Terminal Illness: Mental Health Support Debate
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Mr Connor Rand (Altrincham and Sale West) (Lab)
I beg to move,
That this House has considered mental health support for people with terminal illnesses.
It is a pleasure to serve under your chairmanship, Sir Jeremy. I am here today because of my constituent Mike, who I am pleased to say is in the Gallery to watch the debate. In 2019, Mike experienced the devastating grief of losing a partner, but out of the trauma he is pushing for change and campaigning for better mental health support for those with terminal cancer. I pay tribute to Mike: he is a remarkable man. I thank him for bravely sharing his story with me, and I will try my best to do it justice today.
In 2016, Mike’s wife, Sarah, started to suffer with terrible pain in her back, and by the end of that year she was in constant agony. In early 2017, they found out that Sarah had lung cancer, which had spread to her spine, and she was given six months to live. A course of gruelling treatment followed, including major spinal reconstruction surgery and targeted therapy. In September 2019, Sarah succumbed to her illness, passing away a week before her 53rd birthday.
Sarah lived more than a year longer than doctors had initially predicted, and in that sense her treatment was a success, but that does not tell the whole story. There was a gaping hole in Sarah’s treatment: the lack of appropriate mental health support. Not having that support had a huge impact on Sarah’s quality of life, as well as her family and her family’s quality of life. Following her terminal diagnosis, as the devastating impact of cancer started to take its toll on her body, Sarah became deeply depressed and suffered with anxiety.
We know about the physical symptoms of cancer, such as nausea, crippling pain or a loss of mobility, and just how horrendous those symptoms are, but we talk less about the mental health effects, even though they are as common and sometimes the most crushing consequence of this awful illness. That was certainly the case with Sarah. A previously happy, outgoing and vibrant woman, who loved design, gardening and reading books, she became a shell of her former self—unwilling to go outside, not even to sit in the garden she had so lovingly cared for. She cried every day, sometimes all day, and could not eat, could not read a book and did not know what pleasure felt like. As Mike said to me the very first time we met, “Sarah disappeared into herself.” I cannot begin to imagine how hard that was or the toll it took on Sarah, Mike, her entire family and her friends.
Shamefully, Sarah never saw a psychologist or psychiatrist, and she never had a serious or rigorous mental health assessment. Sarah was offered counselling and cognitive behavioural therapy by Macmillan Cancer Support and local NHS services, but we all know the issues with those services. Waiting lists can be months long, and when Sarah did get therapy, it was often for just a few weeks at a time, before she was back on another waiting list.
Too often, as in this case, the kind of therapy offered is not appropriate for the needs of the patient. Sarah would leave her CBT sessions clutching leaflets that she was supposed to go away and read, even though she could not even look at a newspaper. She was once told to go and do some gardening when the debilitating effects of her cancer had already taken that big joy out of her life. What was needed was treatment by a psycho-oncologist—someone who would offer specialist psychological care for someone affected by cancer—but the one psycho-oncologist at her local hospital was badly overstretched and the appointment never came.
As Mike has so eloquently said, this is not a criticism of our dedicated NHS or care staff. They are not to blame for a health culture that has always been more interested in the physical than in the psychological. That deficiency, in reality, is unlikely to change without more scientists and funding bodies devoting time and cash to researching therapies to support the mental health of those with terminal illnesses. From my perspective, there seems to be precious little work being done in this area; I spoke to Macmillan and other charities ahead of this debate, and they said the same. That deficiency is despite the fact that 17% of cancer patients will be diagnosed with depression and anxiety, but almost half will not receive the treatment that they need—that must change.
I ask the Minister to seriously consider the policy suggestions made by Mike: more funding to map service provision across the national health service to identify good and bad practice, including an assessment of the effectiveness of current National Institute for Health and Care Excellence guidelines on mental health support for the terminally ill; more funding to recruit more psycho-oncologists to work in our palliative care system; a commitment to an immediate baseline mental health assessment for patients upon their diagnosis with a terminal illness and, if needed, a clear pathway for referral to an experience psycho-oncologist on diagnosis of terminal illness. I believe that those are practical and, I hope, achievable steps that could make a real difference to cancer patients.
Edward Morello (West Dorset) (LD)
I thank the hon. Member for giving us an opportunity to talk about this incredibly important issue. I agree 100% with the recommendations that he is making. I also point to the important work that hospices do. A lot of hospices, such as Weldmar and Julia’s House in West Dorset, provide mental health-led hospice services to communities, yet, at the same time, are under extraordinary funding pressures. Weldmar has a £1 million deficit; Julia’s House gets just 8% of its funding from the NHS, yet it is relieving pressure on the NHS. Does the hon. Member think that, along with his recommendations, a sustainable funding model for hospices providing the kind of care that he is talking about is important?
Mr Rand
I am sure that there is recognition on both sides of the House of the incredibly important work that hospices do to support patients in our communities. I am sure that the hospices that the hon. Member mentioned will be grateful for the recognition of their important work. Of course we need to ensure sustainable funding. As he will be aware, this Government have already invested a significant amount in hospice care, but I appreciate the pressures that many hospices still find themselves under.
I would be grateful if the Minister would meet Mike and me to discuss Mike’s policy recommendations in more detail and to see if they could form part of the Government’s welcome review of palliative care services and the framework that has been announced. It feels particularly pressing at this juncture, as the Terminally Ill Adults (End of Life) Bill progresses through Parliament. Although I support that legislation, I worry about the prospects of those with a terminal diagnosis. I am sure that the Minister will want to reflect on that in his response.
Amanda Hack (North West Leicestershire) (Lab)
I thank my hon. Friend for sharing the story of Sarah and Mike—he did it justice. It is really important to think about the whole care of people going through a terminal diagnosis—both the patient and their loved ones. We should make sure that the mental health of those people who are supporting the person going through a terminal illness is also considered in this conversation.
Mr Rand
I could not agree more that throughout treatment we need a whole-person approach. It is the stated aim of the Government to develop that offer in our communities and in our national health service. The extraordinary toll it takes on friends and families is something that our health system should think more about, and we should give more consideration to.
The issue is so important that if we do not get it right, as I think Members across the House would reflect, the consequences may be tragic for people going through their most difficult times and experiences. For Sarah and Mike and the countless other people touched by cancer, I urge the Minister to work with me and Mike on improving mental health support for those with a terminal diagnosis.
I am grateful to the hon. Gentleman for opening the debate. I say this mostly for the benefit of those in the Public Gallery, but we are expecting votes in the main Chamber soon. If that happens, I will suspend the sitting and we will reconvene when the votes are complete. I call Jim Shannon.
The hon. Member for Altrincham and Sale West may have a very brief word.
Mr Rand
I thank everyone who has contributed to the debate in a really constructive way, and I hope that we can work together on both sides of this House to tackle this important issue. I am incredibly grateful to the Minister for his response, and for offering a meeting with myself and Mike. Of course, my last thanks go to Mike for sharing his story with me in such a personal and considered way.
I am very grateful to the hon. Member.
Question put and agreed to.
Resolved,
That this House has considered mental health support for people with terminal illnesses.