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End-of-life Care

Volume 447: debated on Tuesday 20 June 2006

In the White Paper that we published in January, entitled “Our Health, Our Care, Our Say”, we set out proposals for making further improvements to end-of-life care, so that many more people are able to choose where they are cared for at the end of their lives, and where they die.

I am grateful to my right hon. Friend for that answer. There is no doubt that there is good practice in the hospice movement and in some parts of the NHS, and that there are good palliative care consultants, but will she say what steps she is taking to ensure that the lessons learned, and the expertise developed, in those settings are shared with other parts of the NHS? In particular, how is that experience being used to help those dealing with patients who wish to spend their final days and weeks in their own homes?

My hon. Friend is absolutely right. Part of what we are doing is to establish everywhere end-of-life care networks that draw on the expertise available in some parts of the NHS and in the Marie Curie cancer care programme. We will continue to develop the training programme that has ensured that many more community-based staff are trained in palliative care. We must ensure that more palliative care and hospice services are available, both in the community and in people’s homes. In that way, the majority of people who would prefer to die at home or in a hospice will no longer be forced to die in hospital, which is where most people die at present. That is another example of the shift of care from hospitals into the community, which is the best care that we can offer patients.

I thank the Secretary of State for the help that the Government have given recently to plug the short-term funding gap for children’s hospices. Will she say something about how we can get together with the Association of Children’s Hospices to develop a fair, sustainable and long-term funding policy for hospices?

The hon. Gentleman raises an extremely important point, and I am delighted that we have been able to make that funding available over the next three years, beginning in this financial year. It will ensure that the children’s hospices will be able to continue their excellent work. My hon. Friend the Under-Secretary will continue to work with the children’s hospice movement to ensure that the right services are provided for terminally ill children, whether that be in a hospice or in their own home.

I also thank my right hon. Friend for the £27 million that has been announced for children’s hospices, but end-of-life care is not just about making the end of life as caring as possible. It should also be about exploring all possibilities to prolong quality of life. Will she agree to meet me as soon as possible to discuss the case of my constituent, Kath Withington, who has been denied the Tarceva drug, even though her consultant and GP recommended it? People who may be in their last months or weeks should have access to all the treatments that might prolong their lives.

I am always happy to meet my hon. Friend but, on the more general point, it must be right that we ensure that NICE evaluates drugs, and that the drugs it recommends are available right across the NHS. However, we must not try to substitute ministerial decisions for NICE’s recommendations. We played our part in establishing NICE, and in speeding up the evaluation of the growing number of new drugs now available.

The Secretary of State speaks of palliative care being provided in the community. Much of it is provided in small community hospitals, such as Steppingley hospital in my constituency but, unfortunately, many such hospitals are under threat of closure or have already closed due to NHS deficits. Is not the best way to give good, compassionate, end-of-life care in the community to make sure that the beds and nurses are there to provide it?

The greatest need is for palliative care to be available in people’s own homes, because that is where the largest number of people would choose to die if they were given the choice, as I believe they should be. In the case of community hospitals, yes, there are parts of the country where the local NHS is looking at the number of community hospitals and at whether they can be better organised. In the White Paper, we made it clear that they should not be making short-term decisions, because of current financial problems, which may have to be reversed in future years; they should look instead at how to make the best possible use of existing, and new, community facilities to ensure that they are getting the best care for patients, much of which can now be delivered outside hospitals—not only in community hospitals, but also in patients’ own homes.