Editor-At-Large: End of life care is a disgrace. I, for one, am staying home

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The Independent Online

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

Sir Terry, who has Alzheimer's disease, wants assisted suicide to be legalised in this country, and the 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 the 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. A quarter did not meet the legal requirement for patient care, and in some, elderly patients had to wipe their hands on their sheets after eating, while in others doctors had to prescribe water to ensure people were not dehydrated.

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 who made up the vast majority of patients. There was not enough staff to feed them, dress them, talk to them or give them any special attention. Imagine how much worse the situation is now, as the NHS makes sweeping staff cuts. Recently released figures show that 4,500 people – the vast majority elderly – leave hospital severely malnourished, double the number recorded in 2005/6.

Dying in an NHS hospital remains a lottery – last week, a coroner's court heard 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 & 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.

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, including 300 nurses and 1,275 care staff, 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 some of the 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. One in seven privately run homes have been graded poor or adequate by the CQC – and still we dump relatives in them.

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, and even fewer have any confidence in management decisions.

All of which has 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 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.

You can still be 'common' and have staff

Much carping from a left-wing newspaper because Prince William and the new Duchess of Cambridge are advertising for staff to run their London base, a flat in Kensington Palace.

According to one angry commentator, the Royal PR machine cleverly marketed the couple as the new "common" face of the monarchy, in the run up to the royal wedding. We were told that Kate would continue to do her own chores in their rented house in Anglesey and she was photographed shopping at the local branch of Waitrose. William and Kate seemed to be ushering in a new era, worlds apart from his dad with 150 staff. So does the news the couple have advertised for a housekeeper, butler and valet mean they've reverted to type?

Hardly. The number of domestic staff in the UK has risen by a staggering 91 per cent in five years – one in seven of us employ people to help run our homes. With more women working, and a desire to enjoy our limited leisure time over doing chores, it is no longer a sign you belong to a certain class. I never thought that the couple were going to live an ordinary life anyway – good luck to them if they can pay someone to wash up, iron and sort out all the dreary clothes they're going to have to wear at numerous events. Anyway, they're not exactly living in a palace, but a flat once used by a staff cook.

Note to Adele: pay-up and shut-up

Adele won us over with her refusal to dress like a tart and her straightforward approach to fame. She's sold millions of albums on sheer talent, and is said to be worth around £6m. But perhaps it's time for this non-diva to stop mouthing off about having to pay 50 per cent of her earnings in tax.

She told a magazine interviewer she was outraged – but her followers on twitter are unimpressed. One said: "If you fancy swapping paying 50 per cent on your eight million for paying a measly 20 per cent on 20,000, just let me know and I'll be happy to swap places."

Another said: "Pay your tax and stop moaning. Wish I were paying 50 per cent." Others weren't impressed when the BBC used one of her songs as a backing track to a programme about child poverty – oops!

Don't miss a dance treat at Tate

Tonight is the last chance to see the first piece of dance commissioned for the vast Turbine Hall at Tate Modern, created by the astonishing Michael Clark. It's a combination of group pieces, danced by 50 amateurs, and smaller dances by his company of brilliant performers, to music by Kraftwerk, Jarvis Cocker's Relaxed Muscle and David Bowie. I didn't care for the raggedy ensemble stuff, but the smaller works are truly memorable.

Clark himself makes a brief appearance to Bowie's classic anthem "Heroes". Clark's lighting director, Charles Atlas, projects patterns and video across the floor. It's one of the most original uses of this space, which has seen some truly banal artworks. This is unique.