The gap between palliative care need and provision is as wide as ever...
The gap between the need for palliative care and its funding by the Government is not getting any smaller. Writing for the Guardian recently, palliative care professor Baroness Ilora Finlay examined the links between Labour's past promises on palliative care funding, the poor state of hospices' current coffers, and our societal attitudes to the dying.
Our society's current leader, Prime Minister Gordon Brown, has written of his admiration for Cicely Saunders, the founder of modern-day palliative care. Yet the Government is sending out mixed messages about the importance it places on palliative care: hospices are at least as badly off as they were in 2005 when Labour pledged to double end-of-life funding.
Back in 2004 the Government gave voluntary sector hospices £99m. And last year, 2006, it gave slightly more, £112m; yet over that time hospices increased their services - and therefore their costs - 'in the face of increasing need'. As Baroness Finlay said, 'Hospices are not death houses...they provide care for up to 80% of those with terminal illness, doing the job the NHS is not doing, while some obtain only about 10% of the costs from the NHS.'
On top of this, even services already funded by the NHS - such as most specialist palliative care teams based in hospitals - are being threatened with budget and/or service cuts.
And the Government is not giving high legislative priority to palliative care either. The Palliative Care Bill, brought successfully by Baroness Finlay to the House of Lords in February this year, was not granted time in the Commons this parliamentary season.
Grinding despair or peaceful closure?
In her article, Professor Finlay emphasised the desperate need thousands of terminally ill patients have for good symptom control:
No one can overstate the grinding despair from unrelieved symptoms and poor care, nor deny the evidence that palliative care can improve the quality of life - however long is left - and result in a peaceful close at the end of life.
The beginning and the end of life affect each and every one of us. In contrast to all other aspects of healthcare, end of life medical care is only patchily provided by the NHS, yet safe passage at both ends of life needs expert care.
The heart of the matter
Recognising that lack of adequate care is a key part to individuals' and lobbying groups' calls for the legalisation of assisted dying, the Professor called for society to be able to 'work to improve even our last days'. To do otherwise implies that we become of less value when we are old, ill and fragile:
If society has a humanitarian heart then it must ensure that its vulnerable are cared for with respect for the individual, with care given in a way that enhances an individual's dignity and that includes meticulous attention to detail in managing all symptoms and causes of distress however trivial they may seem..failure to fund services that are trying to give that commitment means society becomes utilitarian...To fail to fund specialist palliative care adequately is to state that the quality of life of those with life threatening illnesses does not matter.
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Care Not Killing