Health Bill

Baroness Thornton Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

When we talk about palliative care, if we do not include carers in it, we are not really having a proper conversation. I would like us to take some of the principles included in these amendments, and stop being hung up on the location where palliative care takes place.

[Baroness Thornton (Lab)]

My Lords, I had not intended to speak in this debate—I was saving myself for social care and those other issues—but I was very moved by the interjection by my friend, the noble Lord, Lord Patel, and I disagreed with the noble Baroness, Lady Coffey. This is an important suite of amendments, because comprehensive integrated care has to include end of life—of course it does. I know that the noble Lord and the Minister will be discussing how best to do that; it may not be to put it on the face of the Bill, but it definitely has to be included in this legislation. The amendment from the noble Baroness, Lady Pidgeon, is a very good one, and I completely agree with it.

[Baroness Pidgeon (LD)]

My Lords, I thank the noble Lord, Lord Patel, and my noble friend Lady Barker for their very personal and raw contributions, as recent carers, on the recent losses of loved ones.

I am grateful for the support from the noble Baroness, Lady Thornton, for my Amendment 230 in this group, which also has the support of Marie Curie and Hospice UK. At its heart is the principle that people approaching the end of life should be able to have their wishes, preferences and priorities for care understood, recorded and respected. Advance care planning enables people with terminal illness to express how and where they wish to be cared for. It supports more proactive and personalised care and, as we have heard, it has been shown to improve patient and family satisfaction while reducing the likelihood of crises, avoidable hospital admissions and the need for emergency care out of hours. I have seen at first hand how, in Devon, the system seems fairly well set up to support people in their own homes, and to have these very difficult conversations with a hospice at home service, with people who have real skill in communicating and talking about these difficult topics at a time when someone may have just learned that they have a terminal illness and when lots of things are going around their mind. It is important for them to be able to get some clarity, going forward, about what they wish for and do not wish for. As we have heard, other parts of the country do not work so well.

Importantly, the evidence suggests that advance care planning does not increase costs to the health and care system, and may in some cases reduce healthcare expenditure by ensuring that care is delivered in accordance with patients’ wishes. We will come on to the single patient record on a later date, but I flag here that advance care planning can be effective only if the information is available to those providing care when it is needed. The single patient record offers a significant opportunity to improve co-ordination and continuity of care, but its success will depend not simply on sharing data but on ensuring that advance care planning is routinely embedded in clinical practice so that people’s wishes can be accessed, understood and acted upon, wherever and whenever care is provided.

The other amendments in this group from the noble Baronesses, Lady Finlay and Lady Coffey, highlight the many issues with the current landscape of palliative care and specialist palliative care services, and the difficulty in getting access to those services. I look forward to the Minister’s response to that, and her response to the trick or treat challenge.