Ageing and End-of-life Care

Debate between Julie Minns and Jim Shannon

Thursday 30th October 2025 Commons Chamber

[Jim Shannon]

The hon. Member is absolutely right. Politics aside, I want the Minister and the Government to do the job. It does not matter who the politician or the political party is; let us just give our people some hope. That is what I wish to see come out of this.

What assessment have the Government made of the need for a national strategy for palliative and end-of-life care? How will the Government ensure that palliative care specialists are included in neighbourhood health centres? What progress are the Government making on ensuring that every person with palliative care needs in the UK has access to a 24/7 support and advice line?

I believe that we can find a route towards an acceptable standard of life not simply for those who can afford private healthcare, but for all in our ageing communities. I understand that the Minister has a copy of my notes, and my seven points will be in there. To realise the 10-year plan objectives, which I have clearly said I support and want to see happen as soon as possible, palliative and end-of-life care must be recognised as a vital part of our health and social care system. Without making palliative and end-of-life care a priority for health reform, the Government will not achieve their bold ambition to provide more care in the community. I want the Government to achieve that ambition.

[Ms Julie Minns (Carlisle) (Lab)]

I spoke earlier to the hon. Gentleman to ask if he would take an intervention. When earlier this year my mum was placed on end-of-life care—she was put into the local hospital to receive that care—I had to repeatedly ask hospital staff to transfer her to our local, excellent Eden Valley hospice. It took three days for that request to be actioned. Does the hon. Gentleman agree that one change we could make is that, when someone in our hospitals is placed on end-of-life care, their families could be immediately apprised of the alternative provision that exists in our communities?

[Jim Shannon]

The hon. Lady is absolutely right—by the way, that is one of my seven points. We have spoken, but not exactly about that. The debate brings us together with our requests for the Minister and the Government; we are thankful for that.

Only 38% of those who died aged 85 or older received care from palliative care specialists, compared with 51.5% of those aged 65 to 84 and 59.3% of those aged 18 to 64. To the point made by the right hon. Member for New Forest East, most aged 18 to 64 spent most of their final months in a private home, but fewer than 50% of those aged 65 or older did so. One in seven people—15%—who died in hospital had been in there for less than 24 hours. When someone is coming to their last days, many complex needs are involved—there are also the problems for the family—but they will have to deal with two things in particular: pain, and probably breathlessness.

Almost two thirds of unpaid carers felt anxious most or all the time about the dying person’s illness or treatment. Shifting care from the hospital to the community would benefit older people, support the shift from hospital to community—analogue to digital—and prevent avoidable emergency care admissions. Those are all things that the Government must develop in a national strategy for palliative and end-of-life care.

The strategy must deliver on these seven points. First, an integrated whole-system approach is needed enabling patients at the end of life to move seamlessly through services as their health changes. Secondly, the Government must place palliative care at the centre of plans for neighbourhood health centres and ensure the inclusion of palliative care specialists. A key benefit of including palliative and end-of-life care in neighbourhood health centres will be the earlier identification of palliative care need and greater uptake of advance care planning.

Thirdly, the Government implement models of emergency and urgent care that can minimise avoidable accident and emergency visits. That would provide financial savings for the NHS as well as giving better care in a better system. That also comes to the input of the families, which is the very thing we all wish to see.

Fourthly, the Government need to strengthen the statutory guidance on the legal duty to commission palliative care services in the Health and Care Act 2022. Holding integrated care boards to account for the delivery of this duty must be part of that. Fifthly, we must introduce national quality standards for palliative and end-of-life care that must be met in all health and care settings. That would strengthen accountability while catalysing the 10-year health plan’s targeted shift from hospital to community for patients at the end of life. They must also support more equitable implementation of the vision set out in the ambitious national framework for local action.

Sixthly, there must be access to 24/7 support—the very thing being asked for—by creating a universal gateway to 24/7 specialist palliative and end-of-life care advice, guidance and support through NHS 111. In my constituency, we would say “yin, yin, yin.”

Seventhly, there must be a long-term, sustainable funding solution for palliative and end-of-life care that can reduce reliance on charitable fundraising and ensure parity of esteem for the NHS and non-NHS palliative care workforce. A transformation fund must also be created to invest in innovative and integrated models of care to meet different community needs. The Minister is probably saying, “My goodness, is it just seven points?”, but yes, I will stop at those seven, although I would like to comment on Sue Ryder if I may.

All of these stats can become figures on a page, but when I read them I think of the wee mummy lying on her bathroom floor after a fall, all night in tears; I think of my constituents who sob in my office, begging for help with their dying parent; I think of carers who are run ragged and know that a 15-minute call with that elderly person cannot possibly cater to their hygiene needs as well as feeding them; I think of district nurses who are late home because they would not leave their elderly patient upset after a wound change, and who made them a wee cup of tea and stayed for that comforting chat that time had not been allocated for.

Professor Jugdeep Dhesi, president of the British Geriatrics Society, said:

“Everyone should have access to high quality care until the end of their life, including palliative and end of life care when they need it. Sadly, this is not the case for many older people across the United Kingdom.”

Sue Ryder also asked me to highlight some issues. It is working to create a new ecosystem around palliative and end-of-life care, and to unlock hospital productivity through swiftly shifting care to the community in a progressive way that is sensitive to the resources available across the wider system, and focused on genuine collaboration at a local, place, and system level. The envisaged ecosystem would absorb patients from across the acute setting and increase referrals to community settings, helping our wonderful NHS to use its bed capacity more effectively, and relieving strain on the discharge system. The Sue Ryder model will shift care into the community by increasing hospice-at-home services and virtual wards, funded in line with national currencies and fast-track CHC reform. It is believed that this new approach to hospital care will develop dedicated care, alongside suites on NHS sites to provide compassionate, tailored care for those approaching the end of life, and to relieve pressure on hospital teams.

We must increase support for people in their own homes—that is what I want, what the hon. Member for Carlisle (Ms Minns) wants, and probably what we are all seeking. It is about expanding care in the community through partnerships, virtual wards, and increased hospice-at-home services to help more people die at home and reduce emergency admissions. We must aim to make full use of hospices’ expertise and space to support people with complex multi-morbidities and those in the last 1,000 days of life, preventing emergency admissions and helping people to live well.

I will keep to your timescale, Madam Deputy Speaker; I am coming to the end. The end of life is not a happy topic, but I believe it is a necessary conversation. We must open that conversation to ensure that people feel able to record their wishes for the end of life, so that more of their needs are met by the people involved in their care. We must ensure that there is information, and above all funding to deal with the growing pressure—the family issue that the hon. Member for Carlisle referred to—because how we treat the most vulnerable in our society is the measure that we will all be judged by.

I am no better than anybody else, but as elected representatives you and I, Madam Deputy Speaker, and everyone in the Chamber want to do the best for our people. Today we ask for the best for our people. I work alongside my mum to ensure that her last time on earth is the best we can make it, and I know I can safely say that it is the desire of this House and the Minister to provide that for every person in the United Kingdom of Great Britain and Northern Ireland. But we cannot do it without Government buy-in, or without help from the Minister, and from the Labour Government and those in power. The hospice sector is looking for a way to do things better, so I ask the Minister to join those who know this issue inside out, and find a route to help our ageing community and those in end-of-life care. That is also from Marie Curie, Sue Ryder and Professor Dhesi—all those people, and all of us as MPs on behalf our constituents.

Thank you for your time, Minister, and I look forward to your response.

Adoption and Kinship Placements

Debate between Julie Minns and Jim Shannon

Tuesday 20th May 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mrs Harris. I thank the hon. Member for South West Devon (Rebecca Smith) for leading the debate. The crowd that is present indicates how important the issue is. Adoptive and kinship care is a wonderful thing to offer children a safe and caring environment to grow up in, but there is no doubt that it has challenges that need addressing, and in particular need Government support. It is great to be in Westminster Hall to talk about that.

To give an understanding of the topic, in Northern Ireland there are an estimated 8,000 to 10,000 children living in informal kinship care, and the number of children living with friends and family is consistently increasing. As of March ’24, there were some 4,000 children under the care of local authorities, even though a number of children had been adopted out of care in 2023—there are still many more in care than are being adopted. Northern Ireland, along with Scotland, seems to have the highest rate of kinship care, and there is no doubt that more should be done to support those agreeing to take on the care of relatives.

[Ms Julie Minns (Carlisle) (Lab)]

The hon. Member mentions the challenges that kinship carers face; one is the legal complexity of the current system. I recently spoke to a constituent who has a special guardianship order in place for her grandson, for whom she is the kinship carer. On her diagnosis with lung disease, she went to see whether it was possible to add her son, the child’s uncle, to that agreement. She was told that it was not legally possible—but thankfully, and thanks to advice from the Family Rights Group, she learned that it is. Does the hon. Member agree that more needs to be done to simplify the legal processes around kinship care?

[Jim Shannon]

The hon. Lady is absolutely right. It is frustrating to have a legalistic system that seems to try to hold up the process, when people are looking for a good way forward for the child.

In October 2024, the Government announced that it would provide some £40 million to trial a new kinship allowance in 10 local authorities in England. The aim is to test whether paying some form of allowance to kinship carers could encourage more people to take a family member in when needed. The Government have said that trial will start in the autumn. Finances are often a block, and relatives who already have children of their own often find they simply cannot afford to take on kinship care. Would the Minister and the Government—those who hold the purse strings—consider extending funding for that trial to Northern Ireland and Scotland, where the figures surrounding children living in kinship care with family members are higher? A trial in those two places would give a better perspective, if the Minister does not mind me saying so.

There are many reasons why a family may choose to adopt, but post-adoption support is paramount. I have no doubt that, with specialist long-term assistance, relationships can thrive. Access to therapeutic services for children is incredibly important to support the child’s emotional and mental wellbeing. For example, in education—I find this to be of major importance—children will naturally discuss their family environments, their parents and their grandparents. For many young people who do not have the same environment, those conversations in schools can become uncomfortable for them. Although we have fantastic pastoral support in schools, perhaps it is not a bad idea for outside specialists to engage with those kids in school to ensure that they have the specific support that they need.

Statutory adoption pay is paid at 90% of earnings for the first six weeks and at a further, lower rate of £187.18 a week for the next 33 weeks. Perhaps kinship payments could also be looked at for those relatives who take on care from birth, so that they are not left behind when supporting young children, and giving them the best start.

To conclude, the sacrifice that adoptive and kinship carers make for the lives of young people is incredibly wonderful. Many people out there make that decision for the betterment of a young person and to give them the opportunity to grow up. Government support for them must be unwavering so that they do not struggle, but have access to sufficient finance and wellbeing support. For the children, having access to long-term assistance will allow them to thrive. What more can we ask for in this debate other than their bright futures?

Pubs Code: Guest Beers

Debate between Julie Minns and Jim Shannon

Tuesday 12th November 2024 Commons Chamber

[Ms Minns]

I do welcome that, and I thank my hon. Friend for her intervention.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward this debate. I spoke to her beforehand to ascertain what she was trying to achieve. Strangford has had a resurgence of alcohol production, including the microbrewer Ards Brewing Company, just a few minutes away from me on the Carrowdore Road in Greyabbey. It is a necessity that small brewers can sell in their local pub, and I believe it was a mistake not to allow exemptions for smaller breweries. I support the calls to allow these exceptions. Does she not agree that we must do what we can to let the wonderful craft breweries have a shot in the local market?

[Ms Minns]

I agree with the hon. Gentleman. I have visited and spoken to brewers in my constituency, and they tell me that they just want the chance to compete on a fair basis.