Insight

Further opportunities for private investment in elderly sector

The Maltese Government has promised to invest heavily in community living for persons with disability. If you couple that with Malta’s ageing population and their ever-increasing demands it translates itself into quite a job for the politician tasked with handling both sectors


INTERVIEW HIGHLIGHTS:

  • Authority to oversee level of service at elderly homes
  • Disability pension for persons certified unfit to work to increase, equate minimum wage
  • Four new community homes for persons with disability built in as many years, plans for Naxxar and Paola hubs
  • New holistic lifelong approach for persons on the autism spectrum
  • WHO following Gozo dementia-readiness project for global replication

 

MaltaProfile speaks to Parliamentary Secretary Justyne Caruana about the improvement of policies and services in the field of rights for persons with disability and active ageing. In the process of understanding the goals and pertinent actions we also learn more about further FDI interest in elderly accommodation and how Malta is carving a name for itself in the global Dementia-readiness map.


What were the main achievements of this legislature in relation to rights of persons with disability?

 

Our very first initiative was to devise a horizontal approach by way of a communication and collaboration strategy with all other Ministries. The final aim of this exercise was to ensure that, in all relevant policy decisions taken across the board, affecting persons with disability, the end result would be the improvement of their quality of life: be this in relation to health, education, transport, employment, or any other sector.

We introduced legislation in Parliament, in order to enshrine the UN Convention for the Rights of Persons with Disability (CRPD) into the body of Maltese law. This process will ensure that these persons enjoy ample opportunities to develop while paving the way towards full physical and sensorial accessibility including in the informational sphere and in the democratic processes. Ground-breaking steps were also undertaken in the areas of deaf rights – Malta being one of the few UN members to recognise sign language as an official language – and of ‘hidden’ disabilities.

In line with what was promised in the Government’s electoral manifesto, we passed legislation on social trusts, which parents or carers of people with disability can avail themselves of in order to make provision for their loved ones after their demise. Strict guidelines have been put in place, to ensure that the terms are in the best interests of the intended beneficiaries, and a tax-free ceiling for such vehicles was established.

The Personal Assistants Scheme was also announced during the 2017 Budget Speech, whereby persons with disability will be able to employ a personal assistant, with the state co-financing the service.

All measures were initiated following suggestions of persons with disability – embodying the mantra of ‘Nothing About Us, Without Us’. The secret is maintaining an open channel, on a daily basis.

 

What is the current plan in relation to care within the community necessary for certain persons with disability?


The main effort undertaken in this field is the ‘Fair Society’ project, delivering on a promise conceptualised in the run-up to the 2013 general election. While Government is committed to the principle of independent living as a guiding concept, we recognise the need of care within the community. In this light, the initial phase of the project, currently being implemented, provides for 10 new community homes for persons with disability, over a period of five years. This process is in full swing, with four of these homes being already up and running.

Furthermore, we are also in the process of developing a fully-fledged hub in Naxxar, with further ‘universal-design’ accommodation catering for various aspects of the Maltese disability sector. Named ‘Reach’, this €15 million investment will also offer access to an array of services, supporting independent living. These services will complement outlets promoting social entrepreneurship. A similar initiative will also be undertaken in Paola, a town in the south of Malta.

 

 

WORK IS DIGNITY:  Government is incentivising employment both by decoupling disability assistance and gainful occupation  and by encouraging employers to tap into this new pool of resources and enthusiasm  (Photo Credit: John Sherman)

 

What initiatives were taken in the realm of work and persons with disability?


An important measure to incentivise persons with disability to join the workforce was the removal of existing caps on disability pensions, no longer having this vary with respect to whether a person receives earnings from gainful employment.

We have also provided specific incentives to employers. Companies adhering to disabled employee quotas benefit from tax credits and exemptions from national insurance contributions. On the contrary, employers not meeting said quotas must pay additional contributions with such financial contributions being directly deposited into a fund promoting employment for individuals with a disability.

Another major reform will see disability pension for individuals certified unfit to work, increase to be equivalent to the national minimum wage.

 

Through these last years, you have evidently been focusing on Autism, what has been achieved?


The Maltese Parliament unanimously adopted the Persons within the Autism Spectrum (Empowerment) Act, which is the result of consultations with persons on the autism spectrum and their families. It has the goal of empowering these individuals to achieve the same quality of life as their peers, and to increase self-determination and self-advocacy in all spheres, focusing on abilities as opposed to disabilities.

A Council bringing together the relevant stakeholders also including NGOs and service providers is currently drafting an action plan in the form of a national autism strategy. The most concrete goal of this plan shall be that of ensuring the right conditions towards developing and implementing a holistic lifelong inclusion and empowerment approach for persons on the autism spectrum, from day one, also addressing the services and supports necessary for this. This would be the gold standard, rather than such persons having to rely on sporadic initiatives or to face repetitive assessments in order to be able to exercise their equal rights.

 

Active ageing might be a buzzword, but it is also a major policy area under your remit. Can you walk us through the accomplishments in this regard?


A quarter of the population in Malta is elderly. This statistic crystallises the extent of the task at hand. Government’s main take on this policy area is that our elderly need to be treated not as patients, but as active members of society, which is why this sector was moved from the remit of the Health Ministry to that of the Ministry for the Family and Social Solidarity, which my Parliamentary Secretariat forms part of.

Malta’s Active Ageing strategy has three main pillars. The first is active participation in society. Progress has been registered in this regard as Malta moved up the rankings in both UN and EU active ageing scoreboards. We have equally moved forward promotion of generic wellbeing and related services.

 

New local and foreign companies, some of which had never operated in this sector before, are looking to invest in elderly care

 

However, we are striving to make further gains as to this subject-matter in the employment sector.

My Secretariat is also responsible for community-based and residential services, where we have faced more challenges in working towards our end goals. Providing long-term bed space is a costly and challenging exercise when considering Malta’s ageing population. We are addressing this matter through a public-private partnership, whereby Government operates a series of care homes while engaging the services of the private sector in order to meet the remaining demand for bed space.

The Parliamentary Secretariat has also developed a long-term plan that includes elements of market research, looking at ways to develop public-private partnerships in order to guarantee bed supply.

The Services Standards document was also launched, while we are also in the process of forming an Authority that would oversee the level of service provided. However, we have opted to allow service providers a transitional period, in order for them to be able to upgrade their standards while causing minimum disturbance to the market.

The landscape is now rapidly transforming itself with the inclusion of a number of new investors, some of which had never operated in this sector before and who can work in partnership with the Secretariat. Competition improves the quality of service, an improved offering that our elderly can benefit from.

This sector has also attracted the interest of international investors that are looking at partnership agreements with Maltese outfits and there is still further space for investment in this area.

The Living Carer programme has also been rolled out. It entails that Government train and part-finance the costs of a carer who is living with the elderly person. This initiative has also provided work for a good number of carers. The contribution of €4,200 a year for every such carer, the amount paid out at the start of the programme in 2015, has been increased to €5,200 a year in 2016.

 

 

SERIOUS ABOUT DEMENTIA: The conclusions of a pilot study on dementia-readiness conducted in the village of San Lawrenz, Gozo will be presented during the Maltese EU Council presidency. (Photo credit: DailyCaring)

 

Dementia has been another priority during this legislature. Could you give us a run-through on what is being done in relation to dementia?


Malta is one of the first, and one of the few countries in the world, to approach dementia from a social rather than from a health perspective. World Health Organisation (WHO) studies show that such an approach is more conducive to easing the load on the health system, which is quite hefty when one considers that some studies compare this to that presented by oncology.

As for the provision of care and related responses, Government has developed dementia intervention teams, while also running a fully-fledged pilot project. The Dementia Council, Alzheimer Europe, Alzheimer International and the WHO are all following our pilot project of the first dementia-friendly community in San Lawrenz, Gozo. This locality was chosen as it is a small village, with a high incidence of dementia. We are providing training for all the residents, and transforming the village with signs, colour codes and images that help those affected to associate particular visuals with the place they are in. Other residents will now be able to recognise dementia and use their training to assist. The project ran from December 2015 to December 2016, and we will present the conclusions of this initiative during an expert meeting in Malta, which will happen in the context of Malta’s EU Presidency.

We also look forward to transforming this system into a nationwide policy. To this effect, we have roped in our national Parliament. As part of this effort, the building of the House of Representatives in the capital Valletta will become the first Parliament building in the world to have staff trained on dementia. This training will also prove valuable to any persons requiring assistance in the zone directly around Parliament, considering that this is a central zone of our capital.

 

Some studies have concluded that the cost of addressing dementia is comparable to what is spent on oncology

 

Apart from dementia what will be the main dossiers that you shall be focusing on during Malta’s EU Presidency?


The European Commission is banking on us to wrap up the eight-year exercise on the European Accessibility Act and to have a tangible conclusive version of this legislative draft dealing with the accessibility of products and services, including for persons with disability.

We will also focus on the European Social Pact, which is aimed at seeing the EU move deeper into the social policy field, as opposed to the status quo in which this area is approached in a more generic manner.

 

What is your long-term vision for the country as to the fields of disability and the elderly?

I want us to reach a stage at which there is no need for this Secretariat for the Rights of Persons with Disability, as having it means that there still is much work to be done. The same applies to my other remit in relation to the Elderly. We would like to come to a point where people will not need to rely on state services. This does not mean that the state should not be ready to support our disabled and elderly communities, but the state should not be the only option.

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