The enormous cost of Government tax breaks for wealthy individuals should spark a debate about the most effective use of resources and how we, as a society, wish to develop. In particular, as the population ages, care of the elderly will become more expensive. It is now time to start planning for that eventuality, while the economy is thriving and Government finances are in a healthy state.
Tánaiste and Minister for Health Mary Harney has emphasised the need for new thinking, new policies and new practices in providing services for senior citizens.
But, while an extra €110 million was made available for homecare services, sheltered housing and nursing home subventions in the recent Budget, overall funding from the Department of Finance was parsimonious. At one of the most basic levels, involving the alteration of old people's homes for safety reasons, local authority grant aid has fallen.
In recent years, the Government has effectively withdrawn from the provision of new public nursing homes, leaving it to the private sector to fill the growing demand.
The cost of tax breaks for private nursing homes amounted to €55 million by last year and led to the provision of 1,267 beds. Future investment in the scheme, which is one of the few to be retained, may be significantly higher. There has been little discussion about this departure in Government policy.
Instead, debate has centred on the rising cost to the State of patient subventions to these very nursing homes. And while a succession of ministers promised to develop community based services - to keep elderly people at home for as long as possible - funding was inadequate.
Sweden has been quoted as an example of how a society can provide high-quality care for the elderly, with proper forward planning and investment. That country is about 10 years in advance of us in terms of population structure.
And life expectancy is greater. In spite of that, those who require care are provided with single-bedroom units, whether in the community or in a nursing home and the cost is funded mainly from local taxation. We need to look after our senior citizens and improve their quality of life through the provision of better and more modern services.
While the issue of universal private pensions is still live, because of the contrast between the benefits offered in the Budget to low-paid SSIA savers and the largesse received by a handful of billionaires in tax breaks, consideration should be given to another approach.
The Government is likely to deliver on its election commitment to increase the social welfare pension to €200 a week in 2007, general election year. That will be a considerable achievement.
ut it still only provides for frugal comfort on the part of recipients. Raising social welfare entitlements significantly for everyone, by reducing excessive tax reliefs on private pensions, would be a more equitable approach.