End of Life Care

4/3/16

Last week in Parliament MPs debated End of Life Care. As some of you will recall, in September the House rejected a Private Members Bill which would have paved the way for legalising Assisted Suicide in England; stressing instead the need to ensure appropriate palliative care for those with a terminal illness. This was our first opportunity to look at the provision of this in more detail.

In an international comparison, End of Life care in the UK has been recognised as the best in the world, which is largely due to the Hospice movement. However, there are significant issues with accessing care which seems to vary depending on a number of factors including age, diagnosis, where you live and the setting in which you are treated. We are all mortal and three quarters of us will die expectedly from an on-going condition so we all have a vested interest in making sure appropriate services are available so that we spend the last weeks and months of our lives in comfort and dignity with our families.

Providing this level of care in the home is one of the biggest challenges we face as the vast majority of people, when given the choice, prefer to die at home. In Scotland, patients can access social care if they are over 65 and will receive free personal care but a survey by MND-Scotland showed that all but one of the Local Authorities who replied, provided social care to patients under 65 if they were diagnosed as having a terminal illness with a limited life expectancy of less than 6 months. This is not the case in England where many patients get trapped in hospital near the end of their lives as they have to pay for social care if they have assets of more than £23,500 or wait several weeks to undergo means testing. The main recommendation of the Health Select Committee report in March 2015 was that social care should also be provided free in England for those at the end of their lives so they could be well cared for and not get stuck in hospital. It was very disappointing that, in responding to the debate, Health Minister Ben Gummer made no firm commitments to palliative care provision or a timescale for change. Both countries still face the challenge of delivering the care as the number of patients needing palliative care grows. This needs to be addressed if we are to provide the high quality palliative care which will allow people to end their journey without fear, without pain, at home and without feeling a burden.