Mr. Peter Tyndall:

Members have had an opportunity to see what I was going to say and I am conscious that they have had a busier day than they expected. I will make some brief introductory remarks after which we can get into discussion.

The Office of the Ombudsman has two jobs. One is to investigate complaints and to try to find redress for individuals. The other is to try to promote improvement in public services. This report fits very much into the latter. It was not a report designed to hold individual hospitals to account. It is a report produced in conjunction with the Irish Hospice Foundation to try to highlight ways in which services for people at the end of their lives could be improved in our public hospitals and elsewhere in the health service.

The report tries to do that by deriving its power from the stories of the people who came to us either with their complaints or their loved ones who came to us to complain on their behalf. It is intended, if one likes, to try to promote better services in the future for people who are reaching the end of their lives and put forward some simple propositions as to how services could be improved. Although there are many themes, the single biggest theme that comes across is the importance of good communication so that patients and their family members understand what is going on. They need to understand the role of the clinicians and what is likely to happen. They need to get the support they need at what is a very difficult stage.

Fundamentally the report tries to illustrate the circumstances around a death being managed well - where people understand what is happening, where they have access to privacy which they need and where they have access to the support they need. One cannot get over the grief that is associated with a death, but we can ensure that people do not go on being troubled and upset by the nature of what happened around the process of dying. We cannot take away the grief, but we can make things as good as possible to ensure the person is comfortable, that they are without pain, that their loved ones are with them, that they have access to whatever support they might need by way of religious rights and that the whole process is handled with dignity.

That is all I want to say by way of introduction. The report and my comments stand for themselves.