Cancer: Older People
Baroness Pitkeathley Excerpts(1 year, 4 months ago)
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Baroness Merron (Lab)
I am glad that the noble Lord is, as he describes himself, a happy statistic. We are all grateful for that. I certainly share the view that there are a number of ongoing chronic conditions and impacts on other aspects, such as people’s mental health. The cancer strategy needs to look at this in its development, and I am grateful to him for highlighting it.
Baroness Pitkeathley (Lab)
My Lords, as another happy statistic, I ask whether my noble friend thinks that older people are perhaps more reluctant than our younger friends to mention symptoms and are more inclined to say, “Oh, it’s nothing; I’ll get over it”. Would more public education programmes be useful in this regard?
Baroness Merron (Lab)
I am glad that my noble friend is also a happy statistic—although I see all noble Lords as more than just statistics. She makes a very good point but it is not just about those who are older; many people are reluctant to consider taking action when they have symptoms. My request to them is that they do not wait and that they act. That is how we get things diagnosed earlier, to provide the right support and care. There is a lot of embarrassment about certain symptoms and I make the plea that people should not be embarrassed. Certainly, as she suggests, the new cancer strategy will take account of how we educate people as well as diagnose and treat them.
Hospices: Funding
Baroness Pitkeathley Excerpts(1 year, 5 months ago)
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Baroness Pitkeathley (Lab)
My Lords, I am grateful to the noble Lord, Lord Farmer, for securing this debate and for his excellent speech reminding us of the philosophical basis of hospices. My remarks are focused more on the practical.
In the past six months, I have visited two friends who were in hospices as their lives came to an end. Both were being cared for in the way we would all like in similar circumstances—with skill and compassion and with support for them and their families. However, in both cases the hospices were operating only at half-pace. Each had 50% of its beds unoccupied for lack of money. It was also a source of regret to the staff that they had not only had to close beds but to curtail the outreach services which are so vital to patients and their families—proof, if any were needed, of the crisis in funding faced by hospices. Emergency funding is needed now to supplement the extraordinary fundraising effort volunteers and support groups put in, but this is a short-term solution. In no other area of health would we tolerate such dependence on charitable activity.
Hospices need to be incorporated into the NHS and dying needs to be seen as as much a part of life as being born. This does not negate in any way the voluntary principle on which hospices were founded—I had the privilege of meeting Dame Cicely Saunders and talking to her in the early days of the movement—but builds on it, harnessing that support and good will and enabling anyone who is need of a hospice place, or indeed hospice services in their own home, to access them. I hope that the assisted dying debate, as it proceeds, will highlight the need for more and better palliative care. Of course, hospices are not the only places providing such care, but many of them have expertise and experience from which the whole of the NHS could learn, and I hope that this learning will be encouraged by the Government. That expertise goes beyond the specialist medical care to manage pain and other symptoms over the short stays or those of longer duration with which we are familiar. It also includes research and innovation to improve palliative care services wherever they are provided.
We should not forget hospices’ important links with their local community, for which they are famed. They mobilise volunteers and voluntary efforts so that local communities are familiar with their services and able to access them, for the benefit of patients and their families when their own time comes. Many a bereaved person has been helped to recover from their grief by, in turn, becoming interested and involved in volunteering at a hospice—a two-way street, indeed.
NHS: Independent Investigation
Baroness Pitkeathley Excerpts(1 year, 6 months ago)
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Baroness Merron (Lab)
I am very pleased to see the noble Lord in the rudest of health and to hear of his positive experience. Of course, there are many positive experiences every single day, and the noble Lord is quite right to remind us of that and of the need to thank the whole NHS staff team who make that happen.
On the point about the NHS being broken, I understand the noble Lord’s view. However, I think it is important that we lay it bare and say what we have found. Having read the report by the noble Lord, Lord Darzi, I find it hard not to conclude that there are fundamental points within the National Health Service that are just not working. Of course there is good practice and there are brilliant outcomes in some areas, but it is not universal and that is what drives us to make that point. I hear what the noble Lord says. However, it is important to be honest, and that is what we have said we will be, uncomfortable though it might be at times.
Baroness Pitkeathley (Lab)
Does the Minister agree that integration between the different branches of the NHS, or rather a lack of it, is one of the problems? It is particularly a problem for patients. It works best when you cannot see the joins between various branches—when you cannot tell who the community nurse is working for, whether it is the hospital nurse and so on. Those are the things that puzzle patients. In thinking about the workforce, therefore, will the Government look at ways—for example, joint training—in which we can better integrate the staff, so that they work less in professional silos and much more across various branches of the NHS?
Baroness Merron (Lab)
Yes, I certainly agree with my noble friend about the need for better integration. Joint training is a very practical example and will be part of how we develop the workforce, because silo working clearly is not working, as we can see in the current state of affairs, particularly if we look at the relationship between the National Health Service and the social care service. It is not seamless, and individuals are suffering for that, so I very much agree with my noble friend.
Palliative and End-of-life Care: Funding
Baroness Pitkeathley Excerpts(1 year, 7 months ago)
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Baroness Merron (Lab)
I certainly take on board the point that the right reverend Prelate makes. It is the case that the amount of funding that charitable hospices receive varies by ICB area. That, in part, is dependent on the breadth of a range of palliative and end-of-life care provision within the ICB area. I can assure your Lordships’ House that my colleague, Minister Kinnock, the Minister of State for Care, has recently met with NHS England, and discussions have started on how to reduce inequalities and variation in access to services and their quality.
Baroness Pitkeathley (Lab)
My Lords, does my noble friend agree that when end-of-life or palliative care is delivered at home, the principal deliverers are usually the family—the unpaid carers—of the patient? Does she agree, therefore, that they must be considered in this equation to get them as much support as possible, and that they ought to be given as much information as possible about the patient’s prognosis and the treatment plan, bearing in mind the sensitivities associated with such information?
NHS Continuing Healthcare
Baroness Pitkeathley Excerpts(1 year, 7 months ago)
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Baroness Merron (Lab)
It is crucial that we provide the right support to children and young people. NHS England’s regional teams are working with local systems to explore the delivery of continuing care to that younger group. It is important to say to your Lordships’ House that we do not currently collect data on, for example, children and young people, but we will be doing so from April next year. That will help us capture evidence, which will enable us to improve things in the way the noble Lord and his all-party group want to do. We continue to welcome views from stakeholders and partners in this regard.
Baroness Pitkeathley (Lab)
My Lords, I wonder if other noble Lords share my experience of people who should have continuing care never even being told about its existence. As the noble Lord, Lord Crisp, said, the criteria are obscure, but they are even more obscure if nobody tells you that you could be eligible. Would the noble Baroness be sympathetic to the idea of being much more open about the existence of this facility to both patients and their families?
Baroness Merron (Lab)
I thank my noble friend for that observation and certainly agree that, in all these areas, it is very important that people understand what might be available and how they might best apply. As I said to the noble Lord, Lord Crisp, the assessment is potentially a gateway to other NHS funding. I feel quite strongly that that needs to be clarified, so that people know what they are going into. I will take my noble friend’s comments on board and discuss this within the department.