Palliative Care

– in the House of Lords at 2:55 pm on 8 November 2005.

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Photo of The Earl of Dundee The Earl of Dundee Conservative 2:55, 8 November 2005

asked Her Majesty's Government:

What plans they have to fulfil their commitment to double investment in palliative care services.

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, the details of delivering our manifesto commitment are being discussed with a range of key stakeholders. Alongside this, the views of the public, service users and staff on end-of-life care is one of the issues covered in the Your health, your care, your say consultation process at present in progress. We will be taking account of what people have to say in this consultation in the way we discharge our manifesto commitment.

Photo of The Earl of Dundee The Earl of Dundee Conservative

My Lords, I thank the Minister for his reply. Does he accept that government funding of adult hospices, at 34 per cent, and of those for children, at only 4 per cent, makes hospices the largest fund-raising cause in the United Kingdom? Which improved percentages of public funding for adult and children hospices will therefore be achieved when the Government fulfil their commitment to double investment in palliative care services?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, I fully accept the tremendous contribution made to health and social care services by the voluntary sector in the hospice movement, both in adult and children services. That is strongly supported by the Government, who, as the noble Earl knows, continue to put extra money into palliative care. About half of the extra £50 million we have put in recently went to the voluntary sector in this area. It was made very clear that our manifesto commitment was about increasing opportunities for people to be treated at home, not in other services. Clearly the hospice movement will have some contribution to make in that area.

Photo of Lord Ashley of Stoke Lord Ashley of Stoke Labour

My Lords, the Government's commitment to doubling investment in palliative care is, of course, welcome. But, given the fact that only some 1 per cent of people who die from causes other than cancer receive palliative care—in other words, 99 per cent do not receive such care—the doubling of the investment is inadequate. Does my noble friend agree that what we really need is a very significant increase in funding and other resources?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, we discussed this issue very fully in our debate on 7 July. There was a general acknowledgement that the Government had done a reasonable job in taking forward support of palliative care, although we all recognise that more needs to be done. As to implementing the manifesto pledge, the services will be extended to include children as well as adults and patients with conditions other than cancer. So we will be extending choice in this area when we do what needs to be done to implement our manifesto commitment.

Photo of Baroness Finlay of Llandaff Baroness Finlay of Llandaff Crossbench

My Lords, do the Government recognise that there are already half-a-million patients per annum in this country who would benefit from specialist palliative care skills to maximise their quality of life and allow them to be at home as much as they would wish, but that some PCTs seem unable to meet their commitments to hospice providers providing care in the community?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, I pay tribute to the noble Baroness for the work that she has done in this area, which is of international renown. We have shifted the balance of power to primary care trusts, which are best placed to make judgments about the support to be given to their local services. We have not only shifted the balance of power but we have given them a five-year period of roughly a 9.5 per cent cash increase year on year to expand the services in their areas.

Photo of The Bishop of Newcastle The Bishop of Newcastle Bishop

My Lords, bearing in mind the report of the Select Committee of this House which stated that Britain is a world leader in palliative care but that this branch of medicine is underfunded, when will the Minister be able to give an assurance that more funds will be forthcoming? Will he assure the House that what is euphemistically known as "assisted dying" will not be seen as an alternative to allocating the resources needed so that every terminally ill person receives the palliative care that he or she needs right across the country?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, I made clear in our debate on the Assisted Dying for the Terminally Ill Bill that the Government have a position of neutrality in this area. I have nothing to add to what I said then. We were the only party to put in its election manifesto a commitment to improve funding for palliative care. We will honour that promise. We are consulting the public. We want to listen to what they have to say and to stakeholders, including organisations such as Marie Curie Cancer Care. We will come forward with proposals as soon as those consultations have been completed.

Photo of Baroness Neuberger Baroness Neuberger Spokesperson in the Lords, Health

My Lords, given that the Government have made a commitment to increase funding, as well as listening to the consultation, will they look at the lack of funding, particularly for older people who are dying of conditions other than cancer? Whatever comes out in the consultation, that is a serious inequality in care provision.

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, people will have to be patient until we complete the consultation. There is no point in our making policy until we have heard what the public and stakeholders have to say. We shall bring forward proposals at the end of that process.

Photo of Baroness Knight of Collingtree Baroness Knight of Collingtree Conservative

My Lords, did the Minister mean to imply that there will be no action until the public's voice has been heard? He has mentioned consultation twice. How is it being carried out and when should we expect to know the result?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, we have been through a process of extensive consultation, which has still not been completed. There are questionnaires on websites; 1,000 people met in Birmingham from all over England 10 days ago, when their views were taken on a wide range of issues, including end-of-life issues; and there have been regional consultations. There are many opportunities to find out what we have been doing on the Department of Health website, which the noble Baroness can read if she wishes to do so. Those consultations will lead to a White Paper at the turn of the year, when all will be made clear.

Photo of Lord Laming Lord Laming Crossbench

My Lords, it is encouraging to hear the Minister paying tribute to the remarkable contribution that volunteers make to the hospice movement both in bedded units and in people's homes. Does he agree that there is a danger of volunteers being exploited, and that far too much of their time is diverted into fundraising when they would be much better employed supporting people with special needs?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, there is always a balance to be struck. As a former chairman of the National Council for Voluntary Organisations, I know that the voluntary sector often strikes the balance between fundraising and service provision very well. It is in the nature of the voluntary sector that a degree of fundraising goes on—that is what makes it the voluntary sector. I pay tremendous tribute to its work on palliative care; long may it continue.

Photo of Lord Lyell of Markyate Lord Lyell of Markyate Conservative

My Lords, would it be wholly unjust of noble Lords listening to the Minster's answers if we had the impression that this widespread consultation and the wait for a White Paper might involve a small element of treading water? Will the Minister take care to listen to those professionals in the day-to-day care of the elderly in hospital, who know how badly the opportunity for further palliative care at home is needed? Can he find a quicker way of providing money for that?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, one of the features of this Government—and the reason they have been re-elected three times—is that they listen. I note that the two candidates for the leadership of the noble and learned Lord's party seem to be learning some of those lessons.

Photo of Lord Patel Lord Patel Crossbench

My Lords, will the Minister confirm that the Government and Marie Cure Cancer Care are discussing extending the Delivering Choice programme to a further 11 sites, to improve end-of-life care for patients, irrespective of their diagnosis? When are the chosen centres likely to be announced?

Photo of Lord Warner Lord Warner Minister of State, Department of Health, Minister of State (Department of Health) (NHS Delivery)

My Lords, the initiative referred to by the noble Lord has been discussed, and will continue to be discussed between departmental officials and Marie Curie Cancer Care. The initiative has been taken by Marie Cure itself, which is in the driving seat in terms of how rapidly it wishes to roll it out. We shall have to wait until the consultation process is completed before deciding how we spend the money promised in our election manifesto.