Baroness Finlay of Llandaff: My Lords, I beg to move that this Bill be now read a second time.

I bring this Bill to you 40 years since St Christopher's Hospice opened, and 20 years after the specialty of palliative medicine was officially recognised. What does my Bill do? It lays an obligation on all health service commissioners and providers in England and Wales to work towards ensuring that specialist palliative care services are available for terminally ill people with complex needs and that generalist services can deliver care to meet the ordinary general palliative care needs of patients in the healthcare system as a whole. Such care should be available wherever the patient is. To that end, the Bill requires the development of positive palliative care strategies and annual reports on their achievement.

This is nothing new. Between 1987 and 1999, the Department of Health issued at least eight circulars or executive letters exhorting health authorities to develop palliative care strategies, but co-ordinated strategies have not happened across the board in 20 years. I have contacted all 10 strategic health authorities in England, but I have received very varying responses to my request for their strategies, drawing a blank on four of them. It is hardly surprising that the voluntary sector finds it difficult to plan and provide in partnership with the NHS.

What is palliative care and why is it defined as it is in the Bill? Palliative care provides care for patients with advanced, progressive, incurable illness to live as well as possible until they die of their disease. That covers advanced disease of any diagnosis, not just cancers, and it is not confined to only the last days, weeks or months of life. The definition in my Bill is taken from the guidance of the National Institute for Clinical Excellence in 2004 on improving supportive and palliative care for patients with cancer. It is equally applicable, however, to patients with other illnesses and to all ages, and it has been nationally accepted as the working definition. It states:

“Palliative care is the active holistic care of patients with advanced progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount”...

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