End of Life Care

Lord Howarth of Newport Excerpts

Tuesday 5th September 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is a true expert on this topic and we had a very good debate on the subject, which she initiated, in March this year. In terms of the experience of care, I will check exactly what the charity is looking at. I know that there is now a measure—a questionnaire—of maternity bereavement which is looking at the experience of care and trying to learn from that, and I will see whether that is more broadly the case in terms of siblings and others, and indeed for non-neonatal child deaths. On 24/7 provision, again, we know that it is not yet universal but a couple of pilots are taking place on 24/7 nursing community care, so we are making some progress on that. Indeed, one of the metrics by which we will measure our success is the number of admissions and the time spent in hospital in the final 30 days of life, which speaks to the point she was making in trying to keep those who are dying out of hospital if that is not where they want to be.

[Lord Howarth of Newport (Lab)]

My Lords, does the Minister accept that we live in a society animated by humane values, which is also one of the richest societies in the world, and that there can be no excuse for the extensive failure to provide appropriate palliative care for children who are terminally ill or bereavement support for their parents that has been reported by the Royal College of Paediatrics and Child Health and the charity Together for Short Lives? Will the Secretary of State, who is accountable for these matters, use the authority of his office to ensure that sufficient services are commissioned and sufficient qualified staff are available so that the NICE guidelines can be implemented fully and consistently across the country?

[Lord O'Shaughnessy]

I agree that there is more to do but progress has been made since the first national framework was published a couple of years ago, building on the work of successive Governments. Staffing is important. There are more early-life nurses than there were seven years ago. More than that, additional training is also going on. This is a really important part of this. Health Education England’s mandate now includes end-of-life care training within various care packages. Indeed, through the Nursing and Midwifery Council, midwives are starting to get systematic end-of-life care training. Given that, unfortunately, 40% of these child deaths happen in the neonatal and newborn setting, that is incredibly important. But I take the noble Lord’s point.