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Palliative Care

My Lords, it appears that the noble Baroness, Lady Murphy, is not with us; I had not realised that. She, too, may be struggling to get here. I am most grateful to the noble Baroness, Lady Finlay, for raising the matter, in which I have previously had particular involvement—although not in recent times. I am also delighted that my old colleague, my noble and learned friend Lord Lyell, has managed to get here, and look forward to hearing him speak. I gather that he will probably speak after my noble friend Lady Rawlings. We are not doing too badly, bearing in mind the absolute horrors of public transport in London today. I should declare an interest. I was president of Help the Hospices from 1992 to 1998. Among the many dedicated, devoted and caring people whom one met in the hospice movement at that time, two stand out with enormous prominence and clarity. The first was, of course, Dame Cicely Saunders, who has been referred to before. She was a quite remarkable lady who founded the first modern research and teaching hospice in 1967. I understand that at present she is not very well. Therefore, it would not be inappropriate for a message to go forth from this debate, from all sides of the House, wishing her well and thanking her most warmly for the marvellous work that she has done over the years. Looking at some of her articles, I came across a definition of palliative care which she and a small group produced some years ago. She said,"““Palliative care starts from the understanding that each human being is a person, a single bodily and spiritual whole, and that the proper response to a person is respect. Respect means being so open to each man, woman and child, not as simply an isolated individual, but as someone with a story and a culture, with beliefs and relationships, that we give them the value that is uniquely theirs””." I know some not well informed people often think of the hospice movement as being basically a Christian movement. Of course, it is not in any sense. One should remember that Muslims, Buddhists, humanists are all embraced within the work of hospices. The other person is someone referred to by my noble friend Lord Newton, Anne, Duchess of Norfolk, who, as he said, founded Help the Hospices in 1984. She is coming up to an anniversary. I would not say she is coming of age—in my day one came of age at 21, but now it is rather earlier—but it is an important anniversary. She is a very remarkable person. She brings her unique personality to fund raising. She does not to bully, but she cajoles and persuades all kinds of people to support the work of Help the Hospices for which we are all the better. Both of those wonderful women have encouraged many others in what they are doing. We have to remember that hospices, although an important part of palliative care, are not the whole of it by any means. I certainly do not have the expertise to talk of the other aspects of palliative care. The briefing that I have received shows the shortage of hospice provision is a result of continual under-funding through the sector as   a whole. The representatives of the Marie Curie Cancer Care and Help the Hospices in their briefing have both underlined that fact. Of course, there has been a very widespread welcome to the pledge in the Labour Party manifesto of the doubling of the investment over the coming years. The difficulty is that it does not say what the investment to be doubled is and it does not say for how many years it will be doubled. Therefore, I echo very strongly what my noble friend Lord Newton said to the Minister. Can he spell it out in greater detail? I confess that 30 years ago I had a hand in drafting the manifesto for my party and I know that the words are chosen with infinite care to   create impressions, though not necessarily clear pledges. I therefore very much hope that the Minister, whom we all respect for his support and knowledge in these areas, may be able to help us, if not today, at least in the future by producing a paper that would go some way to ensuring that the expectations held for greater support in the whole area of palliative care are not disappointed. I want to refer to two other matters. The first of them, which was also mentioned by my noble friend Lord Newton, is children’s hospices. One has opened in my old parliamentary constituency and I have noticed that it does not quite make clear the area that it serves. It appears to serve more than one primary care trust and not to get very much from any of them. I wonder whether the Minister can elaborate on why children’s hospices generally get roughly 5 per cent of their costs through official funding, whereas the figure for adult hospices is over 30 per cent. Secondly, I refer to training. Recommendation 18 of the House of Commons Select Committee on Health made the very important point that there should be more training for all staff involved in and associated with palliative care. Of course, that is a matter for the royal colleges and the GMC. However, as was said in their response to that Select Committee’s report, the Government are encouraging those bodies to do better, and I should be grateful to hear what exactly is to happen in that regard. I conclude by sincerely acknowledging the very considerable help that the Government have given in the field of palliative care. As a Minister once responsible for such matters, I can say that, as ever, one always wants more and that more is really needed. I therefore hope that this debate will go some way to encouraging the Government to provide that extra help.