Care of the Dying

Penny Mordaunt Excerpts

Tuesday 17th January 2012 Westminster Hall

[Penny Mordaunt (Portsmouth North) (Con)]

I became interested in end-of-life care in part from having been a hospital visitor at my local hospital for eight years, largely attending those who had no advocate, friends or family and who were nearing the end of their life. I continue to work on these issues with a number of organisations, including the Royal College of Nursing, Age UK and the NHS Confederation.

We have known for some time that older people, in particular, are poorly served in both a hospital and a community setting. To give a recent example, a constituent of mine, who had no continence problems but was bedbound following an operation in hospital, repeatedly asked for a bedpan and at the sixth time of asking was told to wet herself because it was nearly suppertime and no one was around to fetch the pan for her. By that time, she was so desperate for the loo that she did just that, despite how unnatural and unpleasant it felt, and she then had to sit in wet sheets until the meal was over. Only then did the nursing team come and change her whole bed—a procedure that took more staff and time than the simple act of fetching her a bedpan in the first place.

We have had a succession of reports, including from the Care Quality Commission and the Equality and Human Rights Commission, calling for the Government to act. I hope that my hon. Friend the Minister will today update us on progress. With my hospital visitor hat on, I would particularly like to know whether she believes that there are opportunities with the Centre for Social Justice “End Loneliness” campaign, which is focused on befriending and visiting, to consider the support and advocacy services that could be developed to support those who have no one else as they near the end of their life.

I congratulate my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) on securing the debate. I am pleased that it has been focused on good-quality end-of-life care, rather than assisted dying, as that is the immediate issue. I am sorry that those two issues are often conflated or painted as an either/or. The Commission on Assisted Dying added its voice to the previous reports in relation to the patchy nature of good end-of-life care. It was highly critical of the practices at Dignitas and elsewhere, including Oregon. It highlighted the lack of research in the area that we are discussing. One of its key conclusions was that the Government must step up their drive to improve care in this area as a priority.

Poor-quality end-of-life care cannot be a reason for an assisted death. Indeed, one of the safeguards required by the commission’s model for assisted death in the UK would be verification that a terminally ill patient who requested an assisted death was receiving good care. However, the view that, if there were universal provision of good-quality care, there would be no demand for an assisted death is a false one. It assumes two things: good-quality end-of-life care can alleviate all pain and suffering, and the overriding motivation for seeking an assisted death is poor-quality care. Neither is true. Those who request an assisted death are often doing so because of issues about control and their identity, and we must recognise that even with very good care and advances in pain management, there will still be patients who are in considerable discomfort at the end of their life.

All in this place have great sympathy for those who wish to have an assisted death, whether or not we believe that they should be granted one. We have sympathy for the 400 people who commit suicide every year because of a terminal or chronic illness. We all know about the sale of suicide kits—those appalling suffocation devices, which often fail to kill and instead result in brain damage. I would like the Minister’s comments on whether we should be doing more to end that trade on the internet. We also know about the 160 people from the UK who have travelled to Dignitas. In my view and the view of the commission, that is a very unpleasant experience, and such people are often ending their lives very prematurely.

All of us have sympathy and compassion for the people to whom I have referred. Where we differ is in whether we think that measures to enable those people to have a good death, at the time of their choosing, come at too high a price for the rest of us. There are issues that are often discussed—safeguards, for example, are deemed too difficult and have not been thought through—and issues that are just as pressing but are not so often discussed, such as equality of access to such a death. Indeed, certain issues are barely debated at all. This is a difficult subject, but we should, as a Parliament, continue to discuss the plight of those people and their families, as their suffering is profound. I echo the comments of my hon. Friend the Member for Montgomeryshire (Glyn Davies); we should do that in the tone that he outlined.

Such suicides occur once or twice a day in the UK. These are a tiny minority of patients, a minuscale minority of Britons, but each of them, in my view, is entitled to a good and peaceful death.