Inconvenient deaths

Posted by Alexander Hay

Our approach to palliative care is inept and inhumane

What care can the terminally ill really expect?

The statistics look grim. With almost 100,000 people unable to get the palliative care they need in their last few months of life, it seems dying is the latest target of government cuts. Worse, the amount spent on each patient is arbitrary too, ranging from under £200 to over £6000.

What does this mean? That the approach to death in this country remains as erratic as our views on it. A culture that increasingly embraces the amorphous notion of a 'dignified death' or which refers to dying in euphemistic terms - 'passing away', which makes it sound like an occasional inconvenience - is hardly going to have the will or maturity to provide decent support for dying patients.

In the light of this, the Palliative Care Funding Review (published today) seems more akin to a list of regrets than recommendations. Calling for a better organised settlement on funding, with proper assessments and more opportunities for terminal patients to die at home, it has all the innate fatalism of a Forlorn Hope. It won't happen. We need a significant cultural shift before a political shift follows in its wake.

We need money too, and the main problem in that regard is that the government doesn't quite know what it's doing, or how much it can actually spend.

Nor is there any 'joined-up thinking' in how palliative care is organised and staffed. While carers now face poverty at the end of their careers, they are also the people who will have to look after the terminally ill in one fashion or another. They are besieged from all angles.

Short-sighted thinking like this naturally leads onto NHS reform, of the kind which will bring in ever greater private sector involvement in healthcare without any more public accountability.

Fittingly, even David Cameron's claims that the pension system is underfunded is being called into question. Like the rest of the debate on what gets funded and by whom, it is based on vague, contradictory data. All of which is academic for a person whose life is ebbing away and who just wants to be looked after and be made as comfortable as possible.

It does, however, highlight one grim truth about Modern Britain - here, even death is complicated, underfunded and never entirely to plan. Dying peacefully in your sleep has never been so difficult.

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Alexander Hay

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