End of Life Care

John Glen Excerpts

Wednesday 2nd March 2016 Commons Chamber

[John Glen (Salisbury) (Con)]

It is a great pleasure to make a modest contribution to the debate. When I speak on matters to do with the NHS, the emphasis always seems to be on more resources, greater transparency, greater accountability and greater universal provision of reliable quality. Everything is important in the NHS—everything is a priority—but the resources are not infinite.

End-of-life care is a painful and emotive subject that is difficult to get right. As has been mentioned, about half a million—I think the actual figure was 470,000—people died in this country in 2014. They died in different circumstances, with wide variations in their experiences of what the NHS was able to offer. In my constituency, I acknowledge not only an excellent hospital and a number of GPs, but a high level of respect in our community for Salisbury hospice. One of the challenges is to arrive at a settlement that makes clear where the boundaries of responsibility lie between funding from the NHS and the charity element. Clearly, there is a massive amount of good will, but that must not be abused.

The national director at Hospice UK has said:

“The things that make a better death are so simple. It’s basic knowledge about good pain control and conversations with people about the things that matter”.

That goes to the heart of what is required. It will be about resources, to some extent. It will be about transparency, and greater reliability and sufficiency of provision. But it will also be about us, as leaders in our communities, being able to speak about our constituents’ experience of dying. Just as we put great emphasis on the provision of wills to ensure that people’s estates are in good shape, we need to ask people what choices they want to make about the way in which they are looked after and cared for in their last days. We need to ensure that people have greater awareness and make more informed choices so that we can make a better estimate of how to allocate resources and better integrate the different elements in our society.

One challenge that has frustrated me concerns free social care at the end of life. The Select Committee recommends in its excellent report that

“the Government clarify the eligibility criteria for the NHS Continuing Healthcare Fast Track Pathway”.

Some of my constituents have waited far too long to have such matters resolved; for example, I raised the situation of the Vaughans last week in business questions. Ambiguity and long delays in sorting things out cause enormous distress to families who are trying to make sensible provision.

I recognise the great emphasis that is placed on dying at home, and the tragedy that almost half—47%—of the 470,000 people who died in 2014 died in hospital, although the latest survey shows that only 3% of people who stated a preference wanted to die in hospital. By any measure, that is a failure of society, Governments and us all in not delivering what people want. That is not efficient for public services—it is more expensive—but it is also really unpleasant for the families involved when they cannot deliver what their loved ones want.

I hope that the Government will be able to give real and costed responses to the report and to all the various groups that have commented on the need for greater clarity about the Government’s intentions. Our constituents need that, and we need to do more to ensure that this does not become a taboo subject, but one on which there is greater engagement, so that we can secure better outcomes for those who are dying and for their families.