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Palliative Care

Volume 462: debated on Wednesday 4 July 2007

I beg to move,

That leave be given to bring in a Bill to make provision for palliative care for persons who are suffering from a terminal illness; and for connected purposes.

In another place, Baroness Finlay has steered through a similar Bill, without amendment, so it is with that which I wish to continue in this House.

Palliative care is part of supportive care and it embraces many elements of supportive care. It has been defined by the National Institute for Health and Clinical Excellence as affirming life and regarding dying as a normal process; providing relief from pain and other distressing symptoms; integrating the psychological and spiritual aspects of patient care; offering a support system to help patients to live as actively as possible until death; and offering a support system to help the family cope during the patient's illness and in their own bereavement.

As at January 2006, in England, Wales and Northern Ireland there were 193 specialist in-patient units providing 2,774 beds, of which 20 per cent. were NHS beds; 295 home care services—this figure includes both primarily advisory services delivered by hospice or NHS-based community palliative care teams and other more sustained care provided in the patient's home; 314 hospital based services; 234 day care services; and 314 bereavement support services.

Everyone facing a life-threatening illness will need some degree of supportive care in addition to treatment for their condition. NICE has defined supportive care for people with cancer, and with some modification the definition can be used for people with any life-threatening condition. For example, I should like it to be extended to cover sufferers of motor neurone disease.

About 5,000 people are estimated to be living with motor neurone disease in the United Kingdom, and half of those with MND die within 14 months of diagnosis. Many people with MND are unable to access the palliative care services that they require. In a survey carried out by the Motor Neurone Disease Association in 2005, only 39 per cent. of people with MND had been referred to specialist palliative care services. In addition, there are unacceptable geographical variations in the quality of service provision and that can have a negative impact on the quality of life of people with MND and their families. Not surprisingly, the association believes that specialist palliative care services should be available to everyone with MND, in a setting and at a time of their choice.

My Bill seeks to broaden the scope of palliative care to cover all those with a terminal illness. It also aims to cater for the needs of those suffering from a terminal illness in allowing them the choice of where to die. In December 2005, a report by the NHS Confederation highlighted the real need to improve end-of-life care for the terminally ill. The report showed that 56 per cent. of terminally ill patients would prefer to die at home, but only 20 per cent. do so. Alternatively, only 11 per cent. of people want to die in hospital, yet 56 per cent. do so. Better co-ordination between service providers is urgently needed if we are to improve end-of-life care for the terminally ill.

We also need better access to palliative care services. According to Marie Curie Cancer Care, more than 155,000 die of cancer every year, yet Help the Hospices points out that only 3,250 hospice beds are available, and 2,489 are supplied by the voluntary sector. I have campaigned for many years, urging the Government to increase funding to hospices, particularly children’s hospices such as Derian House based in my constituency, which is a leader in child care. We must ensure that the Government release more funding. It is alarming that children’s hospices are the poor relation in palliative care.

First, there is an acute shortage of paediatric palliative care medicine consultants. Secondly, children's hospices receive only in the region of 5 per cent. of funding from official sources, compared with 30 per cent. for adult hospices, so we can already see the vast difference in funding from the NHS. I want that anomaly to be addressed, in addition to the clear postcode lottery that exists with palliative care. Terminal illness places great strain on families and loved ones. The least they can expect is to have the necessary support and help in making those final days as comfortable as possible. Extending palliative care would not involve a huge increase in expenditure—it mainly requires specialist knowledge in the use of pain-relieving drugs and holistic care to ease the dying process. Marie Curie Cancer Care, in its report "Dying at Home", states that for every £1 invested in home palliative care services, £2 will be freed up for the NHS. Despite that, 80 per cent. of resources are allocated to hospital-based care. We need to shift the emphasis in the funding streams.

In recent years, great strides have been made in palliative care—we all recognise that. Our hospices do a wonderful job in supporting the terminally ill and their families. However, we need to do much more to support the terminally ill. We must ensure that their needs are catered for and that access to treatments, help and support are equal regardless of postcode. The answer is not to legalise euthanasia or assisted suicide. Everyone has the right to life and the right to palliative care. That is what my Bill aims to achieve and I commend it to the House.

Question put and agreed to.

Bill ordered to be brought in by Mr. Lindsay Hoyle, David Taylor, Jim Dobbin, Mr. David Crausby, Geraldine Smith, Mr. David Amess, Mr. Julian Brazier, Mr. Ben Wallace, Mr. Nigel Evans, Simon Hughes, Dr. Brian Iddon and Mr. Bob Laxton.

Palliative Care

Mr. Lindsay Hoyle accordingly presented a Bill to make provision for palliative care for persons who are suffering from a terminal illness; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 19 October, and to be printed [Bill 138].