Sarah Newton is the Member of Parliament for Truro and Falmouth and Deputy Chairman of the Conservative Party.
From the publication of the Barker Commission’s report earlier this month to Jeremy Hunt’s vision for a ‘revolution in out of hospital care’, there is growing political will to see greater integration of health and social care and to reduce pressure on hospitals. One area where this is fundamentally important is in supporting people at the end of life to die in the place of their choice.
Research has shown that 79 per cent of people want to die in their own home but only 23 per cent actually do. Part of the reason for this is that those wanting to die at home often require social care support which is difficult to access, is means tested and can be difficult for individuals to fund themselves. An indication of how difficult social care support at the end of life is for individuals to fund is the estimated £425m that local authorities spent in 2011-12 on care home residents who had run out of private funding.
For people at the end of life and their carers, whether that is family members or friends, the process of applying for financial support can also be stressful and confusing. For example, Julie, who looked after her mum at the end of life, needed social care support but was not told it was means-tested until complicated forms dropped through her letterbox. Before Julie could get the support she needed, her mum sadly passed away.
At the end of life people should not be faced with a mountain of paperwork but the current system means exactly that – terminal patients who want to die at home must tick all the right boxes before any assistance can be given. This is wrong. However, a viable alternative to the current system is possible: coordinated and free social care at the end of life.
A report by Macmillan Cancer Support published last month has made a compelling case for free social care at the end of life. The report estimates that in 2012 approximately 36,400 people with cancer died in hospital who would have preferred to die at home. Free social care support for these people, compared with the cost of hospital care, could have saved the NHS approximately £69 million per year. If this were expanded to all conditions it could lead to an even greater saving of £345 million per year.
Looking to the future, if nothing is done by the end of the next parliament in 2020 then an estimated 1.3 million people will have died in hospital who wanted to die at home. That is a staggering number. The moral case for free social care at the end of life is self-evident – people should have the support to die at home if they wish. The economic case, as outlined by Macmillan Cancer Support, has now been made and it is one that we should not ignore.
The Government has already taken an important step to address what has been described as a ‘stunning’ lack of information surrounding palliative care costs. In publishing the Care and Support White Paper the Government said it sees ‘much merit’ in the principle of free social care at the end of life. The Government also committed £1.8 million to collect the data necessary to make the economic case for free social care at the end of life through the Palliative Care Funding Review pilots. Data collection has now concluded and we are waiting for the results to be published this autumn.
Some progress has been made for integrated free social care at the end of life to become a reality, but the momentum cannot be lost. A decision is due to be made on this before the end of this Parliament.
However, it will be the next Government who implements this policy; this makes it an important time to be debating these issues. General election manifestos are in the process of being written and policy positions are taking shape. A manifesto commitment by our party to implement joined up free NHS social care at the end of life would send a clear signal that we want more people to have a good death at home with their loved ones and that we own a policy that is not only popular, but makes strong fiscal sense.