Hospices and Palliative Care Services

Lord Alderdice Excerpts

Wednesday 15th December 2010 Lords Chamber

[Lord Alderdice]

My Lords, I thank my noble friend Lord Bridgeman for not only securing the debate but for introducing it with his usual elegance and eloquence. I identify myself both with his comments and those of the noble Lord, Lord Faulkner of Worcester, in praising the importance of the hospice movement and its work, the significance and value of voluntarism, and the need for public, financial and other resource support.

In the short time available to me I wish to address one specific issue—the need for thoughtful and real support for the staff who work on the front line in the hospices. Some years ago I became aware of this issue when I was doing a consultancy for the Belfast Hospice. It became apparent to me that there is a specific kind of emotional strain and stress on those who work in the hospice movement on the front line with the patients. With all other forms of care, there is a variegation of patients and the acuteness of their problems. However, in a hospice, when a patient comes in everyone knows that this is moving towards the end and there is an intensity about the emotional involvement that is quite unique.

In addition, the situation moves inevitably to a form of bereavement. Even if the patient moves out of the hospice and comes back in, it is inevitably moving in that direction. As human beings we are created in such a way that we can deal with bereavement and emotional intensity, but what I saw with some of the hospice workers who were working on the front line with patients was a psychological equivalent of march fractures. All the time there was the development of a close emotional bond and then the experience of bereavement—and then straight into the same situation again and again and again. Many of those who experienced this time after time themselves became subject to emotional trauma—sometimes they fell physically ill—after a number of years.

If these workers were able to move out into another aspect of hospice care—education, administration or teaching—or to move into the NHS and bring with them their experience of palliative care, pain relief and dealing with cancer and other terminal illnesses, they would be freed of that emotional involvement and make a tremendous contribution. The burden of my request to my noble friend is that the NHS will engage with the hospice movement to provide opportunities for support and constructive engagement that values the experience of those involved in the hospice movement but ensures that they do not find themselves suffering because of the enormous emotional commitment they made to this peculiarly special and costly form of caring.