Mr. Mervyn Taylor:

I wish to respond to the remarks of two Deputies who are no longer here but who deserve an answer. Deputy Ó Caoláin raised the issue of approaching development and co-ordination. My answer is that we need a step approach. I do not advocate that a particular organisation with a particular budget be given responsibility for all advocacy. We are at a stage at which we need a step approach. An inter-sector committee is being developed by the HSE to safeguard vulnerable adults. This is bringing together issues to do with people with intellectual disability and the work of elder abuse officers. There is a great opportunity here and I imagine independent advocacy and support groups will have some impact on the group.

There is an opportunity to get people around the table and working to develop a common agenda.

We also have the decision support service which is not yet in law. We do not know how that will be formed but we have said it should be an independent agency in its own right rather than being under the Courts Service. As part of its remit, it will have the authority to develop codes of practice or to ask others to develop codes of practice. That is another piece of the jigsaw which could examine common standards on issues of advocacy. We ourselves have made a contribution in this regard recently.

The national patient advocacy service is being proposed but we are very close to a general election and do not know whether that will materialise. I remember that this was announced last year in a different context. As regards grappling with patient safety and advocacy, those issues do not necessarily always sail in the same boat. It was an opportunity but we need to hear what is intended.

The other aspect of not rushing it but getting there nevertheless is that there is a need to prepare service providers. That is because there are some service providers for whom the phrase "human rights" is something to do with Ban Ki-moon and the UN but very little to do with them and their day-to-day work. They just cannot make the link between human rights and the fact that somebody cannot leave their nursing home, so there is a need to prepare the ground. There is also a need to prepare the public ground. Advocacy is not about people simply appointing themselves as advocates, appearing on the Joe Duffy radio show and giving out about something. Legislation is required, as are practitioner skills.

Some of the issues that have been referred to are quite complex. I will touch briefly on Deputy Kelleher's point about public service monopolies and the difficulty of having only one provider. One of the things we have put in our detailed submission - I am particularly conscious of Portlaoise and other places - is the need for some form of public interest representative role sitting in on relevant sections of senior management meetings. We no longer have this multidisciplinary approach but we have a multi-perspective one. Somebody is required who can ask hard questions in the public interest, who has access to complaints information on issues from advocates, and who can bring that to the table. We do need to develop a culture of reflection and challenge within that type of monopoly provider.

Senator van Turnhout raised the issue of legislation on access to clients and such legislation will be important. One of the greatest difficulties we have concerns wards of court as well as the difficulty in accessing clients. We can only wish the Assisted Decision-Making (Capacity) Bill well, its speedy emergence and the departure of the whole wards of court system, which has been a terrible blight on our existence.

To come back to the issue of seeking statutory powers, we support that. It should be simple but statutory powers will only bring us so far. The practitioner skills of advocates will also be very important. I am referring to good street-fighting skills as opposed to theoretical and abstract knowledge.

My last point concerns Senator Colm Burke who referred to the enduring power of attorney. SAGE has made a submission to the Department of Justice and Equality to develop this area. I refer to the second-last bullet point in my opening statement, which is the development of a major public campaign to promote the advantages of advanced planning and to give it some financial incentive. If we can incentivise people to plan in advance, we could reduce costs in the system later on. This is because the amount of time that health care practitioners and social care providers often spend in dealing with divided families and complex issues is an enormous cost to the State. If we could encourage early engagement in advanced planning of all forms, including advanced health care directives and the enduring power of attorney, we would be doing the State a great service.