Mr. Bernard Gloster:

Starting from the respect for the assumption of capacity, and moving on from the traditional facilities of wardship, which served a lot of people well in its time to be fair, I have said several times when I dealt with serious challenges in the public service that I have been responsible for is that part of our history as public servants and as public service bodies in Ireland has been our tendency, albeit well-intended, to be over-paternalistic. We are and we need to put our hands up and recognise that. It does not mean we are bad people but that is where we have come from. We have come from traditional models of rescue and recovery, protect at all costs, and ironically people do not always get protected in that setting.

Changing that culture will be a big shift but there are enough really strong, modern-day progressive healthcare professionals now across the system who will bring that tide of change and who will welcome that assumption of capacity, but more importantly the cultural piece of allowing people to have self-determination in every aspect of their lives, healthcare and care. I do not think it will be as slow a burner as people think it will be in terms of the culture. People will struggle with the concept initially because there are people who just do not have capacity and experience very difficult and vulnerable circumstances in their lives. We have to be very careful that, for the majority, what is intended means we have to step back from that very paternalistic approach.