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Improve end-of-life care before rolling out assisted dying, Government told

Improve end-of-life care before rolling out assisted dying, Government told

Telegraph5 days ago

The Government could be forced to improve end-of-life care before it can roll out assisted dying.
Lawyers representing a leading doctor will take legal action against the Department of Health if it fails to develop a plan to improve Britain's palliative care, The Telegraph can reveal.
The House of Commons is set for what looks to be a pivotal, final vote on June 20 on the Assisted dying bill, which would give some terminally ill adults the right to end their lives.
But there are serious concerns about whether they would have a real choice, with critics, including Wes Streeting, the Health Secretary, citing the lack of provision of end-of-life care.
It is one of the issues that could reduce the 55 majority the Bill received in November 2024.
Lawyers are also threatening legal action, which could force the Government's hand.
In a letter to Mr Streeting, a leading consultant cardiologist requested that the Government urgently reviews and sets out a plan to improve end-of-life care following the death of his father.
'Coerced by the lack of support'
Mr Streeting previously said he would vote against the Bill because he did not think palliative care 'in this country is in a condition yet where we are giving people the freedom to choose, without being coerced by the lack of support available '.
But with hospices being forced to shut over costs, a review set to inform the future of social care, led by Baroness Casey, not due until 2028, and the NHS focused on cutting waiting lists, changes to palliative care appear some way off.
A report by the Marie Curie charity in 2024 found that there was a ' patchy and inconsistent provision of care for people approaching the end of life'.
Matthew Reed, the charity's chief executive, said there was a 'postcode lottery in access' and ' no realistic national or local plan ' as he called on the Government to make urgent changes.
Dr Tom Hyde, a heart specialist in the South West, told Mr Streeting that his father Stephen's life 'could have been extended' if he had received proper care in the community.
Stephen had advanced cancer and mobility issues when he died aged 84.
A letter, written by Sinclairslaw on Dr Hyde's behalf, said 'the current systems for palliative and end-of-life care are putting the UK in breach of its duties under the European Convention on Human Rights'.
It is understood that lawyers may apply for a judicial review over the Department of Health's lack of action.
Dr Hyde alleged that his father had 'been inappropriately discharged into the community where he suffered malnutrition, dehydration and lack of care', which contributed to his death.
A government spokesman said the testimony was shocking and that it was determined to fix the 'distressing failures' it had inherited.
Stephen had been admitted to hospital three times over four weeks between June and July 2023 following falls and a kidney injury.
After the first admission, he was discharged back to his home, where he lived with his wife, despite her also being frail. His dietitian reported that he was eating just 600 calories a day despite weighing 80kg, and Dr Hyde raised concerns that his father was suffering from malnutrition.
The final admission came on July 13 2023, where Stephen suffered a non-fatal heart attack while enduring a 12-hour wait on a trolley in A&E.
He was sent to a ward at a different hospital that specialised in palliative care, where he remained until his death just over a week later.
'I would like my freedom'
On July 20, a consultant asked if he could do anything for him, to which Stephen replied: 'That's very kind, I would like a gin and tonic and my freedom.'
Dr Hyde saw his father for the last time two days later, with it apparent his father knew the end was near as he said goodbye. Dr Hyde claimed that the consultant remarked it was good that Stephen had almost passed because it 'looks like we'll have another bed coming up soon'.
He argued that his father should have been admitted to a nursing home where he could have received proper around-the-clock care weeks earlier, which would have helped him to live better for longer.
Dr Hyde told The Telegraph: 'He experienced an unsafe discharge from hospital to his home when he was doubly incontinent, vomiting and with inadequate plans for hydration and nutrition.
'Despite having capacity, his loss of autonomy as the system took over his treatment and care, and my powerlessness to change the situation, was heartbreaking.'
He added: 'There is an urgent need for the Government to address the significant failings in the provision of end-of-life care for the most vulnerable in our society.'
Paul Conrathe, a senior consultant solicitor at Sinclairslaw, said Stephen's experience was 'shared by many in the UK'.
A Department of Health and Social Care spokesman said: 'This testimony is shocking and we wish to express sincere condolences to Dr Hyde and his family.
'Neglect, abuse or disrespect in care settings is completely unacceptable, and the distressing failures in Mr Hyde's care, from inappropriate discharges to the lack of community support assessments, highlight serious systemic issues that this government inherited and is determined to address.
'We are taking action to better join up health and community care services so NHS and care staff have instant access to the latest patient information, to speed up and improve their care.
'We are also working to ensure the Care Quality Commission takes robust action where providers fail to treat people with dignity and respect.'

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