Reverend Dr. Rory Corbett:

I will come in, in as much as I was not in palliative medicine. The impression I got whenever I discussed things with colleagues in general terms is that the position north and south of the Border seems to be very similar. Domiciliary end-of-life care is the problem because there is a whole network, which I alluded to, of communication between all the different people providing the care. For example, there are issues around lack of a communication, who is holding the final responsibility, who is holding the prescription pad and who is there at 3 a.m. when the palliative care nurse is in the house and needs advice about a change of drug. It seems that despite all the modern communication systems, it is all written on paper but nobody is passing it. For example, it goes in the post but does not get to the GP or the patient may have it and forget to give it to the nurse and so forth.

Regarding hospital care, things should be better but still they are very short of good palliative care consultants and staff to look after the patients. Medical staff are often slow to call them in to help as well. We have a long way to go in palliative care. I think it is behind so much of the demands for alternative let-outs.