Part of the debate – in the Senedd at 2:53 pm on 16 May 2017.
This week is Dying Matters Awareness Week 2017, placing the importance of talking about dying, death and bereavement firmly on the Welsh and UK agendas—something I very much welcome, as chair of both the cross-party group on hospices and palliative care and the cross-party group on funerals and bereavement. With an estimated 32,000 people dying in Wales each year, that’s affecting somewhere between 160,000 and a third of a million people directly in Wales each year, many vulnerable to serious additional problems—suicide, loneliness, social isolation, anxiety, depression and social problems from stigma to job loss.
But the majority of end-of-life care in Wales is provided by hospices across a range of settings, including in-patient units and hospice-at-home services. There are lessons that the NHS could learn from hospices and especially about the integration of care services in the home community hospital and hospice. I’ve been asking successive health Ministers and our health Secretary here for many years to ensure that NHS Wales starts asking our wonderful community hospice movement how it can help them deliver more for the resources available—in modern, parlance, designing, delivering and co-producing services with them—and too many still feel that that’s not the case. I wonder if you could respond to that point.
Hospices Cymru, as you’ll be aware, are receiving Welsh Government funding on a ring-fenced basis through health authorities over a three-year period. But that period finishes in 2018. Can you provide assurance to them whether that funding will continue to be ring-fenced when the existing funding expires, because they need to know for their forward planning? If not, can you indicate when you might be able to provide that assurance, or at least information?
At 16 per cent to 20 per cent, hospices in Wales still receive far less Government funding—that’s Welsh Government and Welsh NHS funding—than their English and Scottish counterparts. They also highlight a postcode lottery of hospice services, with a disparity of care available between different parts of Wales. When will the Welsh Government finally, in the context of my previous question, recognise that, by discussing, designing and delivering with them on a more balanced funding basis, it’s win-win for everybody, and the means of delivering in a strict budgetary environment?
The end-of-life implementation board, as you indicate, has been allocated an extra £1 million in 2017-18, and one of the provisional areas identified for that is developing a Compassionate Communities approach to end-of-life care. Two and a half months ago, I attended the Marie Curie lecture on a Compassionate Communities approach to end-of-life care, highlighting the need to provide people near the end of their lives with the support they need to remain in their communities by applying health promotion and community development principles and providing support to those who are dying and those who are bereaved. How, therefore, do you respond, not just in terms of a provisional part of £1 million for one year, but to the call by Marie Curie for Wales to become a compassionate nation, following the lines of a Compassionate Communities model that has successfully been developed in numerous towns and communities around the world, including, they say, Frome in Somerset? It’s not about more money; it’s about using the existing money wisely to improve outcomes and lives.
How do you respond to the calls by Age Cymru on end-of-life care for the Welsh Government to provide direction on effective collaboration between local health boards and local authorities to ensure equal access for older people to hospice care, and for the Welsh Government to carry out robust monitoring of the implementation, delivery and outcomes of its palliative end-of-life care delivery plan to determine whether it is delivering real improvements in palliative care and end-of-life care for older people in Wales? How would you respond to Macmillan’s calls for people approaching the end of their life and who would benefit from the support of palliative care services to be identified so that early discussions might be started about their care, for people’s preferred place of death to be recorded early and for health and social care services to be co-ordinated—