NHS: End-of-life Care

Lord Alton of Liverpool Excerpts

Thursday 8th September 2022 Lords Chamber

[Lord Kamall (Con)]

One thing that often happens at reviews is that we realise how complicated these issues are. One often cannot pinpoint one key issue, or one silver bullet, as it were. Therefore, quite often—and I was on a call on a different issue yesterday—we thought we had to tackle certain issues but realised there were wider systemic issues. Clearly, that is going to be the case here. NHS England’s palliative and end-of-life care programme is an all-age programme, but there are specific pieces of work focused on children and young people. We have also been working very sympathetically with charities such as Together for Short Lives. It has been commissioned to produce written guidance to provide ICBs and ICSs more detail, as the noble Baroness asked for, but also to make sure we make it a better environment and learn.

[Lord Alton of Liverpool (CB)]

My Lords, in my conversation with the family of Charlie Gard, they were emphatic that adding to the tragedy of the loss of a child, the thing they found hardest was having to go to court and go through an adversarial system. Anything the review can do to prevent the necessity of court action, notwithstanding wonderful judges such as my noble and learned friend, would be welcomed by such families.

[Lord Kamall (Con)]

I think many noble Lords will echo the sentiments of the noble Lord on that. That is why we want the review to be as wide-ranging as possible. People have suggested mediation, but should that be mandated or voluntary? There is also a difference between commercial mediation and family mediation. Commercial mediation is usually binding, whereas family mediation is not always binding. A further question is: at what stage do we offer mediation? One thing we are being told is not to offer it when everything else has failed: we should offer it as soon as possible, to encourage a collaborative approach.