Jillian van Turnhout (Independent) | Oireachtas source

The good thing about speaking at this point in the debate is that many Members have raised the issues I wished to raise. I will, therefore, try to keep my contribution succinct.

The Minister of State is very welcome. I commend her and her officials for all the work they have done on the Bill which is so important to so many people for whom we care in our lives and which has the potential to affect all of our lives.

Capacity is an ever-evolving issue and we get the sense that that is the case. I hope what is contained in the Bill will become the norm and that we all understand the importance of supporting decision-making. It seems as if advance health care directives are only discussed in hospitals, but that is not the case. In Belgium, for example, they are discussed when someone is buying a house. People make a will and an advance care directive in order that they just do not think of it when they are going through the hospital doors. These are really important decisions to be discussed as a family and with friends in order that people will understand how someone feels and what he or she is actually thinking.

Earlier in the debate Members were talking about the archaic language that we are now changing. We are moving into a field where there is legal and medical language used, yet we are human and individual and do not necessarily know the vocabulary. I am hoping the Bill will help us to provide that framework and vocabulary.

Not to take in any way from my support of the Bill, but there are some issues I want to look at on Committee Stage. One is the enduring power of attorney. While I know that Bills tend not to be retrospective, the difficulty is that if there are abuses of the enduring power of attorney, they will not come within the remit of the Bill which is setting standards. I do not understand why they do not come within its remit and why we do not ensure that wherever there is an enduring power of attorney, it will come within it.

I concur with my colleagues on the use of chemical restraints. I certainly support the letter to that effect sent on 3 November to the Minister of State by Mr. Mervyn Taylor of the support and advocacy service for older people, Sage.

Another excellent point was raised by Senator Marie-Louise O'Donnell which we debated in the House in recent weeks on foot of a motion proposed by her. It concerned residing in one's place of choice. The difficulty is that too often the nursing home is seen as the only option, the only pathway one may take. We need to ensure we have a system similar to the one in place in England, for example, where there is equal support, whether a person chooses to move into a nursing home or to reside at home. The choices can differ for different people and for different reasons, but there has to be a choice. In Ireland we do not have that scope.

I also concur with my colleagues on the ward of court issue. I certainly concur with Inclusion Ireland which proposes that the Comptroller and Auditor General audit ward of court funds prior to the discharge of wards. My colleagues have outlined the rationale behind this suggestion.

We need to explore more the issue of advance health care directives and why certain groupings such as persons with mental health issues are not included within them. My understanding is that the issue comes within the remit of another Bill, but it is difficult to understand. It would, therefore, be good for us to delve into the issue a little more on Committee Stage.

We use the word "consent" and consider its meaning. Senator Katherine Zappone talked about the importance of allowing people to take risks. How often, when we agree to something, do we actually know what we are jumping into and what we are doing?My father had a stroke three years ago which left him severely paralysed and I have watched him decline. It has helped me to understand what consent actually means because it has evolved and changed. It depends on the circle around him. Family is important but so is the care team around him - the nurses, doctors, catering staff and cleaners. He is in an excellent nursing home in Clonskeagh run by the HSE but the idea of consent, choice and control of one's decisions is vital. This is why I am so supportive of this Bill. It is about dignity, as Senator O'Donnell said. We must ensure it comes into law so that all of us, including my dad, have control of our lives and consent.