Hospice and Palliative Care

Cameron Thomas Excerpts

Monday 13th January 2025 Commons Chamber

[Vikki Slade (Mid Dorset and North Poole) (LD)]

I shall be as fast as I can, Madam Deputy Speaker. There is no doubt that there is massive support for the hospice movement in this place. While the new funding is welcome, Clare Gallie, the chief executive of the Lewis-Manning hospice in Poole said:

“There is simply no point in having fully fitted and beautiful buildings if we cannot afford the staff to run them!”

When someone has a terminal diagnosis, their world turns upside down. It may have come out of the blue, or it may be after years of intensive treatment, when they are already at breaking point and sick. Families have to come to terms with losing the person they love, and learn to cope with managing distressing symptoms, processing their own emotions, and managing money worries and potentially their own health issues. People will be coming in and out of the house at a time when they just want to be left alone. They will also be terrified of being left alone and something awful happening. They are more likely to call their GP on a Friday afternoon, worried that no one will be around at the weekend; more likely to witness a distressing symptom and ring for an ambulance, creating an emergency dash to the hospital and a lengthy stay on a trolley; and more likely to be subjected to blood tests and interventions that will not alter the path of their disease.

I went on that journey when my mum, Lin Foster, died of ovarian cancer aged just 59, but we were lucky: we had the support of district nurses and palliative care teams through Forest Holme. For the last eight weeks of her life, when she did not leave her bed, those people came in and out of her house with no need to knock. They knew where the kettle was, and they knew when we needed our own time. They managed her every need, including supporting her as she planned her own funeral. She did not want to go to hospital. She wanted to end her days in the thatched cottage that had been her lifelong dream. That is what most people say they want, but only 37% of cancer patients are at home at the time of their death.

Junior doctors tell us that palliative patients are spending months in general medical wards, frequently dying there. I was told:

“It is not right, it is not humane because general wards lack the skills”.

It also does not save the NHS money. I have written to the Minister about the Lewis-Manning anticipatory care model, which I also raised with the all-party parliamentary group on hospice and end of life care. That programme seeks involvement at the point of diagnosis. Lewis-Manning ran a pilot from April 2024 to this month that saved NHS Dorset £765,000 across Poole and Purbeck.

[Cameron Thomas (Tewkesbury) (LD)]

I am grateful to my hon. Friend, and to the hon. Member for Spen Valley (Kim Leadbeater) for her Terminally Ill Adults (End of Life) Bill, which has done so much to bring this debate into the national consciousness. Does my hon. Friend agree with the Liberal Democrat policy that the Government should exempt hospices from the NIC rise?

[Vikki Slade]

I completely agree, but what is really ridiculous is that, according to the Department of Health and Social Care, over 10 million hospital days followed an emergency admission in the last year of life, and 10% of people who died of cancer had three or more emergency admissions in the last three months of their life. The anticipatory care model can prevent some of those admissions and reduce the trauma. Further to my letter, sent in November, I urge the Minister to meet me and Clare Gallie to talk about a transformative approach.

I was deeply concerned when Marie Curie emailed me to say that Dorset integrated care board will stop commissioning specialist end of life care from March. The rationale is that personal care commissioning will go via council frameworks, but they do not require expertise in the provision of end of life care. I urge the Minister to insist that the specialists are listened to in the framework and to ensure that Lewis-Manning and Marie Curie are heard. Those organisations are looking to make redundancies and close services at a time when hospital beds are at a premium—