Palliative care, as we know it, was invented by a British nurse, Dame Cicely Saunders, who opened the world’s first hospice in South London in 1967. In 2024 our hospices are having to take hundreds of beds out of use, and lay off staff in the wake of new cost pressures, and a bad year for fundraising.
- Marked rise in palliative care predicted
- MPs back changing the law to allow assisted dying
- Hospice UK warns government of 'broken funding system' in end-of-life care
Have a think about that. This is a branch of medicine the UK should be cutting edge in, funded by neophyte skydivers and cake sales. That’s awful.
In the community, palliative care at home can be delivered superbly by district nurses. But their numbers have halved in the last 14 years. What is filling the vacuum? The answer, as ever in the NHS, is hospitals
I recently witnessed some end-of-life care in the acute sector, and it was dreadful. Hospitals which boast of their prowess in research and innovation collapse in bureaucratic disarray when confronted with someone with the sort of multiple conditions people who are dying present with. This is not a slight on staff, who are caring, skilful and overworked – it’s the wrong place at the wrong time.
In such a landscape how can we justify presenting assisted dying as ‘a choice’? A rushed Private Members bill in Parliament is not the way to go about it. Sure there are ‘the safeguards’. But definitional creep forever stalks medicine, systems never work as they should, and dying people do not always make good decisions.
Credit to Health Secretary Wes Streeting, for making the point that the question of assisted dying needs to be considered with reference to the current state of palliative care. And this to me must include a proper state settlement for the hospice sector which will ensure its long-term future. Otherwise, we are looking at another NHS scandal in early gestation.