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No swift exit from our disgraceful care home crisis

Last night, on BBC2, viewers watched a 71-year-old man die in a clinic run by the non-profit organisation Dignitas in Switzerland. Sir Terry Pratchett's film followed motor neurone disease sufferer Peter Smedley, who took the decision to end his life.

Sir Terry, who has Alzheimer's disease, wants assisted suicide to be legalised in this country and his film is bound to cause controversy, primarily because many feel that showing the act of suicide (whether assisted or not) will encourage copycats.

Funnily enough, showing real death on television has become less of a concern - last month, BBC1 showed an 84-year-old cancer sufferer called Gerald dying of cancer on Inside the Human Body, which programme-makers justified on educational grounds. I've been thinking a lot about death recently and not because of Gerald and Peter. The problems at the care-home provider Southern Cross coincided with a shocking report by the Care Quality Commission (CQC) into standards at 12 NHS trusts in England and Wales.

I once spent a few days working as a care assistant on a general ward for a documentary and the first thing that struck me was the total absence of any quality of life for the elderly. There was not enough staff to feed, dress, talk or give them any special attention. Imagine how much worse the situation is now.

Dying in an NHS hospital remains a lottery - last week, a coroner's court was told how a patient with alcohol and drug problems collapsed and died (after being ignored for 10 hours) in a hospital corridor at Manchester Royal Infirmary. CCTV footage showed staff stepping over his body and eventually dragging it along the floor, like a sack of potatoes.

The coroner said this death was "wholly preventable" - the patient should have been taken to A-amp;E. The NHS trust apologised, but it's a bit late to 'learn a lesson' when staff treat a dying man as an obstacle in a corridor, isn't it?

My sister lay dying in an NHS hospital and was only removed to a hospice when she lapsed into unconsciousness. I do not want to die in an NHS ward; that experience still gives me bad dreams.

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As for the poor residents in the care of Southern Cross, I wonder what quality of life they are enjoying during their final years? Its plan to shed 3,000 jobs won't make life more pleasant for residents.

The trouble is, no one wants to take responsibility for the very old and dying. The Government refuses to bail out Southern Cross, but promises no one will be homeless or without care.

What kind of care in what kind of environment? The company is being restructured, with landlords possibly taking over a large number of homes. But nowhere in all of this is quality of life paramount - it's all about economics.

Meanwhile, the CQC itself is in crisis. It has 280 vacant posts, almost half of which are for care home inspectors. In a recent staff survey, only one in six thought the commission well-run.

All of which made me decide I will not die in a care home. I want to end my life at home, when I choose. So is Sir Terry's film a potent argument for legalising assisted suicide? At the moment it's all about money - Peter Smedley could afford to travel to Switzerland to evade UK legalities.

As one letter-writer put it last week: 'What about the spouses of our local dinner ladies or dustman ... if a small proportion of the medical effort spent on increasing life were addressed to quick death, how much better life would be for everyone - especially those left behind."

Faced with life in a care home, or a quick exit at home, I know which option I'll be taking.

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