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Sage Advocacy launches new campaign to "Shed a Tier" June 2, 2020

Research by Sage Advocacy, confirmed by many other studies, suggests that although the “vast majority” of people in Ireland want to “live and die” at home there is a systemic bias towards care in congregated care settings such as nursing homes.

Mervyn Taylor, Executive Director of Sage Advocacy, which supports vulnerable adults, older people and healthcare patients, said more older people could live in their own homes or in supported living projects in their own communities but only if there was an integrated system of long term support and care with a single source of funding.

Mr Taylor said the current two tier system is only partially regulated and partially under statutory control. 

Sage Advocacy believes it is now time to “Shed a Tier” to create a new inclusive healthcare system in Ireland that delivers a single tier national health service with an integrated system of social care focused on home.

Mr Taylor said: “Currently care in people’s homes is inadequately funded, is not on a statutory basis and is unregulated, but nursing home care is on a statutory basis and is regulate. This is despite decades of policy development which recommended a focus on home”. 

“Covid-19 has exposed the weaknesses in our health and social care systems and we cannot just go back to the way it was. Now is the time to rapidly move forward and develop a single tier integrated support and care system for older people with a single source of funding”. 

This week Sage Advocacy will launch a “Shed a Tier” post card campaign across Ireland to encourage debate and highlight the need for a fairer system that enables older people and vulnerable adults to be supported and cared for in places of their choice.

Mr Taylor said: “We have lived with a system where some people end up in nursing homes against their will because of a lack of community-based alternatives and we need to stand up and say no more”.

“There has to be learning from the experience of Covid-19 and the recently appointed Expert Group on Nursing Homes will have to urgently address the complete lack of clinical oversight of nursing homes and ensure that measures are put in place to integrate private nursing homes into the wider framework of health and social care”. 

“The current ‘pass the parcel’ approach to taking responsibility for the lives of people in private congregated care settings is inherently dangerous and has been shown to be so,” he added.

Sage Advocacy is now calling for a range of options to be developed including a regulated Home Support Service and a network of Community Teaching Hospitals in each of the six new healthcare regions proposed under Sláintecare. 

“In between we need a wider range of options including: home share; colocation of family on the same or nearby sites; care with host families; supported living in clusters of homes; high support living and care villages as well as nursing homes” Mr Taylor urged. 

Emphasising that great work had already been done on these issues, Mr Taylor praised the work of those in the HSE who had worked with NGOs to explore the Teaghleach or Household approach as an alternative to institutional care in large nursing homes.

“A nursing home is hardly your home from home if you find over 30 people in your sitting room” he added. 

The ‘Shed a Tier’ campaign aims to engage those involved in forming the next government and future ministers.

“Postcards and online messaging will be used to remind people of influence that the memory of the many hundreds of older people who died in nursing homes will be better served by positive actions rather than legal distractions,” Mr Taylor added. 

‘Shed a Tier’ postcards can be requested by emailing info@sageadvocacy.ie.


Mervyn Taylor, Executive Director, Sage Advocacy, is available for additional comment or interview.

For further information please contact Francess McDonnell: 087 1738762

Read more on the background to the campaign

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