Submission to the Portfolio Committee on Social Development

1. The SA Council of Churches welcomes the opportunity to make submission on a matter close to the heart of the Churches, namely the care and protection of the older person, especially those who are poor, live in rural areas and are thereby marginalised vulnerable. We also recognise, however, that the older person, by virtue of stereotypes, economic perceptions and social stigma, is perceived as dispensable to modern society and therefore vulnerable to social, psychological and physical abuse. In reality, though, the older person possesses a wealth of wisdom, experience and resourcefulness in the caring of society's children and households where parents are working and/or seeking work. Such care is perhaps underestimated when one recognises that many older persons are central to caring families and communities, frequently volunteering their services to care for children suffering from HIV/Aids.


2. We therefore commend the Department of Social Development for drafting new legislation to repeal The Aged Persons Act 1967 (Act No. 81 of 1967) and The Aged Persons Amendment Act 1998 (Act No. 100 of 1998).¹ These pieces of legislation fail to meet the Constitutional demands that all South Africans, including older persons, shall realise human rights and fundamental freedoms to the fullest extent possible.


3. Much has been done and is being done by government to redress the effects of inequity in social and human development planned by successive apartheid regimes. The presence of this Bill indicates the further commitment by government to redress these inequities and to uphold the Constitutional values of respect, dignity and well being of all, especially of vulnerable, marginalised and older persons. We, therefore, commend the Department for developing legislation that seeks to assign the process of care and protection of the older person within the jurisdiction of a provincial government as required by proclamation R.7 of 1996. Clearly, the realisation of such care and protection requires the effective input, action and monitoring from local institutions, local government as well as the community of older persons. Further, we see as progressive, some attempts to address contemporary and international recommendations for action-on-ageing as related to the Madrid International Plan of 2002 and the UN Peoples Bill for Older People. The latter in particular spells out the needs of older persons as "...independence, care, participation and self fulfilment with dignity".² While much more needs to be done in the Bill to address these international recommendations, there is merit in efforts that focus the main objects of the Bill in order to:
   1. maintain, increase and promote the status, well-being, safety and security of older persons;
   2. maintain and protect the rights of older persons as recipients of services;
   3. regulate the registration of facilities for older persons; and
   4. combat the abuse of older persons.


4. We believe, however, that the Bill needs to be strengthened in identifying the scope of dealing with life-span transition of the older persons as well as clarifying the contextual differences and relations between human development, on the one hand, and social development on the other. According to the 2001 census, the total older person population (60+) was 3,280,506 representing a growth rate of 16,12% over the 1996 figures. By 2009 the Department of Social Development estimates that that figure will have risen to 4,214,648. While this figure represents 7,3% of the total population, indications are that the older person plays a proportionately greater role in family, community, social and economic support to 19,3 million children between ages 0-19 years, 44% of South Africa's population. Of the total older person population, women constitute roughly 61%, while 87% of the older person population, according to the figures of the Costing Report, are to be classified as Totally Vulnerable Older Persons defined as

   "a person over the age of 60 who is in receipt of a social grant by qualifying through a means test and is eligible for other state social services. These are older persons in the community that are at risk of not having their needs met due to inadequate or inaccessible resources, and as a result are susceptible to privation or relative deprivation."³

   The vast majority of totally vulnerable older persons live, not exclusively but significantly, in rural rather than in urban areas. Contrary to these figures of despair, we agree with the submission by the SA Catholic Bishops' Conference (SACBC) that the older person ought not to be perceived as a "burden" but rather as a contributor to the moral, spiritual and mental health of society. The SACC, therefore, agrees with the pretext to the objects of the Bill that " ... growing old should be a period when a person's contribution to society is acknowledged and valued ... (by) increase(ing) the capacity of older persons to support themselves and to contribute to the well-being of those of those around them."⁴


5. The Bill covers essentially three areas of need. These are
   • Programmes for development of older persons (Chapter 1)
   • Ensuring an enabling and supportive environment for older persons (Chapter 2); and
   • Protection for older persons (Chapter 3)

Programmes for development of the older person

6. We agree with the SACBC that the heading and contents of Chapter 1 appear vague in their intention and arbitrary in their commitment⁵, especially as they seek to address the "development of older persons." This begs the question how do we develop another person or category of persons, if this is at all possible. The process of human development is surely a complex one and the result of interaction between biological, natural, environmental, social, political and economic forces. We believe, too, that the complexity of relationships between these forces necessitates that the older person is not just subject to programmes and processes but that the older person has been and is and ought to be able to shape these programmes and processes. This is (and has been so) by virtue of who they are, a blend of mental, social, psychological and spiritual energy. The questions that arise, then, are who develops whom and what is the relation of the older person to the Bill's proposed programmes of development? If we are to give substance to the aims and objects of the memorandum, then, it would appear consistent to rename Chapter One, "Programmes for development of older persons" to, for example, "Programmes for development and the older person."


7. Notwithstanding the fact that the Department of Social Development met with various governmental and societal stakeholders and that such provided valuable information, the Bill needs to reflect such participation further and later down the line. Such an approach would require the Minister to adopt an intentional plan with strategies to be spelt out enhancing the capacity and participation of the older person to address the vision of an inclusive society as envisaged by our Constitution. It also suggests that action on ageing needs to become mainstreamed into all the work of other Departments (rather than a piecemeal opportunity for consultation) so that the process of developing a society that seeks to care for and protect its citizens is the responsibility of government and every citizen. Such a plan of action would then of necessity be worked out with all stakeholders such as government, civil society, not for profit organisations, faith based organisations and communities as well as with traditional leaders. Above all, and in terms of vision for social change relating to the objects of the Bill, the private sector needs to be urged to take this vision on board especially when reviewing the transformation and experience that older persons can bring to economic and labour markets. The introduction of such a plan should not be optional but mandatory to the transformation process of our nation. The SACC therefore recommends that 2.(1) read: "The Minister shall, in consultation with other relevant Ministers and representatives of older persons from various sectors (e.g. local government, community, labour, faith, disabled and business) of civil society establish a National Forum of Older Persons for the implementation of action on ageing." Such an integrated approach will have the effect of relieving the Minister from taking sole responsibility for action on ageing; enable civil society, labour, business and the older persons themselves to identify and work together for measurable programmes toward these ends. Such a Forum may add to and/or amend the fifteen programmes identified under 2.(2) (a)-(o) in the Bill, while giving consideration to an appropriate inter-sectoral mechanism or National Policy Framework. Since a vision for the integration of care, protection and the mutual support for and by older persons is desirable, the Forum would need to include discussions on the promotion of an integral process for ageing with dignity and measured well-being, possibly with the Department of Education. Clearly, the need for a dedicated process of attitude change toward ageing and the older person is crucial and the Bill needs considerable strengthening in this regard.

Ensuring an enabling and supportive environment for older persons

8. This section of the Bill seeks to retain the regulation of facilities and services subject to the norms and standards to be prescribed by the Minister. It further seeks to continue the accountability mechanisms for funding, subsidies, registration and monitoring of such places. While perhaps the majority of these residential care facilities (old age homes) are located in urban areas, they often provide care for older persons who are too frail to care for themselves and who may not have access to community-or home-based-care. At present such facilities provide accommodation for 31 845 persons, less than 1% (0,987%) of the current population of total vulnerable older persons (3 223 965) at a cost of nearly R 300 million.⁶ Government subsidises 654 service centres at a cost of slightly more than R 446 million, NGOs for social work services rendered are subsidised to an amount of about R 12 million while poverty relief projects in all Provinces have received R 25 million.⁷ The registration of a residential care facility, under the current Bill, would, as previously, be contingent upon qualifying at the discretion of the Minister, except that now it would need to qualify as a programme defined in subsection (2). While the Bill focuses understandably on the regulations of residential care facilities, it is silent on commitment or relation to other programmes of care such as service centres, social work in NPO's, or poverty relief programmes. In so doing, the Bill seems to imply that residential services are a priority. This misses the need to identify and acknowledge its relation to other services such as family and community based care that already are provided communities, churches and other faith communities, NPOs, health practitioners and professionals. Already an enabling and supportive environment exists through the care of families, communities and a large number of women and older persons in the community. One way in which the Bill may be strengthened in order to promote an enabling and supportive environment might be to recognise the need for a continuum of care services for the older person including primary care, family and community based care, professional and rehabilitation, long term and palliative care. The Bill could be considerably strengthened if it included:
   • A community plan to conduct a needs assessment for planning locally based care and health services that involves the participation of the older person; and
   • Regulatory mechanisms for such community and family based services as a continuum of care. Consultation with the Department of Health on this plan is essential, as with other programmes, that care for the older person needs to be mainstreamed into every relevant facet of government.

Protection for older persons

9. The SACC understands the serious need to clamp down on all forms of abuse, especially on older persons, since such disregard for the humanity and dignity of the victim reflects the antithesis of our Constitutional democracy. If unchecked, such neglect might lead to further disregard for the rule of law and exacerbate the breakdown of human and social relationships so essential for national unity. The provisions in clauses 14, however, appear to be designed for social workers and/or health care professionals to play a leading role in the care and protection of possible abuse of the older person. Similarly, such powers are extended to "any person who examines, attends to or deals with an older person ... if he or she suspects that the older person-(a) has been abused; or (b) suffers from any abuse-related injury."⁸ Clause 16 makes provision for a person "suspected" of abuse or suffering from any abuse related injury" to be removed to a hospital or any other place as determined by the Director-General of the Department of Social Development.


10. Clause 17 makes provision for the Minister to keep a register of persons convicted of the abuse of an older person, thereby prohibiting such person from owning, managing or operating a facility (of care for an older person).


11. The SACC applauds the steps that recognise the criminalisation of older person abuse but questions whether the "naming and shaming" of abusers will produce significant prevention and/or awareness of older person abuse. Other practical problems that arise are whether the removal of the victim from the place where s/he is abused will bring satisfactory justice for the victim or whether trauma may not be further exacerbated. Frequently, the older person as victim may be further traumatised if s/he becomes the centre of attention within that family or community from whom s/he is removed. The SACC enquires whether, in such an instance of older person abuse, it may not be more appropriate for the alleged abuser/offender to be removed from the place of care and dealt with in terms of criminal law. A further point of concern is the message sent out by trying to deal with abuse primarily through the criminal justice system. The primary understanding of the criminal justice system is that a breach of law is to be dealt with by punitive measures against the offender. An act of abuse against the victim, once criminalized, becomes fundamentally an act against the state. The victim of abuse may in a court of law feel as though s/he is a victim all over again. The criminal justice system seldom delivers satisfactory justice or resolution to the conflict since the victim is unable to ask of the offender why a particular form of abuse has been inflicted on him/her. Apart from the cost and time involved in resolving such conflict through the criminal justice system, the victim seldom experiences a sense of restoration at the end of the criminal justice process. As a dispenser of wisdom and one with immeasurable experience, the role of the older person in such conflict situations raises options for alternate dispute resolution mechanisms as well as for exploring the healing and restorative qualities of justice that are integral to various cultural and community based systems of justice such as the inkundla and/or lekgothloa. Essentially, however, we are saying that as a source of wisdom on conflict resolution, the older person possesses a wealth of experience on how to deal with matters relating to his/her abuse. Such involvement will be well placed to deliver justice that is satisfactory, healing and capable of repairing the breach between human and social relationships that such abuse may have caused.

Conclusion

12. The Bill is a welcome move away from addressing the needs of the older person purely from an institutional point of view. While it acknowledges the need to address issues of care and protection, it fails to deal with the need for a change of attitude toward ageing. Current attitudes may be described as those that embrace a globalised view that beauty, youth, strength and accomplishment are the esteemed values of society. They also devalue the dignity of the older person by portraying the Mandelas and Tutus of South Africa as exceptional rather than iconic of the creative abilities for which all older persons need to be revered. It is important for us to recall (as in the work on the Children's Bill) that a society is often judged on the way it treats its children in conflict with the law. The Jewish theologian, Abraham J. Heschel maintains, however, "The test of a people is how to behave toward the old"⁹ since "Even tyrants and dictators make a point of being fond of children. But the affection and care of the old, the incurable, the helpless are the true goldmines of a people."¹⁰ The recommendations of the SA Council of Churches are therefore based on the dignity and respect deserved by the older person in South Africa as well as on the trust that more needs to be done to keep programmes of development, on the one hand, and a process of attitude change toward the older person, on the other, as an integrated whole. In this way we believe the nation will learn to appreciate the life of the older person as a gift and thereby uncover the "true goldmines" of South Africa.

1. Republic of South Africa, Older Persons Bill [B68-2003], "Repeal of Laws, and transitional provisions and saving", 23.(1) (a) and (b), p.12

2. Report on the Second World Assembly on Ageing available at www.un.org/esa/socdev/ageing/waa/index.html

3. Republic of South Africa, Department of Social Development, Report on the costing of the Older Persons Bill

4. Older Persons Bill [B68-2003], "Memorandum on the objects of the Older Persons Bill, 2003", p.13.

5. South African Catholic Bishops' Conference, Draft Submission on the Older Persons' Bill [B68B-2003], "Concerns about the Bill", p2.

6. Report on the costing of the Older Persons Bill. See Table 2: Current Expenditure and Coverage per Province for Old Age Homes, Service Centres and NGOs; Table 3: Distribution of Total Older Persons (60+) by Province and; Table 4: Distribution of Total Vulnerable Older Persons (60+) by Province.

7. Ibid.

8. Older Persons Bill, p.9.

9. Abraham J. Heschel, "The Older Person and the family in the Perspective of Jewish Tradition," in Carol and Perry LeFevre, eds. Aging and the Human Spirit [Chicago: Exploration Press, 1981] , pp.35.

10. Ibid., p.37