The politics of old age: Older people's interest organisations and collective action in Ireland

THE POLITICS OF OLD AGE

THE POLITICS OF OLD AGE

Older people’s interest organisations and collective action in Ireland

Martha Doyle

Manchester University Press

Copyright © Martha Doyle 2014

The right of Martha Doyle to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988.

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ISBN 978 0 71909047 9 hardback

First published 2014

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Dedicated to

the older and younger generations in my life

Contents

Acknowledgements

1    Introduction: contextualising the ‘politics of old age’

2    Collective action and the nexus of political and cultural systems

3    Older people’s interest organisations

4    The political, economic and social policy context

5    Older people’s interest organisations: directors and members

6    Policy-makers’ perspectives of older people’s interest representation

7    The nexus of resources, political opportunity structures and collective identities

8    Looking forward

Appendix I: Sample profile: older people’s interest organisations

Appendix II: Sample profile: policy-makers

References

Index

Acknowledgements

This book is the outcome of a PhD thesis which I completed while working as a Research Fellow in the Social Policy and Ageing Research Centre in the School of Social Work and Social Policy, Trinity College Dublin. I would like to express my sincere gratitude to Professor Virpi Timonen, Trinity College Dublin, for encouraging me to pursue and complete the doctorate and for her support, guidance, positivity and advice during the completion of the thesis. To Professor Marian Barnes, University of Brighton, and Professor Tom Scharf, National University of Galway, Ireland, I am much indebted for the invaluable advice they gave during and after my PhD viva voce which helped me to clarify my own thoughts and improve upon the theoretical arguments of this book. I would also like to acknowledge the help of a small number of people who during the research journey allowed me to discuss my ideas and, in turn, offered suggestions and direction. While the nature of this contact was in most instances brief, nonetheless the advice and support given at the time was much appreciated. Among those I would like to thank are Dr Achim Goorres, University of Duisburg-Essen, for his encouragement, feedback and advice at the Joint ESPAnet/ESA network in Amsterdam in 2008 and the ECPR workshop in Lisbon in 2009, and Professor Gary Murphy, Dublin City University for allowing me to talk through my ideas in the early stages of the project. I am thankful also to my former colleagues in the Social Policy and Ageing Centre and the Living in Dementia Progamme for their support, encouragement and advice when I shared my concerns and ideas regarding the research over the years. To my family, husband and parents-inlaw I am much indebted and express my sincere thanks for their unfailing support and help with the care of my two beloved little boys, Matthew and Ciaran, so that I could dedicate the additional time required to work on this project. My deepest thanks go to my brother, Dr Cathal Doyle, Middlesex University, for the careful proof-reading of drafts of the book. Finally thanks to each of the seventy-five participants who agreed to be interviewed as part of the research. Without their cooperation this project would not have been possible. Thank you for giving up your time to meet with me. I hope that I have relayed an accurate account of your experiences and perceptions and that the research will be of some value to you.

1

Introduction: contextualising the ‘politics of old age’

In his 2001 budget speech, the Fianna Fáil Minister for Finance, Charlie McCreevy, stated that the government wished to recognise ‘the part played by the workers of yesterday in laying the foundation for so much of our current economic success’ (Humphries, 2000) and granted all persons aged 70 years and over an automatic entitlement to a medical card. The medical card offered beneficiaries free GP services, prescribed drugs and medicines (with some exceptions), in-patient public hospital services, out-patient services and free medical appliances, and dental, optical and aural services. The government decision was announced before any negotiations had taken place with GPs on how much they would be paid for treating the new over-70s card holders. Subsequently, the Irish Medical Organisation demanded that GPs treating the new beneficiaries, who were over 70, get treble the payment that was formerly received for those who held means-tested medical cards. The government acquiesced.

Seven years later, on 14 October 2008, the Fianna Fáil Minister for Finance, Brian Lenihan, presented the Irish Parliament with the government budget for 2009. In an effort to save public money he announced that the automatic universal entitlement for people aged 70 years and over to a medical card would be abolished. Instead, he proposed that a means-based system of assessment would be introduced. The print and television media dedicated a significant amount of time and resources to covering this controversial measure. The two largest older people’s advocacy groups in Ireland, the Senior Citizens’ Parliament and Age Action Ireland, immediately issued press releases condemning the move and called for an immediate reversal of the decision. They organised two public meetings, one of which was attended by over 2,000 older people and another by approximately 15,000. As such, these protests were the largest protests orchestrated and executed by older people to occur in the history of the Irish state. At both these demonstrations, ministers who attempted to address the crowds were heckled and jeered and forced to cut short their speeches. The demonstrators were supported not just by the general public but by the opposition political parties. Support was even garnered from Dublin city taxi drivers who provided free taxis from Dublin’s main train station to the protest demonstration at Leinster House, while Insomnia, a coffee chain, provided free coffees to all persons aged 70 and over who attended the march. There appeared to be few opponents to the organisations’ call to reverse the decision; nursing home representative groups and even doctors, a group who had been critical of its introduction in 2001, were now critical of the move to remove the automatic entitlement to the medical card.

Over the course of ten days the campaign gained momentum. Serious tensions and fissures emerged not just within the coalition government, but also within rank and file members of the Fianna Fáil Parliamentary Party. The full extent of these divisions was laid bare when first a Fianna Fáil TD (member of parliament) resigned from the party and then an Independent TD withdrew his support from the coalition government. To placate the voting electorate the Minister for Finance moved quickly and announced five different eligibility thresholds. The protests resulted in significant changes to the means-test limit but did not result in a complete reversal of the decision. The automatic entitlement to a medical card for all persons aged 70 and over ended on 31December 2008. Under the Health Act 2008, everyone aged over 70 who applies for a medical card is subject to a means-test. People with a weekly gross income above €700 for a single person or €1,400 for a couple would no longer be entitled to a medical card.

During the ‘medical card protests’ the actions of older people’s interest organisations and their members took on, arguably, the greatest relevance since their inception. At face value it appeared that the reversal of the government’s decision signified the coming of age of the older people’s movement and their representative groups. Exploring in detail older people’s interest organisations in Ireland, this book argues that the issue is not so straightforward. It reveals how the work and influence of these organisations continues to be a function of complex, mutable and dynamic processes. It argues that the power they exercise, their legitimacy and existence, remain highly contingent on policy design, political opportunity structures and the prevailing cultural and socio-economic milieu. Furthermore, ideological constructions of representation, the meaning of ‘old age’, and ‘old age’ targeting remain important variables of a dynamic cultural and political environment which contextualises and influences how older people’s interest organisations operate.

Old age, the welfare state and the economy: an evolving relationship

One of the greatest achievements of the twentieth century was the extension of the human lifespan, a trend that is still ongoing in most countries. More people are living longer and often healthier lives. Life expectancy, from infancy to old age, has improved across the world. As a result, significant changes in age distribution have taken place across both the developed and developing world. Populations are ‘ageing’ and a further significant increase in the proportion of the population aged 60 years and over is expected globally. Particularly noteworthy in the coming decades will be the increase in the number of persons aged 80 years and over. To accommodate these changing demographics, it is argued that policy reformulation is required.

Old age is a construct which is politically, historically and culturally defined. Chronological age did not hold any significant relevance in pre-industrial society. Historically age was more a function of a person’s role within the familial network; as Hockey and James (2003) explain, people ‘aged’ when they assumed new roles such as parent or grandparent. Contemporary understandings of ‘old age’ are thought to have emerged from the institutionalisation of pension and welfare policy across the countries of the northern hemisphere from the end of the nineteenth century. For the first time chronological ‘old age’ became a significant marker which denoted one’s entitlement to specific welfare benefits. Old age was objectified through retirement and the provision of welfare supports. According to Biggs and Powell (2001: 10), ‘Social Welfare came to colonize the meaning given to old age.’

The expansion of the welfare states in the United States and Europe and associated allocation of welfare benefits, such as pensions, housing support and long-term care assistance to older people, received widespread public support in the late nineteenth and early to mid-twentieth century (Estes et al., 2003; Walker, 2006a). A considerable degree of consensus existed among Western governments that older people were a deserving group and that public services should be provided to adequately cater for their needs (Estes et al., 2003; Hudson, 2005; Walker, 2006a). While the provision of welfare supports was a significant buffer against poverty, the institutionalisation of old age led to its stigmatisation (Townsend, 1981; Walker, 2006b). As Binstock (2010) argues, morally the provision of welfare supports was justified under the guise of ‘compassionate ageism’. Older people were portrayed as a homogeneous group, frail and vulnerable; old age was conceptualised as a time of disempowerment.

Even though the institutionalisation of welfare supports may have contributed to the categorisation of old age in a negative manner, the provision of pension and welfare benefits provided a security which was beneficial to the older population. The welfare supports provided to the old contributed to a radical improvement in the health and economic well-being of older individuals. Extreme deprivation in old age, as was evident in the pre-war years, was virtually eradicated. The provision of an extensive social security system in the US and Europe resulted in ‘the emergence of retirement as a distinctive and institutionalized stage of life’ (Hudson, 2009:122). However, the economic and moral rationale behind the provision of extensive welfare supports to older people was undermined from the 1970s by conservative advocates who challenged the sustainability and equity of age-based social security benefits.

The emergence of neo-liberal ideologies from the 1980s onwards contributed to a perception that the politics of old age has a negative correlation with the notion of generational equity. In the selective,¹ misguided and at times sensationalist neoliberal discourse ‘the theme of zero-sum trade-offs between the young and old’ (Binstock, 2010: 577) is articulated. The lifecourse is atomised with cohorts pitted against each other. In the US and Europe a number of public officials and academics have been complicit in fuelling this conception of ageing as ‘a crisis’ by identifying older people as the unwarranted beneficiaries of a disproportionate amount of the public budget, at the expense of other (supposedly more deserving) younger people (Binstock, 2009). The argument is problematic and its legitimacy questionable for many reasons. Most notably, advocates of this argument are generally not supportive of extending benefits to the young or working families and focus little attention on inequities and marginalisation within the older population (Hudson, 2009). The argument is further compromised by the fact that there has been little sociological evidence to point to the actual existence of an intergenerational tension (Hudson, 2005). Nonetheless, this constructed notion of intergenerational tension, framed by those seeking to retrench old age benefits, continues to be advanced as a justification for policy reforms which have potentially profoundly negative implications for older people on a global scale.

Pension and health care reforms have been evident across Europe and the US since the 1990s. Among the changes they have introduced are an increase in the retirement age in countries such as the UK, Ireland and Poland, a shift in occupational schemes from defined benefits to defined contributions schemes, and reforms in long-term care policy which include the expansion of the publicly funded long-term care to the private sector (see Ervik and Lindén, 2013 for an analysis of the European context and Hudson, 2005 for an analysis of the US context). The coupling of a ‘marketisation of welfare’ (Powell and Biggs, 2000) and continued calls for greater privatisation of pension and health care, has the impact of transforming old age from a time of relative security to a period of significant risk (Biggs and Powell, 2001). Underlying this neoliberal globalised agenda is the ‘individualization of the social’ (Ferge, 1997) and the argument that individuals, rather than the state, must take responsibility for their own welfare.

The impact of the globalisation of capital on old age policy has also become more discernible since the 1990s (Phillipson, 2002). Within this global framework the social construction of older people as a deserving group and the assumption that the state should allocate a disproportionate amount of resources to them, is questioned. International organisations such as the World Bank and the International Monetary Fund contribute to the construction of the notion of ageing as a crisis by emphasising the economic costs of demographic ageing. Espousing a neo-liberal agenda, these institutions have called for increased privatisation of pension schemes and the reformulation of welfare policies (Baars et al., 2006). Against the international backdrop of budgetary constraints, calls to restructure economic expenditure throw the long-term financial sustainability of welfare systems into doubt. Future projections of dependency ratios are used to paint alarmist pictures of the socio-economic consequences of demographic ageing, with policy discussions on old age dominated and transformed by this notion of demographic ageing as a ‘crisis’.

This evolving relationship between economic policy and social policy as it relates to ageing which commenced in the 1990s continues in the current millennium. Welfare state retrenchment is emphasised and the sovereignty of nation-states is undermined by supranational bodies such as the International Monetary Fund, the World Trade Organization and World Bank, who promote a globalisation of social policy (ibid.). Within this new paradigm, social policy as it relates to older people is shaped by ‘the structures of the international configurations that lack democratic legitimacy’ (Baars, 2006: 19). ‘The burden of ageing’ thus shifts from a national to a global concern (Phillipson, 2006: 51). In this neo-liberal globalised discourse the dominant policy response to changing demographics is that security in old age will become a function of market-based imperatives. For example, examining the policy discourses of the European Union (EU), the Organization for Economic Cooperation and Development (OECD) and the