John McGahon (Fine Gael) | Oireachtas source

I thank the Minister of State for coming to the House to discuss the very important issue of palliative care services in the north east of Ireland, which is where I come from. I am raising this issue today because of a real discrepancy in the services that are being provided in the CHO region - not compared to the rest of Ireland but in the region itself. It concerns the difference between the services provided in Louth and Meath and those provided in Laois and Offaly, which are in CHO 8.

Many specialist palliative care, SPC, teams are similar in structure. They have a team of clinical nurse specialists and three consultants in palliative care medicine. In the summer of 2022, one consultant said on local north-east radio that there would be a waiting list for palliative care services in the north east as a result of increased challenges after the pandemic - a waiting list for terminally ill patients. Patients requiring palliative care have already gone through so many treatments and hospital appointments. They have done literally everything to have an extra day on this earth. Regarding the cancer strategy that was announced in 2017, we guarantee as a right that people will have the ability to die in their own home, own bedroom and own bed. There are people in my county of Louth and my neighbouring county of Meath who are not being given that choice and as a result, are dying in hospital and acute settings, rather than where they want to be.

The reason for that is quite simple. Again, I will focus on CHO 8 in my neighbouring area. In Cavan and Monaghan, with the exception of Louth and Meath, public health nurse services are operational in the management of symptom and pain management and have the skills to administer the syringe treatments and ensure that all patients are being seen in their place of residence as opposed to a hospital. To be clear, in the CHO 8 area, in Laois and Offaly, nurses are able to go into homes and administer pain relief medicine. However, this is not the case in Louth and Meath. Nurses there are not allowed to do that. Instead they are getting the nurses above them - the specialist clinics - to do that but there is a shortage of those specialist clinics. This is not a case of a supply issue or a staff shortage. To be honest, the end-of-life treatment you get is almost a lottery based on your geographical location. If you are in Louth and Meath, we will not send in public health nurses to give pain relief medicine such as injections, syringe-based treatments and palliative care. We are, however, doing it in Laois, Offaly, Cavan and Monaghan, as well as other parts of the country. There is a discrepancy and I do not understand why this is happening. I have example after example of people in my county of Louth dying in hospitals because they were unable to die at home, which was their last wish, because staffing arrangements in the HSE are different in Louth and Meath compared with Laois, Offaly, Cavan or Monaghan. It is upsetting to say the least that this is happening. For as long as I am a Member of this House, I will continue to fight for people in my county of Louth and my town of Dundalk have the same right of access to palliative care as that of people in other parts of the country. It is down to a staffing decision in the HSE. Why on earth is a nurse able to give palliative care treatment in Laois or Offaly but nurses are not allowed to do so in Louth or Meath? It does not make sense.

I appreciate the Minister of State coming in here and that I am throwing a lot at her that she might not have known about before coming in here. Perhaps after this debate, either through the offices of the Minister of State or the Department of Health, we could set up a meeting between myself and CHO 8 in the Louth-Meath area to see how we could fix this.