Health: End of Life

Lord Judd Excerpts

Thursday 12th December 2013 Lords Chamber

[Lord Judd (Lab)]

My Lords, I thank my noble friend Lord Dubs, not only for giving us the opportunity to debate this subject, but for the very sensitive and objective way in which he introduced the debate this afternoon.

Surely it is important, wherever possible, to encourage people to consider their choices of treatment in good time, and for them to have the fullest possible information on which to make well considered choices. If possible, there should always be the opportunity for them to change course.

To believe in human rights must mean the right to control one’s own life for as long as that is possible. That must include the right to seek release from intolerable suffering—not only for yourself but for those around you. Sometimes, sadly, it is just not possible for a person to communicate their wishes, which places a huge responsibility on others who are involved.

Some people of my own faith take an inflexible and absolutist position on this, but there will never be an escape from the responsibility of applying love, understanding and compassion in all that is decided. It is never a matter of just clinically managing a decision on the end of life: there are the real issues of direct, indirect or supposed pressure, and it is always a matter of profound consideration of the individual as an individual. The input, if possible, of those who have known the patient for a long time will be a crucial part of this. The physicians should include, wherever possible, a doctor who has cared for the person concerned for a long time.

Meanwhile, how much of a priority is invariably being given in all training—not least of doctors—to end-of-life care? With increasing longevity and ever-growing survival prospects, dealing with the terminally ill and dying leads to a constantly greater demand on medical professionals and takes up an increasingly important part of their professional lives.

It is absolutely clear that the majority of people do not want to die in hospital, and seek the psychological or emotional security of home or a hospice. What I have experienced from my own involvement as the president of Hospice at Home West Cumbria is that that concept of a hospice at home can be a very valuable available choice. It brings together a community of professionals and volunteers. While the volunteers seek to achieve professional standards in all that they contribute, the professionals are really volunteers themselves in bringing a quality of commitment which is way beyond what could be expected from a contract. At its best, there is a culture of teamwork and mutual support. Volunteers can have a sensitive and effective part to play in family support and bereavement counselling. Strengthening all this is the accessibility of what the hospice offers, very much on a socially inclusive basis, and the widespread feeling in west Cumbria that it is “their” hospice to which they have a responsibility, not least in fundraising. I am convinced that this broad base contributes to a reassuring sense of belonging among patients and families alike.

What is essential is a close, flexible and imaginative working relationship between the hospice and the NHS—a context of mutual support, recognised interdependence. While the hospice can ease the pressures on the NHS, the latter is indispensible to ensuring, for example, support for specialist services, particularly palliative care and pain relief.

It is very significant, when we are looking at the future of health services in our countries, to see the relevance of that kind of initiative. I hope that the Government take it seriously, and that they can play their part in making sure that the necessary resources are available.