‘Impatient MPs ..only want to hear from those who agree with them’

Perhaps the most positive outcome of Kim Leadbeater’s committee has been the light shone on a medical field few of us think about until we or a loved one are in mortal crisis. I can’t be alone in my horror at learning that 40 per cent of hospitals do not have weekend face-to-face palliative cover. Imagine writhing in pain on a Saturday night, unable to see a specialist until Monday morning. For those coping at home, just a third of the UK has a 24-hour palliative phone line, although this was recommended by Nice in 2011.

……about 100,000 people of the 550,000 Britons who die every year miss out on the care necessary for dignified death. The majority of the terminally ill die in institutions because community care is overstretched and the alternative may be lying at home in an unchanged adult nappy. Since most hospices are charities, finding a bed will be easier in wealthier areas that garner bigger donations.

Then there are non-clinical pressures: Glyn Berry, co-chair of the Association of Palliative Care Social Workers, spoke movingly of patients with insecure housing, no one to advocate for their needs or sort out their benefits. Living in chaos, pain and poverty, wouldn’t you want to die?

In this debate the concept of coercion has focused mainly on how relatives might put pressure on an old person to choose death over wasting vast sums of inheritance on residential care. Such is the selflessness of elderly parents and the pitiful value put on old people’s lives, this is easy to imagine — although, remarkably, Leadbeater has refused evidence from the British Geriatrics Society. But less is heard about “societal coercion”, where desperate circumstances might make someone feel life had no point.

Yet Leadbeater’s allies seem to believe poor palliative care is being deployed as an excuse to block their bill. When the health secretary Wes Streeting and the justice secretary Shabana Mahmood cited it as their reason for voting against the second reading, some saw it as a mere cover for religious objections. As palliative care doctors gave evidence this week, the MP Kit Malthouse tutted and scrolled through his phone, while the Lib Dem Tom Gordon asked Dr Sarah Cox, president of the Association for Palliative Medicine, with unconcealed exasperation, “how do you ever define when palliative care is sufficient?”

…these impatient MPs trying to expedite a bill …… only want to hear from those who agree with them. Like the Australian doctor utterly relaxed about “feeling a burden” being cited as a reason for suicide by a third of patients, or the academic who dismissed concerns about Oregon allowing anorexics to die as a “red herring”. When Baroness Falkner, head of the Equality and Human Rights Commission, proposed the bill consider an impact assessment for all vulnerable groups, especially the disabled, you sensed the froideur.

Yet since a commission on improving palliative care has already been launched, it seems bizarre to push through assisted dying before it reports later this year. Palliative care will never be perfect but a universal minimum standard could be put in place first.

……The right to choose death is being trumpeted as progress — a yearned-for piece of landmark legislation for Labour, equivalent to David Cameron’s same-sex marriage victory — so woe betide those who point out its cruel inequities. But it’s far easier to dismiss the religious objectors than earnest NHS doctors who don’t want any patient to choose death for want of the right drug or a hand to hold.

The Times (£) here