legislation serves to reinforce the values of a cohesive society. Laws are an expression of our values as a society, and everyone, young and old, is of value. As well as providing a range of protections at its sharpest point of litigation, the development of equality law on age discrimination will promote awareness of ageism across society in all its forms. It will require consideration of ageism by public authorities when devising policies, services and practice. It will encourage and, when required, force changes in practice, training and development for practitioners. It will challenge the stereotypes and tropes that all too easily go unchallenged in public, political and media discourse. It will prioritise the collection of some of the data about public services that Kellie mentioned, disaggregated by appropriate age categories so that we can see more clearly where we are succeeding in tackling discrimination and where we are not making the impacts that we could be making.

If we achieve all that, the legislation will have secured its intent to protect people from discrimination on the basis of their age. It is simply not acceptable to the Commissioner for Older People to hear from them themselves that they are treated unfairly, unequally and in a discriminatory way. It is especially disturbing to hear older people express ageist thoughts about themselves. Older people are net contributors to our society through taxes, employment, volunteerism, childcare and caring for each other. Instead of being characterised as a drain on our health and social care systems, they in fact provide thousands of hours of unpaid care. It is long past time that the Assembly recognises the value of older people and legislates to protect them from discrimination.

The Chairperson (Ms Bradshaw): Thank you very much. It was a good event yesterday. I was only able to get there for a small part of it, but I have read your report.

In the Age NI submission, a really good point is made that it is not just about disparities between Northern Ireland, the rest of the UK and the Republic of Ireland; there are internal disparities. That was a point really well made. I had a quick Google there. Unfortunately, this is the one day that Claire Sugden is not here. She is thinking about stand-alone age discrimination legislation, and a lot of the evidence that we have received to date has been about whether we should have our own single equality Bill here, tidy it up and learn from issues like financial services and stuff. Do you have a preference for stand-alone age discrimination legislation, or do you think there should be some sort of comprehensive overarching legislation? What do you think as a sector?

Dr Paschal McKeown (Age NI): From Age NI's point of view, we are not prescriptive about how this should be taken forward. From our knowledge and experience, there is something more powerful in having legislation that would speak directly to older people in terms like, "This legislation is about you, it is about age, and it is really important". One of the things that has been referred to is the fact that older people do not always see themselves as rights holders and do not always see the everyday actions, assumptions and prejudices made about age as being about their rights or about being something that they can do anything about, because it is so everyday and it is ingrained in the experiences that they have. There is something very powerful in having "age" in the title of legislation that is about recognising that gap in equality legislation, and also about promoting to older people and others that age is a category in which people should not be discriminated against.

Ms Hoy: I agree with Paschal. I also think that an equality Act would be a very ambitious target for the Northern Ireland Assembly, but we have been talking about age discrimination legislation for 10 years and we still do not have it. I would settle for action.

The Chairperson (Ms Bradshaw): OK.

Dr Turtle: I was just going to note that, whatever way it goes, the work will still have to be done to develop age discrimination law because, with those other pieces of law, it is, as you said, Chair, about tidying things up and pulling them together, whereas we need to develop this almost from scratch. Whichever route the Committee chooses to endorse, it is still going to require somebody to do that work.

The Chairperson (Ms Bradshaw): OK. Also in the Age NI submission, you talked about the public-sector equality duty and the phraseology there around "have due regard to". To what degree do you feel that public services and bodies actually have due regard to age? Is that something that needs to be tidied up as well?

Dr McKeown: We probably need much more up-to-date research on that. We know that, from an older person's point of view — as Kellie said, in our lived experience report and the conversations that we have with older people — there is a very strong sense and perception that they are not treated in the same way as other people but do not know what to do with that information, apart from feel a level of frustration. There is some evidence — it is more up to date in England — on older people's access to mental health therapies, talking therapies and so on, in what older people are prescribed or even the assessment of depression. There is evidence of unequal access to support that might be available to others of a different age. Look at screening services, for example: there is often an age cut-off. There is already evidence that there are things that do affect people based solely on their age.

The Chairperson (Ms Bradshaw): In your submission, you talked about article 2(1) of the Northern Ireland protocol. You said that there is no commitment to keep pace with EU equality legislation relating to some protected characteristics, including age. You talked about amending the protocol and/or the Good Friday Agreement. How far have those conversations gone with the UK Government and NIO?

Ms Hoy: In common with a lot of conversation about alignment with EU law, very little of that has bottomed out.

Going back to the equality duty in the Northern Ireland Act, there are quite stark examples of due regard simply not being paid. We see multiple consultations in a year that have not considered the needs of older people or have screened them out at an early opportunity. We are pursuing a judicial review of the Department of Health's continuing healthcare policy. We won in the lower court, and one of the court's biggest criticisms was that no regard had been paid to the equality impacts on older people. At this point, you hope that — I think that it was said at the COVID inquiry — equality duties are in the DNA of our policy community and part of our thinking about how we develop policy. Sadly, however, the evidence does not always bear that out. Multiple times in a year, we go back to policymakers and say, "What have you done about older people? Where is the evidence that you have gathered on older people, and how have you considered that in the services that you are trying to deliver or the practice that you are trying to bring in?". That is why through age-based GFS legislation, the knowledge, understanding and awareness of all those issues would increase as soon as we started talking about and developing a Bill. That would be very useful.

The Chairperson (Ms Bradshaw): Thank you. I will move on.

Ms Egan: Thank you, everyone, for coming in and for your presentations and submissions to our inquiry. I would be really interested to hear whether, based on your work and research, you feel that there are particular spaces or groups that are especially at risk of ageism. Does it interlink with any other protected characteristics, such as disability, race or gender? Is that something that your work and research has shown?

Ms Hoy: There are about 450,000 people over the age of 60 in Northern Ireland. They are as diverse as the rest of the population. There is no one older who does not have the same diversity of experience as a younger person. They have all the multiple identities that you would imagine — they live with disabilities; they are in minority ethnic communities; they are in lesbian and gay relationships — right across the protected characteristics. Some have dependants, some do not; some are married, some are not. You cannot treat older people as a homogenous group. They will be subject to discrimination for multiple characteristics, but what really frustrates them at the moment is discrimination on the basis of age.

I will give you an example. We had a case where a lady who had lived with sight impairment all her life reached the age of 65. She moved from disability services in a trust to older people's services.

In doing that, she lost some of the services that had been provided to her because she was disabled, as those services were not available in older people's services. That is a silly administrative flaw in the system, but she had no recourse in law to challenge that discrimination. She relied on us to come and advocate on her behalf. When you come across silly things like that, you realise that those things would probably be dealt with at the policy development end if age discrimination legislation existed.

Dr Turtle: I just want to mention that we raised intersectionality quite a lot in our Budget consultation responses that were done in recent months. While it is not a section 75 equality group, social inequality and wealth inequality would be a key intersectoral area where we would see some older people who are more at risk of being treated unfairly. The Equality Act in GB is looking at ways to bring that into the scope of protections for people. Certainly, in recent weeks, the news around the winter fuel payment has put older people and poverty very much back in the spotlight, so there will be groups there that we will be very concerned about.

Mr Conor Tinnelly (Commissioner for Older People for Northern Ireland): It is a point about inequality and a cumulative disadvantage over time. For someone in a particular marginalised group, as they get older, the disadvantages, such as through health issues, that they experienced early in life will become more impactful as they age.
To address wider inequality, age-based legislation is particularly important. When you talk about intersectionality, it can manifest in a lot of different ways. For example, in the likes of domestic abuse, older women will be more at risk and more reliant on their partners for financial reasons and things like that. Equally, research suggests that older men, because of their increased vulnerability, are more likely than younger men to experience domestic abuse, so there are a lot of different ways that it manifests across the lifespan for different characteristics.

Ms Egan: That is great. Do I have time for a supplementary?

The Chairperson (Ms Bradshaw): Yes.

Ms Egan: Thank you. That is really insightful and something that I would be keen to discuss more, Kellie, if that is OK. I think that you mentioned exemptions in the GB laws that you do not want to be replicated here. Could you talk a bit more about those and give us a few examples, if that is helpful?

Dr Turtle: There are two big ones that have caused issues. The first is the financial services sector. The problem there is very much that you are trying to apply an area of equality law across a market-driven sector. The aims of both do not necessarily meet. The type of exemptions that are applied in GB have led to a situation where, according to what we hear anecdotally from our Age UK colleagues, the prohibition really only disallows refusing to sell a product. Anything after that is fair game. So the setting of premiums and all of that kind of practice that goes on in that sector is on a blanket policy of, "Well, once you are over this age, that is it, you pay so much extra".

The Chairperson (Ms Bradshaw): I am sorry, do you mean if somebody applies for a mortgage, for example, at 61, or something? Is that what you are talking about?

Dr Turtle: Yes.

Dr McKeown: Or travel insurance or car insurance. It is about your age. It is those kinds of things, quite often, as well as financial products.

Dr Turtle: That would be the main issue with those types of services. That, then, excludes older people from being able to have the best and cheapest options, so it causes a knock-on effect in increased an financial burden.

The other big issue is with healthcare. Again, there are difficulties with how the equality law is applied when you have public service providers whose budgets are very stretched and are then, even within the law, finding ways of being able to justify, for example, ruling out older people from treatment. There is evidence of older people not getting equal access to cancer treatments. A big one is talking therapies for mental health concerns, where we see a huge drop-off in the number of people who get offered counselling as opposed to medication. As you get older, access to mental health services drops off dramatically. That is something that we are dealing with here, even though we have section 75. In the Health budget that was proposed and consulted on recently, out of the 11 cost-cutting proposals, 10 of them disproportionately impact on older people. The analysis that the Department has done accepts that, but nothing is being presented to mitigate the situation. There is a kind of acceptance that, when you have a tight budget, equality suffers.

Ms Egan: OK.

Ms Hoy: It is also important to understand what public authorities can do and, then, what other marketplaces can do, and it is not just about financial instruments. For example, we see cases now in a very competitive private rental market. In Northern Ireland, over 17,000 people who are over 60 are in private rental accommodation. There is a very competitive market for every property that comes up. If you are an older person who may need aids and adaptations in your dwelling, you are a further complication for a landlord. You are not as suitable a candidate for some of the homes that you could be offered. At the same time, even if you can afford it, you cannot get a mortgage to buy a property. A lot of work has been done recently on over-50s co-ownership mechanisms, but even that has limitations. If you have not bought your house early or are not on the property ladder, it is a very risky place to end up, where you can be discriminated against, quite insidiously, as you get older.

The Chairperson (Ms Bradshaw): Thank you.

Mr Harvey: It was a good event yesterday that seemed to go very well. At what age does one become an older person nowadays? How is it defined? [Laughter.]

Ms Hoy: The commissioner's legislation says that you have to be over 60. However, as we all get a bit closer to 60, we are a bit dubious about that particular age limit. It is one of the reasons that there is no UN charter on the rights of older people: nobody can decide what older means. It is very much a mindset thing.

Dr McKeown: Just as a light comment, I remember a colleague of mine saying, "An older person is always 10 years older than me".

Mr Harvey: That is exactly right.

You mentioned the different laws and stuff around protection so that has been well covered. One thing that got me was about seeking treatment. There was a comment that it was, "not encouraged" from 79% of people, and that is very concerning. Who would not be encouraging?

Dr McKeown: It came through, in our lived experience survey, that older people — not just one, quite a number of people — said, "When I go to the doctor, I feel as if I am not important, not heard and not listened to." Some of that ties into the view of, "Well, you are this age". It is ageism or a perception of, "What would you expect at this age?". More than one person said, "I do not feel that I am encouraged to take anything forward". It was about health professionals not taking the person seriously about concerns that they have about their health and not taking it forward.

Another thing that came through strongly from the survey was older people saying, "People use condescending language when they are talking to me. They perhaps do not give me time when I have to make a decision, and then make an assumption that I cannot make a decision". What comes through is how older people feel that they are being treated. They feel that they are being a nuisance and that, in fact, they are not being given the same time or attention as others.

Ms Hoy: If I can just add to that. I will give you an example of the recent changes to GP services. After COVID, we were faced with massive changes to our GP services, where everyone had to start making telephone appointments. Sometimes, it takes 140 or 150 calls in the morning to get through to your GP. After that, you might get a callback. You may never get a face-to-face conversation. That policy has been implemented across all GP surgeries, and not a single equality impact assessment is associated with it. Not one. Everyone can see the obvious discriminatory action there, but we do not have any goods, facilities and services legislation under which to challenge it. That has an impact on someone no matter how old they are. You might be a younger carer of an older person, so it impacts on you. It is the same for a younger person who has young children in their home. The equality impact assessment has never been done.

Sadly, we saw some very poor practice during COVID. Our lack of planning for the COVID pandemic meant that decisions had to be taken much more quickly and without any opportunity to consider the impacts on, for example, older people coming from care homes who were refused hospital treatment or even admission to hospital. There are lots of examples of that.

Mr Harvey: Is digital exclusion due to a lack of training? It is certainly not due to a lack of ability, but, as you said, people may need a bit more time, and that is grand.

Dr McKeown: For some people, yes, it is about confidence, training and support. It is really important to make sure that all those things are in place. The research evidences that technology is developing at such a pace that, in a sense, you could never catch up with the changes. That is one element. The other element is that, particularly for people who may have a cognitive impairment such as dementia or a visual impairment, it is not only a case of training or making sure that a person has the right device. For many people, technology is not accessible.

Ms Hoy: I will add two things about technology. One is that — I do not mean to be ageist or discriminatory in any way — the current population aged 70-plus did not come up through their lives with smartphones in their hands, but the next generation did. It is potentially ageist to think that older people are digitally excluded, because a huge number of them support childcare for their grandchildren, bank online and are provided with all their government activities, such as booking their MOT tests and everything that we all do, in that way. Not everybody is happy about it, but that is fair enough.

Where technology will be interesting in the next 10 years is around assistive technology for older people as a proxy for care. Take telemedicine, for example, where people have their GP consultation through their television, or the use of assistive technology to track people's movements so that we can monitor falls. My biggest issue with that is that it can never be a proxy for human interaction. It is assistive and very helpful, and I imagine that we will adopt a lot of it because it will be cheaper and more available than a workforce, but it can never really be a replacement for human interaction.

Mr Harvey: Thank you very much. I hope that you get a replacement for Eddie soon. He has been around for a long time. I think that he has been in that job since 2016.

Ms Hoy: Yes. He did two full four-year terms.

Mr Harvey: He will be hard to replace. All the best, and thank you.

Mr Gaston: I will start by picking up on the 2023 lived experience survey, as other members have done. We heard that some people who took part in it felt:

I know that the survey is relatively new, but, on the back of it, have you had any correspondence with the Department of Health about the findings? Have you engaged with the Health Minister? Have you been asked to attend the Health Committee? Your evidence has certainly come across strongly, and it is very concerning. Now that you have the raw data about how people feel, it seems to me that a culture may exist or be perceived to exist, so I am interested to know what you have done to try to change it.

Dr McKeown: The voice of older people is obviously the element that we include in our responses to consultations. We have spent the time sharing the findings with groups and networks. We have not approached the Health Committee yet, but that is a really good idea, which we will take forward. Kellie, do you want to add anything?

Dr Turtle: At our previous all-party group meeting before the summer recess, the topic of discussion was access to primary care and GP services. While that meeting dealt with some of the issues that Evelyn raised around the Phone First policy and how it impacts on older people, we had a robust discussion about how older people feel that they are treated when they get in the room with a GP or primary care providers. The chair of the Royal College of General Practitioners was part of that discussion. She said that she was going to take a lot of that feedback back to her organisation.

There needs to be a focus on training for all healthcare professionals. Some great training is going on out there, and Age NI is part of a lot of that. We work closely with the Public Health Agency (PHA). It is not just what we put in a report; it is what we do in our ongoing work with those health organisations and statutory providers.

Our consultative forum plays a key role. It meets stakeholders and PHA representatives. It helps the PHA to design training materials and helps different trusts with their messaging. We have worked on leaflets and posters that the trust needs to put up that are particularly geared towards older people. Our consultative forum sits down and goes through the content. We have that ongoing relationship with a lot of statutory providers, but you are right: a good sit down with the Health Committee on that would be useful.

Mr Gaston: Your written evidence, which you have given orally as well, suggests that older people have been failed by the Executive. The pledge to extend age discrimination legislation in the 2011-15 Programme for Government did not materialise. There has been a failure to renew the active ageing strategy, which expired in 2022. There was no commitment to legislate on age discrimination in the draft Programme for Government in 2016. New Decade, New Approach promised legislation, but, again, nothing has come forward. There is no commitment to anything in the current draft Programme for Government. Do you believe that devolution, specifically the Executive Office, is delivering for pensioners?

Dr McKeown: Older people feel very disappointed and frustrated — some feel very angry — about the slow pace, if you like, of the introduction of the legislation. They are still hopeful, and the actions of the Committee in looking at the gaps in equality legislation are really important. They are hopeful that change will come.

Ms Hoy: I will add to that. I said very bluntly in my opening statement that the Government are not alert to the needs of older people in Northern Ireland. Beyond that, we are walking blindfolded into the biggest ever demographic change in society. The pace and size of the change is remarkable. We put that to the First Minister and deputy First Minister in a published document, with firm recommendations for the Programme for Government, yet the draft Programme for Government was published without any reference at the highest level to older people. When we dived into that to see whether older people were referenced in pockets elsewhere, it was very hard to find any mention of them. That sits contrary to a desire that we all have to get to that point. Nobody wants to not be an older person at some point in their lives. You will be amazed at how quickly it comes upon you.

It seems to me that it is such an obvious omission. The demographic change will be so difficult for us if we do not plan well for it. We will lose a huge amount of our tax base, unless people work for longer. We therefore have to improve employment rights for older people and start retaining older people as economically productive people in the workforce. Otherwise, it will be very difficult to manage the proportion of older people relative to the proportion of younger people in our society.

Mr Gaston: I have a final point for Age NI. If an elderly person in a care home insisted that they be given a bed bath by someone of the same biological sex, would that be viewed as transphobic by Age NI?

Ms Ní Chuilín: Jesus Christ.

Dr McKeown: We cannot comment on an individual case without knowing what the circumstances are. We are not in a position to comment on that.

Mr Gaston: Kellie, as head of policy for Age NI, is your Twitter account in conflict with Age NI?

Dr Turtle: My personal social media has absolutely nothing to do with my professional role.

Mr Gaston: Even though you are listed as head of policy for Age NI?

Dr Turtle: It does not say that.

Mr Gaston: I just find —.

Dr Turtle: It does not say that on my personal Twitter. I find this line of questioning quite inappropriate.

Ms Hoy: So do I.

Ms Ní Chuilín: So do I. He is consistent.

Mr Gaston: I will let you reflect on what you have on your Twitter account. I find that it does not comply with what Age NI is trying to do.

Ms Ní Chuilín: Chair, that is ridiculous. Seriously, it is ridiculous.

The Chairperson (Ms Bradshaw): I know.

Ms McLaughlin: It is stupid.

The Chairperson (Ms Bradshaw): Are you content for us to move on?

Dr Turtle: Very much so.

The Chairperson (Ms Bradshaw): Apologies if any offence was caused.

Mr Kingston: Thank you for your attendance today. You, rightly, highlight the huge contribution that older people make to society at every level, particularly to family networks. I am sure that many people will agree that, when that older generation goes, so much of the cohesion in families can decline. The older generation very much keeps families together. It is hugely important.

You commented on different types of ageism. I think that there will always be a certain humour around age. I think of the birthday cards that I usually get from my children. There will always be that element, but it is about being aware of that and thinking about how that could become an attitude or, as you highlighted, cause a deprioritisation of the needs of older people. Thank you for your paper that focuses on the lack of age discrimination legislation in the provision of goods, facilities and services.

As you commented, one of the relevant areas is health service provision. Will you give us some more examples of where you feel that that is particularly acute? In fairness, some elderly relatives in my family network have received good care. I am sure that others will also recognise that. Will you highlight where you feel that, in health service provision, there has been a different attitude towards older people?

I do not dismiss all the difficult circumstances around the topic, but are you concerned that those who promote assisted dying or euthanasia could affect people's attitude towards health service provision? The health service should always be pro-life. As a member of a party that is pro-life, I think that the focus should always be on helping people to be well, to live longer and to live a quality life. I am concerned that the debate is promoting a different attitude. There is a danger of implying to some people that they are almost a burden on society.

Ms Hoy: It is quite a complex issue, as you can imagine. The issue of feeling like a burden has come across very much in our ageism work. We have seen it time and again: people say, "I feel like I'm a burden to my family. I feel like I'm a burden to the health service and others". We talk about self-ageist attitudes. What really drives that is a lot of the discourse that comes to older people from the rest of society. For example, the BBC wrote an article this week about the Programme for Government, in which it mentioned that older people were not present in it. The very last line in the article about the Programme for Government was that older people take up so much of the health and social care budget. Of course they do; that is when you need health and social care.

Mr Kingston: They have paid into it all their lives.

Ms Hoy: It was such a negative way to end the article. It was a throwaway line that stated, "It's all about older people blocking beds and clogging up waiting lists and so on". It is absolute nonsense. It is not how anybody in this room would want to be treated when they are that age. I do not understand why we persist with it.

I agree with you about humour. Older people are brilliant craic. When you are in a room with them, you laugh your head off. Some of them are fantastic, and some of them are not. We are all very much the same.

That is not the kind of language that they are objecting to. They are objecting to their GP saying to them, "Well, of course you're sore. You're 80", or "You can't climb the stairs. Who can at 80?". However, if you were a younger person going in and saying, "I have very sore knees, and I'm unable to climb the stairs" — well, "I'll get you some physiotherapy, and I'll get you a pain-killing injection, and I'll get you this, and I'll get you that". It is that pervasive message of, "Och, well, it's your age. You can expect it. That's what happens when we get old". Nonsense. There are plenty of 85-year-olds out walking their dogs, day in, day out, and who would run rings around most of us. It is more about the message that comes at you constantly when you are an older person. It is how people speak to you in shops or on buses. It is all kinds of things like that.

I am not going to tackle the assisted dying issue except to say that we are there to safeguard the interests of older people, and we would do nothing about older people without older people. There will be no consensus on the issue of assisted dying. It will be so personal to people, their faith, their culture, how they lived their life and their experience of profound illness — all those things. We will always represent the plurality of that view rather than the commissioner having a view on assisted dying.

Ms McLaughlin: Evelyn, you mentioned the demographic change. It is going to come at us really quickly.

Ms Hoy: It is here.

Ms McLaughlin: I can see it in my constituency. Our public services are ill-equipped because we have depleted them for many years, and they cannot handle it.

I return to a question that Connie asked earlier about ageism and its impact on certain groups in society. I am really concerned about older women because a lot of them may have been working in the home. They may be dependent on their spouse or partner's pension, and some of them may not have an added pension. We have an awful lot of older women living out their later years in real poverty.

We have heard the discussions about the cut to the winter fuel payment, and the Labour Government are saying that those who most need it are going to get it, because, if you have pension credit, you will get it. However, 40% of people who are entitled to pension credit do not know that they are, because there is a lack — I do not mean this in a critical way — of that advocacy and their ability to stand up, speak up and get the support. The attention for support is not in their space. A lot of people are going to be living out their end years in poverty.

I am concerned that, in ageism issues overall, a greater proportion of those badly affected will be women. From childcare right through to the whole of society, we still do not have the data to drill down to see who we are talking about and what they need. What additional support is needed by women who cared for children, came out of their careers and had depleted wages as a result; women who spent many years in the home, have no pension as a result, and are now living out their end years in poverty? We need a way to deal with the discrimination within age discrimination as well.

Dr Turtle: You are spot on about the data. In a lot of our policy work, we quote a figure from UK research that the highest risk group for poverty in later life is single women. We know that from the UK-wide data, but we cannot extrapolate what that means in Northern Ireland unless someone does that research here.

In our response to the winter fuel payment decision, we raised the fact that we know that it was not equality screened by the UK Government. If it was, they are not releasing that. I have been working with some contacts on the Communities Committee to find out whether the Department for Communities intends to carry out an equality impact assessment on that decision if it is going to be implemented here. I have heard back that the Department intends to put a screening together. In that, we will be looking for not only the disproportionate impact on older people as a group but that on women, older women in particular. Of the people who fall into the bracket where they have just enough income to take them over the pension credit threshold, which is very low at £212 or £218, but are still at risk of financial hardship, those are disproportionately women because of all the issues with lower pensions, as you rightly pointed out, Sinéad. There is a gender pension gap as much as there is a gender pay gap.

Ms Hoy: On data in particular, we have been very shocked over the years by how difficult it is to disaggregate data by age range. In fact, we were looking recently at how, in GB, a dashboard is provided for older people's data on a regular basis so that any researcher or any person who is interested can go and look at what the data is around older people across a range of issues. We have asked for that from NISRA here, and we have been told that one of the cuts that it is making this year is that it will not be able to provide that. That, in itself, is a very discriminatory approach to take. It is also very important to consider who you mean by older people. It is all right knowing about everybody over 60, but that tells you nothing about everybody between 80 and 90. There are over 13,000 people in Northern Ireland who are over 90, and we do not know anything about them. So, the point on data is extremely well made.

Dr McKeown: On data and poverty, as Kellie said, we know that, if you are single and a pensioner, you are more likely to be poor. Furthermore, the older person is more likely to be poor. So, there is something about linking poverty with age. The other element that is raised when you discuss that is the importance of information and advice around what older people are entitled to. Often, older people say, "That is not for me. I'll not get anything there". There is that lack of knowledge and understanding, and there is a point about getting the support to be able to go through, for example, a benefit form. That is why we have an advice service that is about checking benefit entitlement. We know that, sometimes, older people are reluctant to share some of their financial information, because they ask who will see it, what will be done with it and what the implications are for them. As well as that, there are the long forms and the long processes that people have to go through. So, there are a number of barriers in place for people to get the extra help that they are entitled to.

The Chairperson (Ms Bradshaw): We need to move on. Do you have another question?

Ms McLaughlin: No, I will leave it at that, because I am aware that there are other questions.

Ms Ní Chuilín: The consultation on the draft Programme for Government is out, and I am sure that you are about to put a knock-your-socks-off response in. I am counting on it. A lot of sectors are not mentioned. It does not mean to say that they are not there, but the end result needs to show things that need to be done. You probably remember, Paula, from when we were on the Health Committee and were looking at budgets. When we asked for a breakdown of the equality screening and the impact assessment, the Department openly admitted that it had broken equality on five out of 11 groups on age, disability, women, LGBT and children. For me, that will happen now. The winter fuel payment has already been mentioned. I do not know whether the Department for Communities will do a screening exercise. It probably will, but, at the minute, we have a lot of people, particularly women, who have grown up in poverty. Hopefully, they will grow older, but, again, they will be even poorer.

On this Committee, we are looking at gaps in equality. You mentioned goods, facilities and services, so that could be something that we need to do. Screening and equality impacts are among the biggest gaps. It is massive. I would particularly welcome that recommendation about NISRA, which you just mentioned, if it was a recommendation from yourselves, because how do we know, otherwise? I do not mind answering, "Are you 35 to 55?", for instance, because I understand the need. I encourage you to put that in.

Mr Tinnelly: Yes, we wrote a letter.

Ms Hoy: We have already written to NISRA, and we have written to the First Minister and deputy First Minister about it.

Ms Ní Chuilín: Write to this Committee.

Ms Hoy: We will write to the Committee, as well. The issue is not the data collection; it is the provision of the analysis. There is probably tons and tons of information across all of government on older people, their provision of services and the practice that goes on. I must say that we see excellent practice across the health service and across social care, all the time.

Ms Ní Chuilín: So do I.

Ms Hoy: I do not want it to come across as if it is all broken and there is no chance. However, where it is not the norm, it can be a brutal experience. We need to be a bit more creative around that. The Programme for Government will set the tone for what data we collect. I am resistant to older people being called a sector. They are not a sector; they are 460,000 citizens. That is why the issue of an ageing society is far more important in the Programme for Government, because it will impact on everybody, not just older people. I accept your point about the data.

Ms Ní Chuilín: The other aspect of the data, for us, is that it will help to prepare future-proofed services for us all.

Ms Hoy: Yes.

Ms Ní Chuilín: There are huge issues with the adaptation of homes due to the mobility issues of children, young people and older people. There are massive issues around disability and the ageing community within that. It is going to be horrific. My bugbear is that, often, good relations gets primacy above equality. Good relations needs to be defined in law to make sure that people are not using it as a reason not to provide services on an equal basis. On that — the discrimination on the multiple characteristics — what, if you were sitting on the Committee, would you say we should be saying on all those massive gaps? Is it the legislation, the data, age discrimination, the single equality Bill? You know that all those things were blocked.

Ms Hoy: For us, it would be the age-based GFS legislation, first and foremost. You have to put that in, because a lot of the other stuff, such as the gathering of data and the policymakers' approach to new policies to protect people from discrimination on the basis of their age, will derive from that. I also think that it is the Programme for Government. You cannot go past that.

Ms Ní Chuilín: Thank you.

The Chairperson (Ms Bradshaw): Emma, you have been very patient; are you still there?

Ms Sheerin: My feed has been cutting in and out, so, if I break up, I will turn my camera off, again.

Thanks very much for the presentation and the written briefing that you provided. In your briefing, you refer to instances of people having mismatched care, and there was a particular reference to inappropriate care in nursing home facilities. One of the biggest constituency issues that I deal with in a rural setting is around care packages and the provision of domiciliary care. It links into all that we are talking about around an ageing population and societal changes, such as family size. What are your thoughts on older people accessing healthcare in the home? We are moving away from bigger families. It is one of my frustrations, all the time: you can be contacted by families with six, eight or nine siblings, and they are expected to take on the role of unpaid carer for a family member. That puts a lot of pressure on families, and then you see relationship breakdowns and people under a lot of stress when the person is entitled to help, but it is not available. Can I get your thoughts on that and whether we are meeting people's needs?

Ms Hoy: We are definitely not meeting people's needs, Emma. We have released two reports on social care, and we have been involved in a lot of the conversation around social care reform. Domiciliary care was very strange during COVID because it kind of dropped off the radar a bit. People who normally worked for a living went on furlough, so they were much more available to their older relatives during that time. When they then went back to work, domiciliary care services that should have been there no longer really existed. It was a difficult gap to fill.

The issue is also that nobody starts needing domiciliary care at the point where they are asking for it. There has usually been a few years of the family — all the siblings, the older spouse or the younger spouse — taking care of someone in their home until that becomes too stressful and difficult. Many older people tell us that they do not want to go into a residential home, so there is that issue as well.

I would even say that the Health Department is very clear now about its inability to meet those service needs. That is then inevitably creating blockages in all parts of the system — on health waiting lists and in hospitals — because people are coming out of hospital and are unable to get a bit of help to rehabilitate them to a much less dependent lifestyle. Bring on social care reform: it cannot happen fast enough.

Dr McKeown: To echo some of that: after benefits entitlements and financial arrangements, care arrangements account for the second-highest level of enquiries that Age NI receives to its advice service. First, it is a very complicated process. How do you go about it? Whom do you ask? How do I know what I am entitled to? The other issue is that, quite often, it happens at a time of crisis, so an older person is brought into that complicated system at a time when they are probably not feeling great and the family around them are very worried. Often, the older person is not really at the heart of the decision; it is about what the family does. How can we move people? Older people tell us that they feel that pressure. They do not want to stay in hospital for any longer than they need to. Often, from a health point of view, it is not a good place to be because of the risk of muscle wastage and deconditioning. You want older people to be out of hospital as quickly as possible, but the right support needs to be in the home so that that can happen. That is where most people want to go.

It is also important that it should happen before, and not because of, a crisis. I think that Evelyn talked about people's having to wait. It should be about helping them to live the independent life that they want to live, to stay well, to be out and about and to do the things that they want to do, and not have to wait for a crisis situation to arise. Unfortunately, that is an effect of the lack of investment in the social care system and the lack of priority for social care support.

The Chairperson (Ms Bradshaw): Sorry: we are getting a wee bit off topic. A motion on social care reform will come to the Assembly in a couple of weeks. If you want to make submissions to the political parties, they will pick up on that.

Emma, do you have a follow-up question?

Ms Sheerin: Thanks very much for that. Sorry: I have had to turn my camera off because you were breaking up.

That links in with the intersectionality that you mentioned in your responses to Connie's question. I suppose that I have a specific interest in it, because I see that as an issue that impacts disproportionately on rural dwellers. Again, going off topic, it is obviously the result of not paying workers appropriately and, therefore, making it difficult to recruit. It causes that problem. I appreciate the report and research. Obviously, we commit to doing whatever we can to support you there. Thank you.

The Chairperson (Ms Bradshaw): Thank you, Emma.

I will give the last word to you, Kellie, because that was quite a personalised line of questioning. Is there anything that you would like to say in response, now that you have had a couple of minutes to reflect?

Dr Turtle: No.

The Chairperson (Ms Bradshaw): No. Are you OK?

Dr Turtle: I am fine, yes. It was quite unusual.

The Chairperson (Ms Bradshaw): Yes. Thank you very much. Thank you all.

Go ahead, quickly.

Mr Kingston: Before the panel leaves, I would just like to say that I thought that the comment by the member was very inappropriate. I am not interested in what it related to; it did not relate to our agenda. I want to apologise that it happened in a Committee of which I am a member. I think that the member responsible should apologise, and I hope that he will take that action. When people come to present evidence, it is not relating to their personal lives in any way. It is in their professional capacity. I would not want the panel to leave without that being said.

The Chairperson (Ms Bradshaw): Thank you.

Dr McKeown: We really appreciate that. Thank you.

Mr Gaston: If I could make a comment —.

The Chairperson (Ms Bradshaw): Yes, please. Go ahead. Thank you.

Mr Gaston: Certainly, from what I said earlier on, I do not believe that I have any need to withdraw. From looking down through the Twitter account references [Interruption.]

Mr Kingston: It is not relevant, Chair.

The Chairperson (Ms Bradshaw): Look, OK. I am going to draw a line.

Mr Gaston: Some of the accusations that have been

political [Interruption.]

The Chairperson (Ms Bradshaw): Thank you very much.

Mr Kingston: That is not relevant. It is about knowing appropriate behaviour as an elected representative. [Inaudible.]

Ms Ní Chuilín: No, it's not. Put a complaint in.

The Chairperson (Ms Bradshaw): We will be in touch. We may come back when we have our recommendations in draft form. Thank you.