Monday, December 2, 2013

Comparative Systems: NI's Independent Commissioner for Older People

Clair KeatingeAt the heart of comparative research is the opportunity to rethink your own system.  I was reminded of this point last week when meeting Claire Keatinge, the Commissioner for Older People in Northern Ireland (COPNI).  Commissioner Keatinge is -- in a word -- dynamic, and it is impossible not to be impressed with her dedication to meeting the needs of older persons in her country.  She is a leader, both actually and symbolically, for a hard-working team tackling a number of issues in ageing policy. 

It is clear to me that "independence" is at the core of the role for the COPNI.  What do I mean by independence?   The COPNI is funded with public dollars, but the job includes making an independent evaluation of the needs and interests of the demographic, and then reporting and advocating for appropriate response by the government or other sectors. By comparison, I wonder whether state officers or offices charged with policy and laws in the U.S.are more likely to be serving a governmental agenda, and trying to sell that agenda to voters.  This strikes me as a potentially important, if subtle, difference in systems.

A small example of the importance of independence:  One of the COPNI's several goals is to identify and improve "uptake" of benefits available to older persons in the country.  In Northern Ireland, and elsewhere in the U.K., there are official statistics on the dollars (whoops, I mean pounds) left on the table by individuals who fail to seek available public benefits or services.  In N.I., there is a known gap. By comparison, I would be surprised to learn that we keep similar statistics on either the state or federal level in the U.S., much less have a policy of trying to reduce any gap.

Claire Keatinge also stressed that an individual assessment of need for health care, social care and security, should be exactly that, and not simply an assessment of what services are available.  Helping individuals or their family members access services in the public, private and voluntary sectors is part of the COPNI plan of action, but, it strikes me that the emphasis on evidence-based policies may result in development of new services or better funding for existing programs.

Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care | Permalink

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Verrrrry innnnnterrrresting, Katherine. Northern Ireland is about the size of Connecticut, 5,345 square miles and only 1.8 million population, and racially homogenous, so a national commissioner of programs for the aging would have a relatively easy set of programs to manage. Here we have both federal and state programs and widely varied legal environments. I agree that it would be helpful to have a comprehensive database showing program utilization across the nation, but that would be extremely difficult. Also, in the current paranoiac atmosphere, it would be difficult to develop a national database of service utilization.

Posted by: John Payne | Dec 2, 2013 1:37:18 PM

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