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

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

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Photo of Caroline Jones Caroline Jones UKIP 3:16, 16 May 2017

Thank you for your statement, Cabinet Secretary. The sad fact is that while everyone will eventually die, we don’t all die well. Because of the latter, it is essential that we have excellent end-of-life care.

I welcome the Welsh Government’s palliative and end-of-life care plan, and the commitment to improve the care given to those approaching the end of their lives, and those they leave behind. If current trends continue, the number of people dying in Wales will increase by 9 per cent. We know that around 6,200 people who die each year do not get the palliative care they need, but these figures come from Marie Curie, and they’re not coming from the NHS, and therefore don’t feed into the workforce planning.

We need an all-round approach to palliative care, as often the whole family are involved. Therefore it is essential that staff are properly trained to deal with sensitive situations such as this, and it’s pleasing to see that £150,000 is provided to train staff in advanced communication skills and end-of-life care. Although this is a good start in recognising the specialist skills needed, could you provide more information on how many staff you anticipate this will train, and what areas will be covered in Wales? Some may be more than others, due to logistic situations.

Funding to provide access to hospice-at-home provision is welcome, along with palliative care registers for all GPs who have a register of all patients with supportive palliative care needs. Could you also tell me how these registers are compiled? Because there are some people, obviously, without families, who go unnoticed, who become ill, and they’re reluctant to visit their GPs. I wonder how we can reach these people who sometimes—very often, actually—die at home and are discovered days or weeks later. Can we do more to ensure people like this are included?

Also, to bring back something Rhun had said, a Marie Curie report has highlighted, as I indeed highlighted in the last statement, additional barriers faced by bereaved LGBT and BME communities, beyond the universal pain experienced after losing a partner. Despite this, there are no specific actions outlined in the delivery plan aimed at addressing these issues. Cabinet Secretary, do you agree with me that, if we are to improve the end-of-life care for BME and LGBT communities, we must address the shortcomings in this plan?

In England, the NHS conducts a survey of the bereaved called VOICES, and this shows the level of care and support given to families at the end of their loved ones’ lives. We don’t conduct any such survey in Wales. If we are going to ensure that everyone who needs specialist palliative care gets it, and we’re going to ensure that an individual’s needs, priorities and preferences for end-of-life care can be identified, documented, reviewed, respected and acted upon, then we must conduct a survey of the bereaved also in Wales. I see there is no provision for this in the statement.

Rather than relying on data collected through the iWantGreatCare programme, which many patients are unaware of, does your Government have plans to introduce a comprehensive survey of bereaved families in Wales? The website launch of ‘Byw Nawr’ is welcome and is definitely the way forward. However, we must not depend on the statement that nowadays most people find most of their information online. Although this is true, there are many people without access to online services and, therefore, we need to be inclusive.

So, it’s important that this plan is inclusive and beneficial to all. I note that consultants in palliative care are now available on call 24/7. Can you tell me how people will become aware of this service? The work with Tŷ Hafan children’s hospice and a 24 hours out-of-hours telephone call service for paediatric palliative care is essential and is very, very welcome.

I thank all hospital staff involved in this extremely sensitive area, whilst also acknowledging the dedication of families to their loved ones. I recognise the positive ongoing work and the commitment shown by the Welsh Government and the Cabinet Secretary in this statement. However, I look forward to working with you positively and constructively to further improve the services in palliative care. Thank you.