Charity calls for death strategy

Help the Hospices wants the Government to appoint a Minister for Palliative Care and devise a national strategy on death and bereavement.

Giving evidence to the Health Select Committee's inquiry into palliative care at the end of last month, Help the Hospices' acting chief executive Christine Shaw led calls for a more joined-up strategy to reach across all relevant Government departments and cover terminally ill people of all ages and diseases.

At present, palliative care is split between Public Health Minister Melanie Johnson, who has responsibility for adults, and Community Care Minister Stephen Ladyman, who oversees children. The Department of Health is working on a policy for palliative care for cancer patients, but there is no such policy for people with other diseases.

Shaw said a national strategy should touch on all of people's circumstances at the end of life. This would include clinical treatments and ethical issues, but also welfare benefits and support for patients' families.

She said the charity had no firm view on which department should appoint a Minister for Palliative Care. "Health is a big component so the Department of Health would play a big part, but the minister would need a remit beyond that too. Maybe they should sit in the Cabinet Office, which tends to have cross-cutting responsibilities."

She said other charities that gave evidence to the committee - Marie Curie Cancer Care and Macmillan Cancer Relief - were also pressing for a more cohesive care policy.

Help the Hospices also told the committee it wanted the Department of Health to set an interim national tariff for hospice care by 2005/6, so that voluntary hospices are paid an appropriate rate for the services that they provide on behalf of the NHS.

"Hospice funding needs to be secure and sustainable. Hospices currently provide £300m-worth of care each year, and more than £200m of this is raised in their local communities. We don't want 100 per cent funding from government, but we do want the NHS to pay for the services it would provide itself if hospices didn't exist."

Currently, statutory funding is provided mainly through service level agreements with Primary Care Trusts, or grants.

Any extra money raised by the hospices would pay for things that improve patients' quality of life, such as extra nurses or complementary therapy, which the NHS is not obliged to fund.

Shaw said she felt the select committee was "very receptive" to the proposals.

Further hearings are planned before the committee will make its recommendations.

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