Colm Burke (Fine Gael) | Oireachtas source

I formally withdraw the amendment. I welcome the Minister of State to the House. I also welcome this debate and thank the Senators for bringing it forward.

As set out in the motion, on average 29,000 people die every year and for every person who dies ten people, directly or indirectly, are affected which amounts to 290,000 people. The motion covers a number of different issues. It is important that we look at how and where people die which has been referred to by a number of speakers. A survey was conducted a number of years on Irish people and 67% indicated that if they were dying they would prefer to be cared for at home. However, only 25% of people die in their own home, 70% die in care institutions, and 43% of deaths occur in acute hospitals. It is in that context that we need to decide whether it is necessary, for instance, to transfer people from nursing homes to hospitals for the last few days of their lives. We need to examine the issue immediately. Between the fair deal scheme being operated in private nursing homes, community hospitals and care facilities for the elderly, over 27,000 people are cared for. Surely we could start with them and adopt a more progressive approach instead of unnecessarily transferring people to hospitals at this time. We need to look at the matter.

We must also examine palliative care. We focus very much on palliative care for people with cancer. Interestingly, the figures show that 29% of people with cancer in this country take up most of the palliative care support. In fact, 33% of deaths are due to disorders of the circulatory system but we do not take that fact into account when it comes to providing palliative care. It is right that support is given to people with cancer but palliative care should also be provided to people with other health problems.

Let me turn to the Department's document entitled Future Health: A Strategic Framework for Reform of the Health Service 2012-2015 which shows that the HSE is working on a prospective funding model for palliative care. The review will be chaired by Professor Charles Normand who is the professor of health policy and management at Trinity College. The review will include the following: an analysis of international approaches to palliative care funding; a description of the best palliative care model provision; a description of current data collection systems for palliative care activity; a description of the current funding for palliative care and will refer, as I mentioned earlier, to palliative care not being confined to people with cancer; and a definition of the current spend on palliative care.

Let me outline one of the palliative care issues. This year a budgeted spend of €73 million, in the national service plan, has been provided for palliative care but that sum does not include spending on palliative care in acute hospitals. Quite a big budget already exists but is it being used effectively? How can we develop the programme to accommodate all of the needs of the people who are ill?

The motion deals with a number of different areas. It is about adopting a joined-up thinking approach to providing support and care to people who are facing death. All of their medical care is being provided but we must assist their immediate family. As a practising solicitor I have discovered that people do not take into account the best way to deal with their affairs. This motion deals with the legal and taxation aspects of death. Solicitors are asked to visit hospitals at a very late stage in order to look after people's affairs. People simply do not give serious thought to drafting a will. As a result, solicitors are finding more and more that issues arise after the person has died which cause even further conflict. Over the past decade I have dealt with a number of cases where a family who worked very well together before a death changed once the death occurred. Major problems arose that led to major divisions and people ended up not talking to one another at all. In any review on such a matter we need to educate the public generally on the need to plan ahead, especially for taxation purposes.

I welcome this debate. It is a start but we need to continue the debate. All of the professions involved need to adopt a joined-up approach and I refer to the medical, legal and care sectors. However, the debate is very welcome.