Denis Naughten (Roscommon-South Leitrim, Fine Gael)

Yes, there are serious ethical issues in that regard over and above the monitoring required of the standard level of care. Every Member regularly receives complaints about the operation of the health service, particularly in respect of acute hospitals and nursing homes. In most cases, nothing is done to address these complaints. I hope the establishment of the HIQA will bring a change in this regard. It is of fundamental importance that such protection is in place for the people who use these facilities.

I urge the Minister not to ignore the tremendous work being done by the Mayo-Roscommon Hospice Foundation, an organisation that put its neck on the line in getting the projects in Mayo and Roscommon off the ground. It experienced great difficulty in securing HSE support before the latter eventually provided sites for the two projects. I am concerned that a situation will arise where this particular incentive is focused on large population centres to the detriment of smaller community facilities.

The objective of palliative and hospice care is to keep the services as close as possible to patients and their families. The Government and the Health Service Executive are taking an alternative view of regional acute hospitals, with smaller hospitals and accident and emergency units being closed and centres of excellence established. It would be wrong if the hospice movement and palliative services were forced down the same road. The Minister is facilitating that development. I do not believe that is the Minister's intention and I urge him to re-examine this amendment and re-draft it to facilitate smaller projects like those in Roscommon and Mayo.

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