Niall Ó Brolcháin (Green Party)

The business of the House, at a very difficult time for the country, is being disrupted and this is an example of it.

I welcome the Minister of State for this important debate. This is a very good debate and I commend the Independent Senators for tabling this subject for debate in Private Members' time. Their points are very well made. The Government amendment shows that many of the points are being examined and I hope the debate will move things forward.

There are very few people who have not had experience of the need for palliative care or hospice care when people are dying. There are very few people who do not have experience of the significant and valuable work being carried on in the community, in particular fund-raising and helping out when older people are dying and looking after people who may not have family to help them through this difficult end period of their lifetime. Another speaker noted that Ireland is rated as the fourth best place in Europe in which to die, which may not be a statistic one should be counting. It is crucial we take seriously the difficult times people face at the end of their lives. The thrust of this debate concerns community care. The excellent hospice in Galway provides an excellent outreach service. Many other hospices do so as well. If possible, everyone wants to die in their own bed. That is the optimum for anyone but is not always the best when people suffer from appallingly bad health and difficult times. Sometimes families cannot cope and one's own bed may not be the best place to die. In those cases we need inpatient hospices.

We need to up our game in respect of primary care teams and we are doing so at the moment. Sixteen of the 26 teams in the Galway-Roscommon area are now in place. This matter passes below the radar in terms of the health care debate. Implementation of community health care is being improved slowly and steadily. We can see the implementation of primary health care teams. This is something people are not talking about. It is going quite well. We need to aim to have the best community health care service in the world.

I had the honour of signing Galway city into the World Health Organisation healthy cities network. On that occasion, I went to visit the Finnish health minister in Turku, Finland, which has the best health service in the world. I am not clear how good it is in respect of palliative care but community care is the linchpin of the Finnish model. I have always believed community care is what we should aim for and that anything that can be done in the home, with support services, should be done there. For many years I have campaigned on home births. The community care aspect of care from the cradle to the grave should be the linchpin of our new health care model in Ireland. People do not want to travel great distances for any aspect of health care. They want to be in or near their homes when they die and in or near their homes when they are born and for all events in between. We should be bolstering our primary health care teams to ensure all aspects of living, dying and community health care are underpinned by the primary care teams we are putting in place. At present, primary care teams are not entirely multidisciplinary but they provide a structure that will allow that to be the case.

I commend the motion before the House and I take the point that we must do everything we can to ensure the maximum number of services are focused on allowing people to be in their homes when they die. Relation supports, respite care and other services should be put in place. This model is better value and more human. At the end of the day we want to see a more human health care service in this country.