Access to Palliative Care Bill [HL]

Lord Haskel Excerpts

Friday 23rd October 2015 Lords Chamber

[Lord Haskel (Lab)]

My Lords, in the years that the noble Baroness, Lady Finlay, has served in your Lordships’ House, she has been a fighter and a champion for better palliative care, particularly in her home country of Wales. As a result, Wales has a system of seven-day specialist palliative care which many organisations say is good and successful, and when the noble Baroness wants to bring this to us here in England, we should sit up and take notice.

As the noble Baroness explained, here in England it is up to the clinical commissioning groups to allocate resources to palliative care departments in hospitals or to buy it in from hospices and other organisations—not only beds but their expertise. Apparently there are many guidelines, and many separate agencies—as well as doctors, nurses and the carers themselves—are involved. There are new ways of controlling the pain, as the noble Baroness, Lady O’Neill, just told us about. The Bill seeks to bring order and lay down a more comprehensive approach. The Care Quality Commission is required to examine and evaluate this. This requirement for better care, better organisation and better targeting surely must be welcomed because, as the noble Baroness, Lady Finlay, said, the variation between what is done and what should be done is quite large. This month’s report from the Economist Intelligence Unit points out that such improvements in end-of-life care need not cost more—it just has to be managed and organised better, which is what the Bill seeks to do.

I therefore welcome the Bill; but does it go far enough? For my part, I would welcome a clearer framework for people approaching the end of life to make their own decisions. Other noble Lords have referred to this. The Bill refers to advance decisions to refuse treatment and the Mental Capacity Act, but conversations and discussions need to start early. The Bill deals with patients once they have been confirmed as being end of life. But would discussions and earlier identification not help? That would enable more input from the patients themselves, so that people can have the end-of-life care that they wish for and which is right for them. I welcome the briefing from Compassion in Dying—yes, it did arrive in time—which supports, and even provides, advance decision forms. Can the noble Baroness, Lady Finlay, say how her Bill will help earlier identification and help people to make choices for end-of-life care and know that their choices will be respected?

I congratulate the noble Baroness on the Bill. The changes it proposes and the standards it lays down for the best palliative care possible deserve the support of all noble Lords.