BaileNuachtCartlann Aitheasc agus Preaseisiúintí

Speech by the Taoiseach, Mr. Enda Kenny, T.D., at the Forum on End-of-Life Conference Croke Park On Wednesday 12th October, 2011 at 1.00 p.m.


Wednesday 12th October, 2011

I have a huge affection for the Irish Hospice Foundation.....huge respect for their work. I share their vision that no one should have to face death or bereavement without the appropriate care and support.

So, it's an honour and pleasure to be here.

Think Ahead
The Think Ahead initiative helps prevent shock, helps avoid encouraging us to think, talk and tell.

Think Ahead takes the attention...the intention....and desire of the way we live ...... and applies them equally..... exquisitely..... to our death and dying....
So we have some control, choice, peace, dignity at the end.

Many of us have sat beside loved ones in their last hours, with Match of the Day or Coronation Street or exclamations over holiday snaps blasting through the curtain around the bed.

A friend told me about her godmother who was dying...

How at 11 a.m. on that last morning... she was given a small private room.

It was to use her words..... like chrism.

It was that last gift to her godmother..... an intensely private woman.........the silence.

As she put it..

"All of a sudden, she heard the silence.... the separateness of that space...a room of her own... for her own spirit..... and at last.... she could start the last journey..... she could let go.

In that small private space, I laid down the plastic card with the plastic prayers and did what she always said she wanted at the end.

I sang to her.

All her favourites, all day.

I told her I loved her out loud and went through all our stories, instead of whispering and being mortified for the two of us.... like before.

She'd had a harrowing week but in her own room, by 2 a.m. she'd let go. At half two..... the last bits of her had gone."


That was in an acute hospital.

With all the practices and priorities of keeping people in life....

Fewer ..... way fewer...... for allowing them to ....leave it....


And while your study in 2004 found that two-thirds of people wish to die in their own home..... in their own bed....

For even more than that..... for 70 per cent of us..... that doesn't happen.

In fact, right now....half of us die in those busy, acute hospitals.

Think of the trauma.... the confusion for the dying..... and for those friends and family who have gathered there to walk them over..... on that final journey.


Hospice-Friendly Hospitals
Which is why I commend you on your Hospice-Friendly Hospitals programme.

A programme that allows 60 frontline staff..... right across Ireland... to deal with death and dying..... with all the dignity and mindfulness.....they require and deserve.

I believe that to be with someone in their final hours.... their final moments... is a privilege..... a life-gift......that is given to too few.

As Taoiseach, I am absolutely committed to bringing the dignity, the respect, the nurturing and love of the individual....

All those things that define hospice care.....our humanity widely as possible..... to the general hospital setting.

I am deeply impressed with this initiative that deals with death in such a strangely... lifegiving.... way....

Giving hope and comfort and clarity...but above all

Allowing possibility...
It's like the poem that says
Happy the man, who, dying can
Place his hand on his heart and say:
"At least I didn't neglect to tell
the thrush how beautifully she sings." ('Going without Saying', Bernard O' Donoghue)
Patient Choice/Health Service
Putting the patients' choices and concerns at the centre of health services is a key aim of and driver for Government's reform programme for our health services.

The end of life is no less precious than any other stage.

In fact in many ways it is even more so....

Which is why when we're at that stage....

We are entitled to dignity and respect..... to have our wishes and concerns taken on board.

The new 'Think Ahead' form is a key part of this new approach.

Government Policy
My Government is reforming our model of delivering healthcare, so that more care is delivered in the community.

We are committed to supporting older people to live in their own homes and communities for as long as they wish.

Our health service will also continue to support access to quality long-term residential care or other appropriate care, notwithstanding the severe resource limitations.

Central to this is continuing the close and long-established partnership with voluntary organisations, including many of you represented here today. I have been conscious for many years of the key role played by these groups in relation to Palliative and End-of-Life care.
For the government's part in this regard, our immediate aim is to
- Implement the various Care at End-of-Life projects agreed between the HSE and the Irish Hospice Foundation
- Progress the National Children's Palliative Care Policy. This includes the recent appointment of Ireland's first Consultant in Children's Palliative Medicine, and working towards filling the remaining 6 Outreach Nursing posts
- Develop a new Minimum Data for Palliative Care to give better information for future policies and services.
Hospice Care
At present, over 6,000 people use hospice-services annually.
6,000 men, women and children.
To give an idea of the challenges facing us all, it is estimated that up to 13,000 patients will require access to hospice and specialist palliative care by 2016.
So the provision of modern high quality Palliative Care will remain high on the Government agenda.

There is, I believe, recognition and acceptance by all the major stakeholders that scope exists to provide these services in a better, smarter and more collaborative way in the future.

I would like to mention that the HSE, together with the Law Reform Commission and other relevant agencies, are examining the area of Advance Care Directives.
The intention of this is to improve the quality of life for older people by facilitating timely, sensitive and appropriate advance care planning. The work is currently at a relatively early stage of development, and will include public consultation. In addition, there is ongoing and close discussion on a range of issues around End-of-Life care between the HSE and the IHF.

Just as we must be realistic, innovative and flexible in rebuilding and recasting our economy, so we must be in reforming and reshaping our health service to ensure it is delivering the best care possible.
I'm delighted to work with you and others in this regard.... the public interest.
But as I leave you.... as we leave our lives..... it is the personal and private space that concerns us.....
Think Ahead gives people courage and for that you are to be thanked.
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