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Entering a new age

Pensions are becoming unsustainable and waiting lists for old people’s homes are getting longer. Just what can we do to cope with a growing ageing population? Miriam Dunn asks Parliamentary Secretary for the Elderly, Antoine Mifsud Bonnici

In an era where people are living longer and countries the world over are having to deal with the consequences of a growing ageing population, you might be forgiven for thinking twice about accepting the post of Parliamentary Secretary for the Elderly.

And the man who has held the post in both this and the former Nationalist administration, Antoine Mifsud Bonnici, admits that increased longevity, which is a by-product of the many medical breakthroughs witnessed during recent years, brings its own problems.

"At present, the elderly make up 20% of the population, and that is set to increase to 24% - almost one quarter of the population - in about 25 years’ time," he says. "This means that for every four people in Malta, one will be over 60."

Undoubtedly the biggest headache for the Government is how to deal with a pensions system that is fast becoming unsustainable, although growing waiting lists at homes for the elderly probably come a close second.

Dr Mifsud Bonnici, who is one of a quartet of MPs currently celebrating an uninterrupted 25 years in politics, believes the solution to the pension issue will probably be two-pronged.

"Obviously, different suggestions will be put forward," he says. "But two ideas that are definitely being explored are an increase in the retirement age, coupled with making room for private pensions alongside the two thirds’ state pension."

The Parliamentary Secretary, who is a GP by profession, stresses that introducing measures such as these, is not a sign that the Government is abdicating its responsibility, rather an indication that adaptations have to be made, as society changes.

"Much has been done to improve the welfare state," he says. "And while the Government is committed to continuing with this aim, we now have to look at things differently.

"We need to think more in terms of a welfare society. Of course, the Government has a responsibility to continue shouldering the improvements needed in a welfare state, but society should also now act in a way that shows it is in solidarity with us."

He says that one idea being explored is a possible increase in the retirement age, although he accepts there is a social aspect to this proposal.

"I think if this happens, it has to be introduced gradually, so that those soon approaching 60 will not have a problem adapting," he says. "The other of the two basic principles is that although everyone will have a state pension, with the Government providing the basic two thirds pension for every worker, it makes sense for there to be room for private pensions."

Although Dr Mifsud Bonnici highlights the need to introduce any changeovers gradually to ensure older workers won’t suffer any hardships, he also believes that the younger generations accept that the current pensions situation is becoming unsustainable.

"I think the younger generations are realising that the Government cannot be relied upon to provide everything," he says. "New employees are already conscious that they will need to supplement the state pension."

And when will we know what will formally be decided upon? I ask. After all, there has been some criticism that the commission set up to review welfare reform has been dragging its feet, only producing an interim report since it was set up.

"Yes, the report has been a long time coming, but I think that by the end of the year, it will be finalised," he answers. "Remember, however, that the Government can accept or reject the commission’s suggestions, although my own belief is that if the commission works on the principle that in the future there should be a basic two thirds pension guaranteed by the Government and everyone is then at liberty to take out his own private pension, we will be on the right track."

And does he envisage protests at any changes?

Dr Mifsud Bonnici smiles.

"It is almost certain that we will have problems with the unions on the question of retirement age which is, admittedly, delicate, but I’m sure both sides will be happy to talk," he answers.

Although the pension debate is undoubtedly the most pressing issue related to the elderly, Dr Mifsud Bonnici stresses that there are many other aspects of ageing which are being tackled.

"Prior to 1987, I would say that the main issue related to the elderly was pensions," he explains. "But the Prime Minister took an important step forward following the election that year, when he introduced the portfolio I hold now."

Dr Mifsud Bonnici believes that the setting up of the portfolio for the elderly has helped introduce a new culture and attitude towards getting older, dispelling the mindset that reaching the age of 60 means being pensioned off, while also ensuring a number of services are available to help older people continue living in their homes where possible.

"It is our belief that the elderly should be given the chance to remain in their own homes where possible, within their own communities and villages, and services such as homehelp, telecare and meals on wheels help them to do so," he says.

Other projects, such as day centres and the University of the Third Age, have a more social aspect, encouraging older people to participate at more levels in society.

But Dr Mifsud Bonnici admits that despite the facilities being made available, there is still a growing list for places in homes for the elderly.

St Vincent de Paule - the Government’s largest home for the elderly - has 1020 residents and a waiting list of 700. The trend is also mirrored in growing waiting lists for places at private and church homes.

Another headache for the Secretariat is the high number of social cases blocking beds at St Luke’s Hospital - elderly patients who have been medically discharged in theory, but are incapable of looking after themselves at home and are simply waiting for a place at St Vincent de Paule.

This problem is widely recognised to stem from the changes witnessed in the Maltese family set-up; smaller families and more women out at work mean that not so many people can dedicate themselves to caring for an elderly relative in their own home.

Is a new home for the elderly the answer, I ask Dr Mifsud Bonnici.

"There is no doubt that we need a new home, but we will also be reviewing our policies, with the idea of entering into more public/private partnerships," he answers.

"We have already adopted this principle at the Zejtun and Cospicua homes which are government-owned, but run by private administrations. And now, we are exploring the idea of expanding this concept into the building of new homes, making them joint ventures."

The Parliamentary Secretary explains that the Government intends to build a home in Mellieha, which has been on the agenda for many years. He hopes that by the end of this month, the relevant documents will be submitted to the Planning Authority and, if the permits are issued, the home should be ready within a couple of years.

Dr Mifsud Bonnici also highlights the ongoing renovation work, which is being carried out at St Vincent de Paule.

He admits the size and functions of this massive building means that refurbishing it is a major challenge.

"In the past, St Vincent de Paule was primarily a residence for independent elderly people, but today, because we are living longer, the residents are semi-dependent or dependent," he says. "In this respect I regard the refurbishment project at this home as important, because I believe it is only socially just that the Government provides improved services for these residents."

In line with this, the Serenity wards were recently opened, while a new ward in the female block will be opened next month, to be followed by a new ward on the male side, while, by the end of the year, there are plans to open podology and speech therapy clinics.

Dr Mifsud Bonnici believes that his four-plus decades as a GP have helped him gain an understanding of the difficulties that the elderly face, and their requirements and needs. He is also quick to praise parliamentarians on the other side of the political divide for the sterling work they carried out.

"Both parties have done a lot and there is no doubt that the Labour party made much progress in the area of welfare state, especially where pensions, social benefits and allowances are concerned," he says. "But now, although the Government must shoulder its responsibilities, it is vital that we recognise the different society we live in, today and to play our part accordingly."