Access to Palliative Care Bill [HL]

Lord Maclennan of Rogart Excerpts

Friday 23rd October 2015 Lords Chamber

[Lord Maclennan of Rogart (LD)]

My Lords, it is a privilege to follow the noble Lord, Lord Howarth, who focused very much on the area I intend to speak about, which is children. I am grateful to the noble Baroness, Lady Finlay of Llandaff, for bringing forward this Bill because I believe that the best palliative care is helpful to families as well as to dying people. We need to spread this form of care, which at its best can be very good, across the country.

The Royal College of Physicians points out that only 21% of sites have access to face-to-face palliative care seven days a week, which is a recommendation that has long been advanced. It also shows in its National Care of the Dying Audit—Hospitals, which was completed in 2014, that mandatory training in care of the dying was required for doctors in only 19% of trusts and for nurses in 28%, despite national recommendations that such training should be provided. That is not satisfactory and this Bill should help the position considerably. The audit also mentions that 53% of trusts have a named board member with responsibility for care of the dying, but 47% do not. That seems unacceptable, and I hope that it will be taken into account in the implementation of this Bill.

The clinical reader in palliative medicine at Oxford University, who no doubt sent his letter to most Members of the House, points out that there needs to be an awareness that palliative care is a form of emergency medicine and intensive care. It needs to be proactive to prevent crises as well as reactive to cries for help, and that sensitive communication skills embedded within a holistic approach is key to quality palliative care.

On the issue of children, we have had an extensive and thoughtful briefing from the charity Together for Short Lives. It is somewhat disturbing that the number of children with life-threatening and life-limiting conditions has gone up from 30,000 10 years ago to 40,000 today. It is clear that we need to be specific about how to help children and young people. The noble Lord, Lord Howarth, was very specific and I embrace what he had to say. However, we have heard that between 2013-14 and 2014-15, 23% of children’s hospices have had their funding cut as a result of financial restrictions on NHS commissioners. I hope that that will be noted by the Government and that their response will be positive. The treatment for young people with the expectation of short lives is clearly different from that for older people reaching the end of their normal lives. It requires specialist education, and I hope that that will be considered. The professional skills, experience and competencies needed to care for children and young people are not adequate, and should be a necessary part of the education of nurses and doctors.