Ms Frances Spillane:

In response to Senator Colm Burke's questions, HIQA is the independent regulator so it operates very independently. It has regulations and standards which its applies, and it applies those standards in an objective manner. That is the advantage of having an independent regulator in the social care area. That can have knock-on effects in terms of services and we have seen that in both the nursing home and disability centre areas over the past number of years. It involves huge change for service providers and for people working in the services as well in terms of getting used to the independent inspection and regulation.

Huge advances have been made in that area in terms of satisfying the public as to the high standards available in centres. People can look up the Internet very easily to see what kind of report a nursing home has received, and people do that all the time in terms of trying to make decisions.

The second issue mentioned was about enduring power of attorney and the lack of forward planning. Again, that is something that is dealt with in the Assisted Decision-Making (Capacity) Act, so it is more a matter for the Department of Justice and Equality. However, just for the information of the committee, the Act provides for new arrangements. As I understand it, enduring power of attorney is covered under a 1996 Act at the moment, so all the enduring powers of attorney under that Act will continue. However, the Assisted Decision-Making (Capacity) Act provides for new arrangements. The idea is that people should plan ahead, especially as people are living much longer. They should make their arrangements for enduring power of attorney which then kicks in at a stage when they lack capacity and when the big decisions are needed. That is where I hope and I would expect that the decision support service would be very active in trying to publicise all that. Equally, the national safeguarding committee has been good in terms of raising awareness of these issues but I would agree that planning for the future is an area in which Irish people are not particularly proactive. Interestingly, in the Assisted Decision-Making (Capacity) Act, there is a provision for advanced health care directives, which is the same sort of thinking in terms of future important health care decisions. Again, we are going to need much education of the public and awareness-raising about that important area.