Access to Palliative Care Bill [HL] - Second Reading

Part of the debate – in the House of Lords at 10:49 am on 14th June 2019.

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Photo of Lord Browne of Ladyton Lord Browne of Ladyton Labour 10:49 am, 14th June 2019

My Lords, I thank and congratulate the noble Baroness, Lady Finlay, on introducing this Bill to your Lordships’ House. I commend her for her persistence on this issue and for the excellent introductory speech she has made. This Bill deserves to, and I suspect will, garner support from all parts of the House. It is only to be hoped that, on this occasion, the Government Front Bench will join the chorus of support; we shall see.

I am significantly out of my comfort zone debating England’s health policy in your Lordships’ House. I was a Member of Parliament in the west of Scotland for 13 years, for all but two of which we had a Scottish Parliament, and therefore devolved responsibility for health matters. I do not even have a wealth of anecdotes or experience to share with the House; I did not learn very much about health policy during that time. So why, noble Lords may ask, am I taking up precious time to make a contribution to this debate? In explaining why, I will make the one point I want to make.

For the past week or so, I have been preparing to make a contribution to a debate that took place yesterday on inequalities. During the course of my research, I came across an excellent document from Marie Curie, for which I understand the noble Baroness, Lady Finlay, has management responsibility. For those who would like to read it, the document is dated April 2015 and is entitled Equity in the Provision of Palliative Care in the UK: Review of Evidence. I thought I would find evidence of inequality in there and to my horror I did—in spades. Then, I noticed that this debate was taking place, so I did not deploy this argument yesterday but kept it for today. I am pleased to see that we have the same Minister today. She made an excellent contribution to yesterday’s debate and showed a significant degree of empathy for the issues being raised. But I am hoping that she has learned a lesson from yesterday, which I will ask her to implement today.

I do not feel the need to add to the vast amount of evidence of disparity of provision and quality in this space. I went back and read the 2015 debate, and I think I get the Government’s position. I say to the Minister, with all humility and respect, that it will not be any response to this debate to remind us that the United Kingdom sits at the top of some perceived league table on palliative care. That is no answer to the people who suffer from this inequity. It is no answer to those who suffer from care that is not the best it could be. Equally—the recording of this is important—I hope that the people who provide the best palliative care in this country are congratulated on doing what they do at a superb level. But that is no answer to the people who suffer from inequity or from what is not the best care. With respect, it is no answer to say that the infrastructure of the provision of health in this country now puts the responsibility at a local level, and that we do a disservice to localism or local provision if we try to deal with this.

The reason is simple—yesterday’s debate was redolent of it. We know that, if we allow inequity and inequalities to persist, they get worse. They do not cure themselves; they get worse and they become the norm. People put up with it, yet they have no reason to put up with it if something better can be provided. We also know that, whether or not the responsible mechanism for the delivery of the best is local, in an inequitable environment it requires some authority with an aerial view to see where there is better, why there is a difference and how it can be done.

With all due respect to everyone who will contribute to this debate, the noble Baroness, Lady Finlay, has offered the Government an elegant solution to a problem which even the Government accept exists. It is an elegant, easy solution. It should be embraced, and resources should be devoted to implementing that decision once embraced; then the local people can get on and deliver it.