Hospices and Palliative Care Services

Earl of Selborne Excerpts

Wednesday 15th December 2010 Lords Chamber

[The Earl of Selborne]

My Lords, I join others in thanking my noble friend Lord Bridgeman for introducing this debate and giving us the opportunity to talk about the future of hospices and palliative care. Like my noble friend Lord Bridgeman and the noble Baroness, Lady Masham, I make a plea for the cause of palliative care in the community. I declare an interest as a patron of a charity called Hospices At Home TLC, which operates in Hampshire, where I live, West Sussex and Surrey. Developed from the palliative nursing service and funded by the Big Lottery, it provides help for adults with a limited life prognosis and their family and carers.

As my noble friend Lord Bridgeman reminded us, surveys consistently show how many people would prefer to have support at home and to die at home if that is feasible. Of course this requires the relevant level of care in the community to be provided. My noble friend mentioned that the significant figure of £160 million could be saved, but specialist therapies, specialist medical equipment, volunteers working alongside nurses and bereavement counselling are the sort of services which are being provided by charities and the hospice movement.

There are difficulties, some of which arise from the interface with the primary care trusts. Sometimes they are not always aware of their own criteria for qualifying for continuing care in the community. While the gold standards framework aims to improve the organisation and quality of care for everyone in the last years of life, it is often when a patient is placed on the palliative care register that patients and families and carers are not able to understand just what support, and further support as the condition changes, is available within the primary care trust area. I simply make a plea that everyone involved with the primary care trusts not only understands for themselves the criteria for support but makes them accessible in a way that everyone else can understand. We need to move towards a national cover for palliative care services in the community. We are enormously lucky in our area to have just such a cover.