NHS: Death at Home

Baroness Masham of Ilton Excerpts

Thursday 8th November 2012 Lords Chamber

[Baroness Masham of Ilton]

My Lords, I congratulate the noble Lord, Lord Warner, on instigating this most timely debate.

It is in memory of my late husband that I find it important to speak to your Lordships today. I know that he would have wished to have died at home, but it was not to be. My husband, in his last years, had several complicated conditions. He was diabetic; he had had strokes; he had Parkinson’s disease; and a wound that would not heal due to a tumour that was cancerous.

I live in a rural area, and I take this opportunity to say that rural healthcare is different from urban healthcare. I think that that should be recognised in the NHS Constitution. So many health problems seem to happen at weekends, and one is dependent on the out-of-hours service. I feel that there should be a register in each out-of hours-area of people with long-term complicated conditions, so that the out-of-hours doctors know which patients are at risk. There is no way to retrieve individual health records at weekends or at night.

As it was on a Friday evening when my husband had problems, I got the out-of-hours duty doctor to come out. She had to make the 24 mile journey from Harrogate and, because my husband had a swallowing problem, she prescribed a liquid antibiotic. We had great difficulty finding a supermarket which could provide that and, over the weekend, his swallowing became more difficult. On Saturday, I spoke to another out-of-hours doctor who did not come out and rather inferred over the telephone that all was all right. On Sunday, I had to represent my husband at his church lunch, which he would have gone to. On my return, things had got worse. After another agonising wait for another out-of-hours doctor to ring back, an ambulance was sent and my husband was taken to hospital with me and my helper following behind by car.

I have tried to get an antibiotic given to him by drip, but this was not to be and is still not available in the community in a rural area. I had carers for my husband who could have managed a drip.

He died in the A&E department with me with him. If only more help was available in the community, all the stress and trauma would be removed. As it was, two young and inexperienced police officers arrived at the hospital and nobody seemed to know what to do. My husband died of pneumonia, which can develop very quickly.

I tell this story as I hope that more people can die at home with the comfort of knowing that all that can be done to help is forthcoming. With the economic situation, this is very doubtful but I was pleased to read over the weekend that the Secretary of State for Health is doing something which I hope will give hope to people who have become very concerned at the treatment and care of the dying because of the Liverpool care pathway. I cannot think of a more cruel practice than being denied fluids or food if one wants them. I often wake in the early hours with a very dry mouth and I keep a bottle of water next to my bed. To keep the mouth moist and clean should be a basic care need. Many people now fear having to go to hospital and many doctors feel guilty at having used the Liverpool care pathway, which seems to have gone down the wrong road and, instead of care, it has become a way of speeding up death in an underhand way.

I hope that the Secretary of State for Health, Jeremy Hunt, will make it clear, with his colleagues, that not only should everyone concerned be involved in end-of-life care but that the patient should not be starved to death. They should be allowed to die in as much comfort as possible when their time comes. This should be made clear in the NHS Constitution and I agree that there should be no decision made about me without me, be it in the community or hospital.