A big point of contention in the assisted-dying debate can be resolved fairly easily
MISapprehensions ABOUND about palliative care. That it happens in hospices when most are cared for at home. That it is about death when it is about improving quality of life. As a parliamentary vote on whether to allow assisted dying in England and Wales approaches, another misconception risks taking hold.
Wes Streeting, the health secretary, asserts that the state of palliative care “wouldn’t give people a real choice” if assisted dying were to be legalised. In fact, this is something well within Mr Streeting’s power to fix.
It is true that 100,000 Britons a year die needing palliative care but without being able to get it. Although Britain routinely tops international rankings for this kind of treatment, a service is not gold-standard if not everyone has access to it. Spiralling costs and stagnant statutory contributions mean that most hospice funding now comes from charitable donations; informal carers often pick up the pieces.
The hospice sector requires an immediate injection of cash to cover its deficits, estimated to be £50m-60m ($64m-76m) last year. It also needs a longer-term plan to make it sustainable. Around 660,000 Britons died in 2023; that number is forecast to rise to almost 800,000 by 2040. The best solution is probably for the NHS to cover hospices’ clinical-care costs, leaving extras like bereavement services to be funded by donations.
A sustainable new contract for adult hospice care (including wider community services and at-home care) would probably cost the NHS in England an extra £350m annually, reckons Toby Porter of Hospice UK, a charity. That is around 0.2% of its budget.
But, as Amanda Pritchard, the NHS’s chief executive, has acknowledged, a third of all NHS hospital-bed days are accounted for by the 1% of Britons who are in their last year of life. Moving just 10% of their care into the community would suit patients and free up beds equivalent to the capacity of three large hospitals. Funding palliative care properly is morally right and financially wise, whichever way the vote in Parliament goes.
This article appeared in the Britain section of the print edition under the headline “False dilemma” (Nov 21st 2024)
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