Judith Cross Age NI Capacity assessments- will they be done by social workers? Which sector will they be from- statutory or voluntary? What about capacity and statutory sector? Funding-will services be there when required? Position of carers- where do they fit into the process? Training-will adequate training be provided for staff who are affected by provisions of bill? Compliance-how to ensure provisions of Bill will be met? Age NI Perspective- Serious decisions are very relevant re nursing/ residential move Culture change required- Ageism Concerns ; 1. Composition of panel? Specific to topic of discussion? Open and transparent? Regional variations? 2. Ageing populations in prison- provision of treatment + moves to health care provision 3. In palliative care setting- query over next of kin and access to advocacy (when financial implications could be manipulated) 4. How to communicate this to the public Need a better advocacy service, earlier point Interpretation of capacity is varied Family members being consulted Capacity changes over time- issue specific How is capacity to make day to day decisions Who asks the person to decide the older person has capacity? Social worker? Nurse? Psychologist? Problematic issue: if an older person states ‘I don’t want to be here’ What does the best interest check list look like? What are the safeguards to support decision making? What about RQIA? Where is the improvement element? L.P.A- costs for some - complex documentation -denying access to save older people Cost-people living older (EPOA) discrimination- legal aid Lasting power of attorney Older people caring for people without capacity-implications Parents planning future of their children- there are risks with this Older people- ageing population- dementia and other issues Safeguards-presumption of capacity Opportunity to hold professionals to account Subordinate legislation and codes of practice need to be worked out Finances tp back up training, advocacy and legislation Presumption of capacity important Advocacy stressed as important at early stage of legislation Funding for advocacy Resource issue important Discrimination and stigma creates barriers to care Risk assessments and dignity and choices e.g. restraint Eamonn McNally- Children’s law centre Age appropriate and provision of same codes of practice Timescales-can it be done- committee stages Consultation over summer Transitions 16/17 Access to education clause-hurdles to advocacy Independence of the advocate Education of the public- bill in general and what it means Lack of info to service users and parents Weight attached to consultation responses Pat Conway- NIACRO 3 key points 1. Disproportionate representation in criminal justice system 2. 2. Pathways to resettlement (address main issues to reduce returners and victims) 3. Joint up provision- capacity can fluctuate- does the capacity bill have the capacity to bring about change Bamford recommendations-when? Benchmarking-concerns that no local Advocacy- what shape will that take? Is it crucial? Nominated person-measures in place are biased and affected on personal autonomy Serious concerns about lack of therapeutic services for those in crisis at serious risk DOJ resistance to new types of interventions Resources are a big concern. How can we ensure this is funded? Misunderstanding in practical terms Code of practice that is easy to follow and understand and that relates to all people involved 2 departments- already seems to be a disjoint-DOJ have only provided policy proposals so difficult to comment Divergence between statutory and voluntary sector Capacity of statutory sector to carry out assessment function Benchmarking- was comparison with Scotland sufficient? NIACRO-Mental health diagnosis high prevalence in prison Timeline concerns- Concern about limited choices leading to potentially unwise decisions. Services need investment Concern about limited choices leading to potentially unwise decisions. Services need investment Capacity to deliver quality advocacy in a timely, clear, fashion Would improve delivery of ideal operation of the bill Cultural shift required to address mental health inequalities in CJS Custody- limited choices available vs com Capacity inhibited by detention Focus on one aspect of person- what about dual diagnosis? Lack of awareness of dementia in prison Unfit to plead but retains capacity challenge Low educational attainment= need for advocacy- need to resource appropriately Risk as a dominant discourse- will over power capacity in practice 1. People in CJS-95% mental health issue/substance abuse 2. Re-settlements pathways. Programme in place- reduce offending- 6k in prison each year-30k people 3. Capacity fluctuations- tied to resources exist outside of bill 4. Closed mental health units- e.g. Windsor 5. Who is going to fund advocacy? 6. Point of transfer to hospital 7. Criminal record stigmatism 8. Codification could make system worse