Geraldine Feeney (Fianna Fail)

I move amendment No. 1:

To delete all words after 'Seanad Éireann' and submit an amending motion in the following terms:

"Commends the Minister for Health and Children on the dedicated funding made available in recent years by the Government for palliative care services, now in the region of €79 million per annum, welcomes the fact that Ireland was ranked second in Europe in a study of palliative care in the European Union for the European Parliament Committee on the Environment, Public Health and Food Safety and was recently ranked fourth overall in Europe in a recent Quality of Death report published by the Economist Intelligence Unit;

- welcomes the launch on 23 September last by the Health Information and Quality Authority of draft national standards for safer better health care;

- notes the first national audit of end-of-life care in hospitals commissioned by the Hospice Friendly Hospitals programme;

- notes the report of the Forum on End of Life and the new quality standards for end of life care, initiated by the Irish Hospice Foundation.

Considering the need to take account of issues such as quality of care, standardised guidelines, clinical governance, training requirements, support services and infrastructural environments for people facing end of life and bearing in mind overall health service priorities and resource availability in the future for health and personal social services,

- recognises the role of home care packages towards supporting end of life care in the community;

- acknowledges the evidence based priorities set out in the medium term strategy for palliative care published by the HSE in July 2009, agreed by all relevant stakeholders;

- acknowledges Palliative Care for Children with Life-limiting Conditions – A National Policy adopted by Government on 15 December 2009 and published in March 2010. Ultimately, this policy aims to ensure that all children with life-limiting conditions will have the choice and opportunity to be cared for at home;

- notes the work of the joint performance information group, JPIG, of the Department of Health and Children and the Health Service Executive towards improving data on palliative care services;

- acknowledges Department of Health and Children national lottery funding recently awarded to the Irish Hospice Foundation to support a pilot project to enhance the hospital environment for people facing end of life;

commends the importance given to end of life care in both the national quality standards for residential care settings for older people in Ireland approved by the Minister in February 2009 and the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2009, which underpin the standards."

I welcome the Minister of State, Deputy Brady, and I am delighted to have an opportunity to contribute to the debate. I commend Senator Mullen for moving the motion. He is calling for more training for hospital staff in end-of-life care skills, including bereavement support and the need to improve the physical environment of hospitals for people facing end of life.

From my perspective I believe the Government is very committed to ensure that people live long, and we all know that. I commend the Minister of State and her Department for the enormous changes and improvements we have all seen in hospitals in that regard. It is a shame we did not have a copy of Senator Mullen's speech, as I should have liked to underline the various points as he went along. He talked about multi-bedded wards, people dying and no dignity associated with that. That is a horrible picture. I have never experienced anything like that. Both my parents died in hospital, although neither of them was sick. My mother died of an aneurysm to the brain. She was rushed into hospital and thankfully died very quickly, as she would not have had any quality of life had she survived. Like Senator Quinn said, I can only speak from my experience. Our experience was a terrible shock of losing a mother, and yet it was very dignified because she died in intensive care in a very private setting. It was almost as if people were walking on eggshells, tiptoeing around us because it was a very distraught time for everyone. Indeed my father died, I would say, of a broken heart, two years later. He had no desire to continue living his life when my mother died. They had been married for well over 50 years. I would say he probably should not have died in a hospital, however.

Even though a patient might have the best resources at home, I believe that sometimes GPs like to put an elderly patient into hospital because they believe this might be better for the family, and for the patient too with professionals on tap to deal with him or her.

My father was in hospital for only one day, and we knew when he was going in that he was going to die. He was in a semi-private ward and there was another gentleman with him. It was a lovely experience for us and I commend the nursing staff. There is an issue I must mention although, again, I do not want to personalise things too much. My father had respiratory failure and we wanted him to have a nice peaceful death but the young doctor on duty that night could not prescribe anything for him because the drug would have instigated his death much more quickly. We certainly would have liked that. My father was an old man and it would have been so much nicer for him to go. It was a public hospital. The other experience I had was with my only aunt on my mother's side who had a beautiful, peaceful death in a lovely private room in a publicly run nursing home in Tullamore. Perhaps I am one of the lucky ones in that everything has been very nice for me when I have lost people, but that is not to take from what Senators Quinn and Mullen are saying.

We as a people have a great nature when it comes to birth and death. We are all emotional when there is a birth and we rejoice and celebrate. I am very emotional at weddings. There are always tears in my eyes and a lump in my throat, although I might not know the couple getting married. That is the nature of the Irish people, as was pointed out by Senator Quinn.

When it comes to death, perhaps the demographics have changed. Heretofore we, and I speak for most people in the Chamber, including those in the Visitors Gallery, always knew that if one was not seriously sick, one was not in hospital. One was looked after at home. People who had colds did not go to doctors but were nursed at home. I remember, as a child growing up, that there was always a saucepan for hot lemon drinks in the house. Any amount of lemons - they must have been very cheap - were piled into boiling water, and it was the cure for everything. I was one of a big family of 11. We were only brought to the doctor when there was a concern that an illness was serious.

Our grandparents did not go into hospital but were nursed at home and were in good form and good health right into old age. Even when they had dementia they were still kept at home. Unfortunately, life has changed and society as we knew it back then will never be with us again. The whole make-up of families has changed. We are no longer able, whether it is because of work or for financial reasons, to keep parents at home and they end up in a nursing home or in hospital whether they want to or not.

It is embedded in the DNA of all Irish people to want the nicest possible surroundings for their loved ones and for themselves when their day comes. I keep saying that I will be clear about how and where I would like to die and the people I want around me. Life moves quickly and one keeps putting it off while meaning to say it to someone. Then, all of a sudden, there is no opportunity. Even though our hospitals are very busy, they are centres for curing people rather than for end-of-life care. That is what we have always known them for. As I said, one went into hospital if one was seriously ill and stayed at home if one was not. Nowadays, the statistics show that large numbers of people die in hospitals. Hospital management, together with the professional health care teams, do try to make things as comfortable as they possibly can for people who have to die in hospital, but it would be much nicer if we could keep everyone at home. I know I would like to die in my own home, and if I do not, I certainly want to be waked in my own home. I am an old fashioned woman when it comes to these traditions.

I commend the Irish Hospice Foundation, the North West Hospice, which is my own local hospice in Sligo, the Carers Association and the health care professionals in our hospitals who do a tremendous amount of work under difficult circumstances. In particular, I thank the hospice movement for the wonderful facilities it provides for people, especially those who are terminally ill, and for the wonderful solace and peace they give to patients and their families who are ready to say goodbye to them. I would like to have had longer to explore this subject. Perhaps we could continue the debate another time. I commend Senator Mullen on bringing this to the Chamber.