Mary Henry (Independent)

I congratulate the Minister of State for the way he has brought this Bill through the House. I support the Minister's belief that people should be looked after in their own homes for as long as is possible as that is what the vast majority want. People in hospitals who are old and dying only wish to get out again and return to their own home. I have heard them say so many times and it is very important we help them in that way.

In recent years, Government policy has been to rely very much on private nursing homes. I have no philosophical argument with that but we must consider the level of trained staff in private nursing homes and their ability to support patients as death approaches. The situation is not like in public hospitals, where there were many trained nurses who knew that, for all of us, an end would come at some stage.

I have had the unfortunate experience of being in the accident and emergency department at St Vincent's Hospital, not that I was in a particularly bad way. I was very well treated but saw three elderly people who were close to death and had obviously been brought in by people who were panicking about what might be said to them had they died in a nursing home. However, they were going to die and an accident and emergency department is no place to die. Worse still is an acute bed in a hospital.

I am aware the Government intends bringing forward further legislation on nursing homes but we must ensure the patient's welfare, both in life and through death, is properly protected. Hospices provide a wonderful palliative service but they cannot be everywhere so we must enhance the training of staff in private nursing homes, who require more support than those in public nursing homes. Over 50% of the beds in the Dublin area are now in private nursing homes, which represents a huge change because it used to be between 20% and 30%. It also puts a huge burden on accident and emergency units and on acute beds. It is unnecessary from the point of view of the hospitals and very wrong from that of the patient.