Ageing and End-of-life Care

Julian Lewis Excerpts

Thursday 30th October 2025 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the ageing community and end of life care.

I thank the Backbench Business Committee for selecting this subject for debate. I declare an interest as the son of Mona Shannon, who is 94 years young and resides in a nursing home near Killyleagh in my constituency. Along with most other middle-aged sons or daughters—in my case, maybe a wee bit more than middle-aged—I am acutely aware that time is marching on and so are my mum’s needs.

The wee five-foot-nothing lady who kept three six-foot sons under control is no longer to live alone, but she is as sharp as a tack and I am thankful for the wisdom she gives me when I visit her twice weekly. Indeed, I suspect that every Friday and every Sunday I get a wee bit of wisdom—and maybe a wee bit of a telling off. She always likes to know what happens in this House and I am able to tell her that, but she will also give me her opinion, which I never ignore—indeed, I probably keep to it as much as I can.

Those visits to the nursing home, coupled with the focus on assisted dying, have highlighted to me with greater effect the changes that are needed in how we handle our older generation and their needs. I have spoken with representatives of both Sue Ryder and Marie Curie not simply to highlight the difficulties that most of us will be aware of, but to offer some ways that we can improve.

I am pleased to see the Under-Secretary of State for Health and Social Care, the hon. Member for Glasgow South West (Dr Ahmed), in his place. He and I are becoming a bit of a tag team, because on three days this week he has been the Minister responding to the debates that I have been involved in. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), has been there as well, so he should not be left out.

According to Marie Curie, in the next 25 years in Northern Ireland—I know it is not the Minister’s responsibility, but I want to give the stats, because they are important— there will be 20,500 people requiring this type of care, which is a rise of 32%. That includes a doubling of need by those aged over 85. It is also projected that the number of deaths in the community in Northern Ireland could rise by 74% during that time. Approximately 60% of the cost of care delivered through the independent hospice sector in Northern Ireland is reliant on charity. That is unsustainable. A new palliative care strategy for Northern Ireland that takes account of demographic changes and associated requirements for service transformation and investment is urgently needed.

That is what is happening in Northern Ireland, and in the mainland, things are very similar. Marie Curie has highlighted that as the population ages, more people will be living with and dying with multiple complex conditions. Every week in my office, when it comes to assisting those of my mum’s generation—and perhaps some of my own—with benefits, I see people with multiple complex needs more than ever. It is not just one thing that people are suffering from, but a multitude of things.

By 2050, the number of people in need of palliative and end-of-life care in the UK will rise by 147,000 to over 745,000 every year, and that increase will be driven by a growth in the number of people dying over the age of 85. These are really important stats, and we cannot ignore them; indeed, I believe the Minister will be focusing on them. Around 90% of the people who die each year need palliative care, but one in four of them is missing out. Older people, and particularly those with a non-cancer diagnosis, are at risk of missing out on the palliative care they need at the end of life. Research indicates that most people want to receive care at the end of their life and die at home. Elderly people tell me that all the time—they want to be at home.

[Sir Julian Lewis]

I am grateful to the hon. Member for giving way; I know he is pressed for time. The charity Together for Short Lives points out that where children’s palliative care is concerned, there is wide variation across different regions in the country. Is he afraid that this applies to the ageing population as well—that there is no consistency in the amount of palliative care available?

[Jim Shannon]

I thank the right hon. Member for his intervention and for the wisdom that he brings to all the debates he participates in. The Minister is listening, and he is a good Minister, so I know he will come back with the response we hope to have.

How often have we listened to family members who are past themselves with exhaustion and guilt about how they are caring for their loved one and who feel unprepared and yet unwilling to let them go into nursing care? With more support, their lives would be easier and their loved one’s life happier. This knowledge is why I was not surprised to learn that almost £12 billion of public funds was spent on healthcare for people in their last year of life, 81% of which was spent in hospital, with only 11% spent on primary and community care.

Access to a 24/7 palliative care advice and support telephone line has been recommended as a minimum service requirement for nearly two decades, but research shows that very little has happened, which underlines the issue that the right hon. Member for New Forest East (Sir Julian Lewis) raised. Only seven of the 42 integrated care boards in England said they have a dedicated 24/7 single point of access to palliative and end-of-life care advice, guidance and onward referral to other services, when needed—those are all important factors.

Despite the introduction of a new legal duty for ICBs to commission palliative care services in the Health and Care Act 2022, the urgency and importance of ensuring that everyone has the best possible care and support at the end of life has yet to be recognised as a national priority. I hope the Minister will be able to provide assurance on this, because that is what Marie Curie wants, it is what Sue Ryder wants, and it is what every mum, dad and family member wants as well.