Palliative care : fourth report of session 2003-04 / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
2004
Catalogue details

Licence: Open Government Licence

Credit: Palliative care : fourth report of session 2003-04 / Health Committee. Source: Wellcome Collection.

    43/60 (page 39)
    Conclusions and recommendations 1. Non-specialists in palliative care looking after patients with severely disabling or potentially terminal illnesses must appreciate the value of early referral to palliative care consultants. (Paragraph 22) 2. | While we sympathise with, and support, the aspiration to allow all patients to die at home if they choose, we question how realistic this objective really is at the present time. The option to die at home will only be realisable if there is a guarantee of 24- hour care and support, with back-up from appropriate specialists. In the absence of such back-up, relatives and other carers will, understandably, be reluctant to take care of a patient at home. (Paragraph 23) 3. | Werecommend that the Department of Health should consider the recent economic analysis produced by Marie Curie Cancer Care of the potential cost benefits arising from a shift towards more patients dying in their homes. If indeed there are “massive savings’ to be made from such a shift, as one health Minister predicted, we hope that urgent measures will be taken to develop this strategy. (Paragraph 26) 4. We welcome the suggestion from Dr Ladyman that the Government, following consultation, is considering legislation relating to extra rights for carers in the workplace. The Canadian model of care is itself only at an early stage of development but it seems to offer an imaginative and sensible solution. We recommend that the Department seeks feedback from the Canadian authorities on their experiences of additional support to carers to establish the impact the scheme is having on choice in place of death, the quality of care and on the ensuing costs. (Paragraph 33) 5. | We recommend that the Government legislates to provide for a period of paid leave for carers, taking account of the flexibilities provided by the Canadian model. We believe that such a step would empower many more people to achieve their wish to die at home. We also believe that at least some of the cost to public funds of such a measure would be offset by savings accruing from reduced hospital care. (Paragraph 34) 6. We strongly encourage the Department to support Marie Curie in its efforts to develop pilot schemes, in conjunction with a range of partners, to explore the best ways of supporting carers when someone is dying at home. (Paragraph 35) 7. | When people wish to spend their final days at home, there are particular challenges to health and social care services, and it is vital that they are properly integrated. We are concerned that the emphasis on personal care within social services has been to the detriment of equally important domestic support. We do not believe that it is acceptable for people who choose to die at home to find that they are doing so in increasingly squalid surroundings. Indeed, it is likely that it is poor domestic conditions that often precipitate admission to hospital for people who should be supported so as to be able to remain in their own homes. We recommend that the Department of Health should review the place of domestic support within the overall spectrum of social care services, and ensure that people’s needs for domestic help are