Hospices: Impact of NHS Pay Increases

Lord Blair of Boughton Excerpts

Monday 18th June 2018 Lords Chamber

[Lord O'Shaughnessy]

My noble friend gives a compelling reason. It is salutary to note that while around half of deaths occur in hospital, most people—about 70% to 80%—would prefer to die at home or in a hospice, which means that we need to have a thriving hospice sector. That is why it is important to make sure that it can compete on a level playing field for staff.

[Lord Blair of Boughton (CB)]

My Lords, I declare an interest as the chair of Helen & Douglas House, the first ever hospice in the world for children. When I last spoke about this subject, the Minister invited me for a meeting. I am afraid that that meeting has never been proffered since, but I am delighted to tell the House that the threat of a meeting with a Minister was enough to get the clinical commissioning group to start paying towards our hospice. However, I echo the point made by the noble Lord, Lord Howard: that a hospice that is struggling for staff, which is then presented with a pay deal only for the NHS, will struggle more. Can the Minister really consider the effect of this on hospices?

[Lord O'Shaughnessy]

I am sorry that that meeting has not taken place, and of course I am always glad to meet the noble Lord to discuss this issue. I am glad that the threat of a meeting has had the desired result, and clearly, I agree with him that we have to make sure that hospices are equally attractive places to work as is the NHS more broadly.

Health: Medical Respite for Children

Lord Blair of Boughton Excerpts

Wednesday 21st March 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness makes an important point. That is the reason we are providing more funding, both through social care budgets and through the NHS itself. More money was found at the Budget as well, but I do not think in this case the issue is necessarily funding. It is a case of the parties involved working together, as they are obliged to do, to find the right outcome and the right solution for these children.

[Lord Blair of Boughton (CB)]

My Lords, I join the noble Baroness, Lady Brinton, in this case and declare my interest as the chair of Helen & Douglas House in Oxford, which was the first children’s hospice in the world. It covers a vast area of the Thames Valley and provides end-of-life care and respite care for children with life-limiting diseases, but the Oxfordshire CCG has completely refused to supply any funds to it. Would the Minister meet with me to discuss that situation?

[Lord O'Shaughnessy]

Yes, I would be happy to do so. I am disturbed by the picture that the noble Lord has painted. He will know, I am sure, that the Government have set out our commitment to end the variation in end-of-life care, and of course this is a co-commissioned service. I would be very pleased to meet him to investigate that.

Care Quality Commission: Morecambe Bay Hospitals

Lord Blair of Boughton Excerpts

Thursday 20th June 2013 Lords Chamber

[Earl Howe]

My Lords, the deputy Information Commissioner is quoted as saying that confidentiality and data protection issues should not stand in the way of disclosure where disclosure is clearly in the public interest. I completely agree with that. That is why our instant reaction yesterday, when we were told by the CQC that legal advice had said that the names of the individuals had to be kept confidential, was to challenge that. I am pleased that that decision is to be reversed and the names will be released.

On my noble and learned friend’s second point, most certainly yes: the CQC should take a view about matters relating to negligence. However, I would add that apart from the CQC, we now have the new Healthwatch bodies, part of whose function will be to make sure they provide good soft intelligence on what is happening in NHS and social providers in their local areas. The Healthwatch bodies can then act as the eyes and ears of the CQC, which, with the best will in the world, cannot be everywhere at once. In terms of the future—this is clearly a longer-term agenda—I hope we will have a system that is better equipped to pick up this kind of incident should it ever occur again.

[Lord Blair of Boughton]

My Lords, I welcome the idea of a statutory duty of candour and all the other means of regulation being discussed, but what appears to have happened here—and obviously it is just an allegation—is a simple case of malfeasance in public office. One of the things that seem to have happened over scandals such as Stafford, or even LIBOR, is that the ordinary criminal law of the United Kingdom has not been considered. I assume that the CQC is a public body. It is certainly paid for by public funds, and therefore its officials are subject to the common law.

[Earl Howe]

My Lords, clearly it is a matter for the police to investigate criminal offences and for the Crown Prosecution Service to consider whether the test for prosecuting individuals has been met in this case. It is too early to reach a conclusion about whether this case highlights a gap in the law but if it does, I can assure the noble Lord that we will pursue it. We keep the criminal law under review. It is too early for me to say—I am not a lawyer—whether he is right, but I am sure that his comments will resonate strongly with the House.

NHS: Death at Home

Lord Blair of Boughton Excerpts

Thursday 8th November 2012 Lords Chamber

[Lord Blair of Boughton]

My Lords, I need to declare an interest, in that I was a member of the Commission on Assisted Dying chaired by the noble and learned Lord, Lord Falconer. It was a very moving experience; it was also a very educative experience. I do not think it was something to which I had given much thought. I was a bit in agreement with Woody Allen, who said, “I don’t mind dying; I just don’t want to be there when it happens”. The Bill will be brought forward by the noble and learned Lord, Lord Falconer, in the new year. The right to die at home—the subject of this debate—seems to be just one small part of thinking about our approach to death.

First, I want to reflect on something said at a Dignity in Dying conference in July, which I was asked to address as a member of the commission to discuss its findings. It was followed by a lobby of Parliament, which noble Lords may remember. One of the speakers said that after anti-slavery, women’s rights, the abolition of capital punishment, the legalisation of abortion and gay rights, thinking of ways to die, to ease death and to give more choice about death is the next great liberal cause. I agree with those sentiments. I note that the chair of one of the major medical bodies recently said that a botched death should now rank with a botched abortion as a medical disaster.

Ann McPherson was a wonderful Oxford general practitioner who founded the organisation Healthcare Professionals for Assisted Dying before she was diagnosed herself with pancreatic cancer. She gave evidence to the commission, but died at the end of May. Ann’s daughter has written an account of her death at home; it is available on the internet. It was a terrible death, but the important point that she wrote about was that it was at home. If a death as complicated as that could be managed at home, then that is the point of this debate.

Being able to choose to die at home or where people live should be a first starting point in the end-of-life care. I support the views put forward by many noble Lords, particularly by the noble Lord, Lord Warner, in this debate. Norman Lamb MP, Minister for Care and Support, recently stated that a review in 2013 of progress in the end-of-life care strategy,

“will inform us when a right to choose to die at home, including a care home, might feasibly be introduced”.—[Official Report, Commons, 30/10/12; col. 149W.]

I hope it comes soon.

Above all, I think we need to talk about this a lot more. Very few people who came before our commission seemed to know about the choices mentioned by the noble Viscount, Lord Craigavon, of advance decisions, lasting powers of attorney, advance statements and advance care planning. Not enough people seem even to know the term “palliative care”, let alone be able to access it. It is a common saying that the only two certainties in life are death and taxes. It seems to me that in this great Chamber, we spend a much greater amount of time talking about taxes than we do about death. As the noble Lord, Lord Dubs, said, we should talk about it more. As the Times put it in the leader already referred to this week:

“Without discussing how we die, we have not truly explored how we live”.

I thank the noble Lord for organising this debate and I look forward to further discussions about these matters when the Bill to be put forward by the noble and learned Lord, Lord Falconer, enters this House.