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Access to Palliative Care and Treatment of Children Bill [HL] - Second Reading

Part of the debate – in the House of Lords at 2:10 pm on 7th February 2020.

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Photo of Lord Berkeley of Knighton Lord Berkeley of Knighton Crossbench 2:10 pm, 7th February 2020

My Lords, it is a pleasure to follow the noble Baroness, Lady Stroud, and I agree with a great deal of what she said. It is also a privilege to have heard, and be able to salute, the excellent maiden speech of the noble Lord, Lord Brownlow of Shurlock Row. The points he touched on suggest that he will be a valuable addition to your Lordships’ House.

I am delighted, too, to support my noble friend’s Bill for a variety of reasons. I hope that the Government will find our deliberations constructive, whichever way they feel they must go at the end of our debate, because there is considerable room for improvement in end-of-life and palliative care. My noble friend Lady Finlay is absolutely right about that. I hope she will forgive me but I must say that, curiously, I come to support her through our divergence of views over assisted dying. My noble friend eloquently opposed assisted dying because, as with so many of the medical profession, she felt it incompatible with her role as a doctor but also—perhaps more importantly, relative to our discussion today—because she feels that in this day and age no one should die in pain, given the palliative care that is potentially available. That is at the crux of her Bill.

There was, as I recall, a fairly widespread desire in the assisted dying debate to see better palliative care. I completely accept that assisted dying is a matter of principle that goes well beyond the scope of this Bill; nevertheless, there are several areas where the two debates intersect. They intersect because though no one should now die in agony, the fact is that they sometimes do. Even if that is seldom the case, which of course we all hope, what is beyond contention is that palliative care and hospice availability is something of a postcode lottery, as we have heard.

Before going any further I pay tribute to the many quite exceptional staff, up and down the country, who provide absolutely wonderful care and support, which amounts to love and compassion. I have been privileged to witness this and was deeply moved by the generous commitment of staff. We hear all too often about abuse and cruelty in the care of the elderly and vulnerable, and of course that is terrible, but not often enough about examples of best practice in our hospices or the dedication of doctors such as my noble friend. To find oneself at the end of life in one of these hospices with an enlightened consultant is great fortune indeed. But it should not be a question of good fortune or luck, or depend on where you live.

One thing that is certain in this world—even in your Lordships’ House—is that every one of us will die. Many of us will not need neurosurgery, cardiac treatment or a new hip but we will, as sure as night follows day, vacate our perch. We should face that unavoidable fact, not morbidly, but with imagination and creativity. We will not all die in our sleep, quietly and peacefully, however much we might wish for that—although palliative care can help. Surely the one thing we all want is the best possible medical assistance to lead us gently from one world to the next, even if the next is only the unquiet grave.

It is odd, as my noble friend has pointed out, that this area of medicine suffers in comparison with other healthcare services. It is good, as we have also heard already, that the Prime Minister announced in August last year that £25 million would be provided for hospices and palliative care services. Unfortunately, spread over these combined care facilities, that does not go terribly far, so I ask the Minister, as others have done, whether there will be a similar figure for 2020 and possibly for succeeding years.

I turn to the second part of the Bill. Clearly, the painful cases—and, oh, how painful they are—where medical advice goes against the wishes of the family of children receiving treatment that doctors might wish to withdraw or alter, and where a High Court application has to be made, are circumstances that we should seek to limit as much as possible. Whether mediation, a necessarily rather amorphous and pliable concept, could assist in reducing such applications I am not quite sure—fortunately, I shall be followed by a much greater legal mind than mine—but anything that helps the relationship between the parties has to be welcomed.

Both these subjects are sensitive, even taboo to some, but airing them with clarity and compassion can only help us to find better ways of living and, indeed, dying.