4. 3. Statement: End-of-life Care

Part of the debate – in the Senedd at 3:05 pm on 16 May 2017.

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Photo of Vaughan Gething Vaughan Gething Labour 3:05, 16 May 2017

Thank you for the series of questions and comments. In terms of the priorities that Age Cymru identify, many of those are already covered in the work that I’ve outlined that the board is taking forward. Part of the strength of the work that we’re doing is having that genuine cross-section of people with a direct interest in the area setting an agreed list of priorities. The difficulty otherwise is that we potentially get different bids made during the year and not having a properly organised approach to improvement, but I think that the list that you’ve identified—as I say, they’re covered in the contribution I’ve already made in terms of the opening of this debate, but also in the priorities that the board has set for itself in the year ahead.

In terms of the second particular issue you raised, about paediatric palliative care, there was a concern about whether this was properly taken account of in moving forward. I met a group of paediatric palliative care clinicians, and it was a very constructive conversation. I think they’ve moved forward, and they’re in a much better place now about understanding and accepting that their issues are properly taken account of, and there was a definite step forward in this iteration of the plans. So, there is progress that’s been made.

But in this and in every other area—almost every area on which I attend this Chamber to speak—there is always more to be done, and always more that we could do. There’s got to be an essential honesty about that as well. That includes bereavement support, again identified in my opening contribution as an area for improvement for the family that is left behind. That’s part of our challenge. It’s also why we’re having a national conversation about this, and why we should take the opportunity to use time in this Chamber to continue to do that. If we don’t normalise the conversation in this place about the importance of it then we’re unlikely to have a national conversation that takes place in a wider part of our society, so that it is a normal conversation that takes place about what we want.

It’s also why the advance care plans website has been launched, and actually having people having that conversation at a time when they can make choices—a much more active choice—about what they would want is a really important thing to do, because lots of people know they’re coming to end-of-life care. All those people that are on end-of-life care registers and receiving palliative care in primary care—there should be efforts made to improve and increase the numbers of people that have actually gone forward and had an advance care plan drawn up that they’ve actively contributed to. We made real progress last year and improved the numbers of people that have a plan like that, but we understand there’s only just over a third of people who are on a primary care register who now have an advance care plan in place. So, significant progress last year, yes, but lots more to do to get people into a place where they can receive the care that they want at the end of their life.

Finally, on your point about black and Asian origin communities in Wales, there is a real challenge here about the sort of care they want to receive. Some of this is about the differing nature of family support that exists in some of those communities, and the way they feel about looking after a relative. Some of it also is the work that Marie Curie themselves had done. I attended the launch of the work, both at the consultation start of it, and then at the final report stage. They recognise that, actually, the hospice movement, as well as the health service, needs to do more to promote the opportunities that exist for end-of-life care and for people to make different choices. There’s something about the health service and the hospice that provide a lot of that care to be more proactive in going out to a number of those communities who don’t take part and don’t take up palliative care in the way that other communities do, to say, ‘This is an option’. I’m pleased to see that they recognise that they had a problem and they want to do something about it, and I’m certainly interested to see that that does take place and, over the time of this plan, maybe seeing more people in different communities around Wales having access to palliative care and making active choices about their end of days.