More work needed until Wales offers “compassionate” end-of-life care

(Title Image: © Copyright Tony Hodge and licensed for reuse under Creative Commons Licence BY-SA-2.0)

The Motion

The Senedd:

 

  • Notes the Cross Party Group on Hospices and Palliative Care’s report on Inequalities in Access to Hospice and Palliative Care.
  • Acknowledges that approximately 23,000 people in Wales have a palliative care need at any one time, including over 1,000 children.
  • Recognises that whilst some progress has been made in widening access to hospice and palliative care in Wales, there remains significant unmet need and under-met need and calls on the Welsh Government to address this.
  • Calls on the Welsh Government to outline how Wales will become a ‘compassionate country’ and ensure the strengthened provision of palliative care is made central to this approach, fix data gaps, update funding mechanisms for charitable hospices and increase the level of direct funding provided to adult and children’s hospices.

Unmet and under-met need

Shadow Communities Minister, Mark Isherwood AM (Con, North Wales), said the cross-party group found that while access to palliative care has widened, there were still gaps, particularly concerning bereavement support offered to families of patients who’ve died in intensive or acute care.

“….despite their importance within wider care service provision, hospices are experiencing a number of challenges, which impact on their ability to provide sufficient support services. These include a lack of statutory Welsh Government funding, resulting in financial pressures that are restricting the ability of hospices to provide services; an out-of-date funding formula leading to a postcode lottery of services; and unmet need caused by a lack of specialist palliative care staff.”
– Shadow Communities Minister, Mark Isherwood

£28million of the £36million budget of Wales’ hospices was raised through fundraising and statutory government funding has “flatlined” and was lower as a proportion of all funding compared to England and Scotland. The need for reform was more apparent with 75% of the 34,000 people who die in Wales each year requiring some form of palliative care.

Helen Mary Jones AM (Plaid, Mid & West Wales) tabled amendments to the motion stressing the importance of carers and their particular needs depending on the circumstances of the person they’re caring for. She also acknowledged the progress made, but the evidence was now there on what needed to be done to make Wales a “compassionate country”.

Shadow Social Care Minister, Janet Finch-Saunders AM (Con, Aberconwy), said 6,000 people could be missing out every year on the palliative care they need. The funding formula hasn’t been reviewed for a decade meaning some hospices receive more funding than others.

John Griffiths AM (Lab, Newport East) raised concerns that hospices haven’t received a pay rise passported from health boards with a dispute over whether the money has already been provided or not. Mohammad Asghar AM (Con, South Wales East) said the report found significant regional variations as well as concerns over staffing pressures as the likes of GPs and district nurses who co-ordinate palliative care.

Weaknesses are being addressed

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), maintained that the Welsh Government’s policy is for anyone requiring palliative care to access the best possible care.

“We invest over £8.4 million annually to support specialist palliative care services and to take forward the actions in the delivery plan. We are making real progress. We have resources and facilities in place to support advance care planning to ensure that adults and children are central to the design of their care; we have a single all-Wales ‘Do not attempt cardiopulmonary resuscitation’ form to ensure that people’s wishes are respected; and we have a serious illness conversation training programme to ensure that our staff are equipped to handle what can be very difficult conversations with clarity and compassion.”
– Health Minister, Vaughan Gething

Comparisons with the rest of the UK on funding weren’t exact because of different ways different health services work with hospices. To meet the vision of a compassionate country, some taboos around dying need to be addressed and end of life care should be supported and celebrated. A fresh review is due to be published in December and a government statement on end-of-life care is due in the new year.

Vote

A softer-worded motion tabled by the Welsh Government acknowledging progress was passed by 27-9 with 11 abstentions.

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