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

Part of the debate – in the Senedd at 3:09 pm on 16 May 2017.

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Photo of Julie Morgan Julie Morgan Labour 3:09, 16 May 2017

I declare an interest in this subject as I am the vice-president of George Thomas Hospice Care, based in the grounds of Whitchurch hospital in Cardiff North. This delivers specialist palliative care for Cardiff to allow people to live in their homes and maintain their independence for as long as possible. I think it is an example of good partnership working between the voluntary sector and the statutory sector, between the Welsh Government and the local authority. And, also, I think we would all want to pay tribute to the long-standing investment of the voluntary sector in the hospice movement from which this grew.

I think that this plan is a very important plan, the palliative and end-of-life care delivery plan, and a crucial plan, and I'd like to pay tribute to Professor Ilora, Baroness Finlay, who has been so instrumental in this plan and who is standing down as the national clinical lead for end-of-life care in July. I've worked for many years with Ilora, and I think she's made a tremendous contribution to this area of work.

One of the issues that I'm very concerned about, which the Cabinet Secretary, I believe, did refer to in his introduction, was the really crucial issue of people, when they are very ill, being moved into hospital for treatment when, basically, it would be better if they were to stay at home if the support services there could be given for them to remain at home. And this does happen with many seriously ill people who have been receiving this support, but, when the situation becomes much worse, they then go into hospital. So, it's how we manage to keep people in that situation at home. And I’ve had several examples of that in my own constituency, where, actually, on a weekend, someone who was very near the end of their life was taken into a hospital A&E because the on-call doctor was so concerned about their condition, whereas I think, with a bit more collaboration and working together, they could have remained at home with a bit of increased support. So, I think that is one of the crucial areas, and I wonder if the Cabinet Secretary could say a bit more about that.

I welcome the point made that we need a review of the capacity of existing bereavement services, as I think these are a vital part of planning for end-of-life care. And, in George Thomas Hospice Care, the consultant has described to me about how they are providing pre-bereavement counselling for children who have a parent, or a grandparent, maybe, or perhaps a sibling, who is dying, and she says that this absolutely helps enormously if you do it before the loved person dies and that that does mean you tend to need less frequent follow-up sessions afterwards. So, I wondered if the Cabinet Secretary had any views about that and whether this was something that was happening to any extent throughout Wales.

And then, of course, there is the whole issue of children's services for the small, but very important, group of children who do need palliative care, and I'm sure he is aware of the work of the Together for Short Lives body, which has put forward several proposals.

And then the final point I wanted to make was in terms of advance planning. We have to take account now of the number of people diagnosed with a dementia who will need end-of-life care, and we are having a debate on that later on in the afternoon, about dementia. But, in George Thomas Hospice Care, 75 per cent of their patients have cancer, and, up until now, the next group that they were working with were people with heart disease. But now the next-biggest group is people who have dementia, and I think that that is something that we've really got to take into consideration in planning for palliative care, if people do have a dementia. And I note that—I think it was Macmillan who have said that we need to do a lot of pre-planning with older people, and I think we've just got to take into account the fact that a large number of people have dementia.

And then I just want to say that I do agree with all the issues about, you know, trying to learn perhaps from the Compassionate Communities movement. We do need the big conversation, and we do need to move on to make death much more a part of life.