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Today we meet on the cusp of great changes in our world and in our plans for public services.

But what I want to argue this morning is that the cause which you were founded 13 years ago to promote will over the next five years assume an unprecedented profile.

So I hope to join you on your 18th birthday - and I hope that together we might be able to spend a little time reminiscing about what you and I were able to achieve together to make dignity for care and dignity for life, a reality for all.

Over the last five years we have made large strides in securing better health and care for our older citizens.

We know that GPs and consultants are actually now far less likely to arbitrarily deny a person over 70 treatment because of their age. For instance, heart surgery in the over-75s has risen from two per cent to 10 per cent.

And death rates for heart disease, stroke and cancer amongst older people are down.

We've cut by two thirds the number of delayed discharges - which has released 1.7m bed days per year and meant that people have had to spend less time in hospital.

We've also hit our target for the number of people being taken care of at home two years early.

Now this progress is excellent. It didn't happen by accident by the way - it happened because we invested the social dividends of stable economic growth. Put £30 billion extra into the NHS, hired 100,000 more medical staff and knocked 400,000 off the waiting lists.

But government is about the future and in the future this question of older people's health will grow and grow.

Because average life expectancy in the UK has doubled in the last two hundred years. By 2021, there will be more people over 80 than under the age of 5; over a quarter of the population will be over 60.

Already, in 12 local authorities, the number of over 55s make up 40% the population. The baby boom of the post war years is about to become the senior boom.

The danger is that whilst people are living longer their extended life is one of frailty and disability. The number of people over 65 with a long term condition will double by the end of the decade.

There is a risk that debilitating disease could erode our enjoyment of the life expectancy gains that advances in public health, medicine and living standards have brought us. As American Congressman Frank Clark once said 'we've put more effort into helping folks reach old age than into helping them enjoy it.'

We have to avoid this trap of 'apocalyptic demography'. For we have added years to life. Now we need to add life to years.

With the right policies in place, disability free, healthy, independent life expectancy can advance alongside total life expectancy.

This is because the incidence of the so-called geriatric giants, (cardiovascular disease, stroke, diabetes, COPD, musculoskeletal conditions, mental health conditions and sensory impairment) can all be reduced by tackling the key risk factors - tobacco use, lack of physical exercise and inadequate diet.

Active aging is, as Prof Walker puts it, 'primarily a preventative concept  [1]...in which the main focus should be on preventing ill-health, disability, dependence, and loss of skills.'

That's why Our health, our care, our say, the new White Paper, is so important.

Because it embraces the concept of personal control. Because it allows people to express their independence and make their own choices. Because it acknowledges the focus we need to give to preventing ill health.

Let me demonstrate.

Page 83.

Individual budgets to strengthen personal control of care.

We are going to develop individual budgets alongside direct payments and spearhead, with 13 pilot projects, what I hope will be a national implementation as early as 2010.

Individual budgets will bring together different funding streams. They will allow people to decide when, how and from whom they get their care.

Another example.

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Choice at the end of life.

People told us they didn't understand why, when over 50% of the 500,000 adults who die in England each year expressed a wish to end their days at home, only 20% managed it.

It is a fundamental human desire to choose where you are going to die.

We will give people that choice. There will be increased funding to support more people to die where they want.

We are going to have more community based palliative care. More co-operative working in networks, bringing together the NHS, Social Services and the Voluntary Sector. And more use of best practice approaches to caring for those at the end of their lives.

A final example.

Page 35.

Helping people tackle risk factors in their lives through the NHS 'Life Check.'

The 'Life check' will be piloted in 2007, helping people assess their risks of ill health and the lifestyle changes they need to make to live healthy lives.

Whether people smoke. How much they drink. What exercise they take. It will be a major step as we move to a health and care system focused on prevention.

And one of the age groups we will initially be targeting will be the 50 pluses. This will help people adopt healthy lifestyles before they reach old age, setting a pattern they will hopefully continue in retirement.

Now what you see woven across these innovations is a simple idea: the idea of empowerment - the same theme that you see in David Miliband's new agenda for local government, John Hutton's reform of Incapacity Benefit and Ruth Kelly's reforms for education.

But ultimately, as the PM said in Scotland, 'empowerment is not about institutions or constitutions. It is a frame of mind. It is to say that the purpose of collective action is always to set the individual free.'

That is why this idea of dignity is so vital - because people's possibilities in life rest in such large part on the conduct of others towards them. Will they offer a helping hand or a slap down? Will their words be warm or cold? Do they seek to support, or restrain, or ignore. Or abuse?

I've heard about this first hand. Just last week in Newcastle a lady told me how when she was in hospital her food was placed just out of reach and then taken away before she could eat anything.

Unthinking treatment that deprived this lady of the human right of sustenance.

And 'Human rights' said the American social commentator, Robert Maynard, 'rest on human dignity. The dignity of man is an ideal worth fighting for and worth dying for.'

He was absolutely right.

I look around this room today and I see people convinced that we must be battling for the dignity of the most vulnerable in our society. I too, am committed to this struggle.

That is why, in each week since the launch of the White Paper, I have announced fresh steps to strengthen our drive for dignity in care.

Last month I announced that the General Social Care Council will be starting a consultation on how we go about registering the thousands of social care staff.

Those who work in care homes. Those who work in domiciliary care. Registration to give these people the status they deserve as professionals.

And I announced that we would be doing further research on elder abuse in partnership with Comic Relief, which will build on the findings of the report Action on Elder Abuse has published today.

This will help us know how common elder abuse and mistreatment are and will help us develop new measures to stamp them out. Because they simply cannot, and will not, be tolerated.

At the beginning of this month, we went further by introducing the Safeguarding Vulnerable Groups Bill to Parliament, acting on the recommendations of the Bichard inquiry.

This Bill will ensure that those who work with vulnerable adults and children are vetted so that they are suitable.

It will build on the success of the Protection of Vulnerable Adults Scheme. As of the end of February, almost 4,000 people had been referred to this scheme and over 1,750 had been prevented from working in social care.

And we have also changed legislation to allow CSCI to focus, like a laser, on poorly performing care homes. Well-performing care homes will have more freedom to continue providing high quality care.

But there will be more rigorous scrutiny of the services that most need to improve. This is a necessity - as today's report reveals there are disproportionably high levels of abuse in care homes, given that only 5% of older people live in residential care.

Underpinning this new regime will be the greater use of unannounced spot checks. Inspection will see the reality of the care that is being provided.

Then just last week we have launched a nationwide TV Ad campaign to attract more people into social care. It had a very effective message 'Can you do the little things that matter?' The little things that make dignity a reality.

And I announced the role of the new Director General of Social Care in the Department of Health.

This individual will fulfil one of the biggest jobs in social care.

They will give a new and deserved prominence to social care within the Department.

They will provide national leadership for those who work in social care.

They will ensure social care is integral to the Department's system reform agenda. They will make the links across government.

They will strengthen social care's impact at a local level. Making sure we are using Local Area Agreements realistically and effectively.

And they will be championing our drive for dignity.

Six significant developments. But now I say we have to go further still. Over the next 12 months we have to reform care regulation - reshape it around a new credo of care.

National Minimum standards are under examination. We are merging the Healthcare Commission and the Commission for Social Care Inspection. We want new rules based on outcomes.

But just as the White Paper was co-produced through great collaboration, so too must this reform of regulation.

Empowerment doesn't just mean choice - it means voice. That is why I am travelling the country each week listening to the views of older people in Luton, London and Leeds, Newcastle, Stoke and Sheffield.

And I also pleased to announce that I am establishing a new group of dignity guardians. Experts in the field from Help the aged, Age Concern, the Alzheimers Society, the Relatives and Residents Association, Which? and, of course, Action on Elder Abuse to provide me with personal advice on shaping reform with one purpose - to deliver dignity in care and dignity for life.

Finally, I am pleased that the partnership between the Department of Health and Action on Elder Abuse has led to the publication of this important report.

I welcome the three recommendations it contains.

I agree that we must introduce a national data collection of reports of abuse. We will work with stakeholder to make this a reality.

I agree that we need a performance indicator across social care and health to improve outcomes for abused adults. Such an indicator will be part of our greater focus on outcomes for individuals.

The final recommendation - to introduce legislation for procedures for dealing with adult abuse equivalent to that already on the statute for children - I need to consider in more detail. I will ask my officials what would be required for such legislation to be introduced.

Conclusion

You who have come so far know better than most how far there is still to go.

There is much more work to be done. That will, I'm sure, be the theme of the rest of this conference.

For the dignity of vulnerable adults is not yet at the centre of public consciousness.

But together we can change that. By promoting the two sides of dignity. By empowering people to be active and independent. By ensuring that older people's dignity is protected.

At all times. In all places. For all people.

Thank you.