Opening address by Minister Hoctor for the Consultation Session in Dublin Castle

23 October 2008

Good morning everybody. I would like to welcome you all here to Dublin Castle.

Today we are putting the spotlight on one particular and important aspect of our society and that is the lives, choices, problems and possibilities faced by some of our older citizens, and how we can ensure their best health care with each and everyone of us working together within this new framework of high standards.

We are all aware that the first choice for older people is to remain living at home for as long as possible with the support of their families and community support services, where necessary. This is the essence of Government policy.

When this is no longer possible, it is important that older people have access to the best possible residential care available. Government policy is also to develop and improve health services in all regions of the country and to ensure quality and patient safety.

One of the great achievements of our times is that most of us are living longer and staying more active than ever before. The Department’s publication Health in Ireland: Key Trends 2007 is a handy reference guide to trends in health and health care over the past decade. One key trend highlights that the population of Ireland has been growing more rapidly than any time since the foundation of the State. In addition to this growth in recent years the numbers of people over the age of 65 are projected to increase to over 800,000 between now and 2025.

These projections have clear implications for the health system and for health service planning. We must ensure that our older people receive appropriate levels of care in surroundings which are of a high standard. The vast majority of residents will not care whether their care is provided in the public, private or voluntary sector as long as they receive the best quality care. To ensure quality we must have evidence-based standards.

Standards must acknowledge the unique and complex needs of the individual person at the centre of care. They must recognise the additional specific knowledge, skills and facilities needed in order for service providers to deliver a person-centred and comprehensive service that promotes health, well-being and quality of life. They must set service providers the goal of providing a setting in which older people can experience a good quality of life.

There are challenging times ahead as we strive to improve services for older people in all settings. We need to work together to provide housing which is underpinned by a desire to treat older people with respect and dignity, in an environment where they have control and a range of flexible services that enhance their lifestyle, not dictate it.


A fundamental principle of the Health Service Reform Programme is to put the users of health and personal social services at the centre of the services.

We need to ensure the protection of residents, to safeguard and promote their health, welfare and quality of life and to ensure that there is a focus on the well-being, dignity and autonomy of older people.

You will all be aware that under the Health Act 2007, the existing inspection and registration systems for residential services will be replaced by a strengthened and expanded system and the Act strengthens and modernises the registration and de-registration process. Statutory responsibility will be given to the Chief Inspector of Social Services for inspecting and registering children’s residential centres, residential centres for people with disabilities and residential centres for older people, including private nursing homes. He, or she, will inspect centres against the regulations governing these centres and standards set by HIQA.


We all agree that quality and patient care is of critical concern. We strive to provide for the highest possible standards of care for older people in long-stay facilities. Knowing and believing in the benefits of standards is a long way from implementing and sustaining them. However I am well familiar with the effort that has been put in to producing these standards by such a wide ranging Working Group established by HIQA last year and the significant contribution made in developing these Standards. Earlier this year the HIQA Board submitted their final draft National Quality Standards for Residential Care Settings for Older People to my colleague Minister Harney for her approval, as required under the 2007 Health Act. There are 32 standards under the following 7 groupings.

The draft standards provides for a “Resident’s Care Plan”. It recognises that these standards are linked to Regulations and that while we will bring in Regulations to underpin the standards not all standards will be regulated for.

As Minister for Older People I have had the opportunity to visit many facilities across the country. The standard of care being provided at present is, by and large, of a high quality. However there is a consensus which I think we can all agree with -we must work together and continue to ensure consistently high standards of care across the public, private and voluntary sector.

This is the core of what these standards are about. It recognises that the standards are designed to encourage continuous improvement.

The significance of the standards lies in the framework it creates for nursing home care across the country and for the provision of sufficient care to maintain the well-being of the persons cared for in the residential care setting with regard to the nature and extent of their dependency.


Today provides a timely opportunity for key stakeholders to come together to discuss the significant changes that are progressing in residential care.

I firmly believe that improvements in services will only be achieved through partnership between Government, service providers, both public, private and voluntary organisations and older people themselves. We will continue to work with private nursing home operators and other key stakeholders including the Health Service Executive and the Health Information and Quality Authority to further develop long-term residential care.

Our main purpose here today is to listen to you, representatives of the many groups and organisations involved and interested in standards for residential care for older people. We want to have a first class discussion and I am grateful to have Derek McDowell here to facilitate the morning. We also have a guest speaker here to discuss the impact regulations had when they were introduced in child care residential settings which I hope will set a practical tone for the morning. Following a short break we will open the discussion to the floor before Minister Harney’s closing remarks.

Thank you all for being here, for the different perspectives you bring with you and what you will share here today. I hope you will all enjoy the morning and as Minister for Older People I am delighted to open this session.