Care minister “determined” to introduce free end-of-life social care

Care minister Norman Lamb has given his personal backing to free end-of-life social care, but said he could not yet commit the government to the measure.

Speaking in a debate on the Care Bill last Thursday, Lamb said although he was “not in a position to commit the government” to free end-of-life social care, he said that “I want us to do this” and was “determined that we achieve that objective”. He added that as the responsible minister he had “some degree of influence over decision-making”.

He made the comments in response to an amendment from Conservative MP Sarah Wollaston proposing that terminally-ill people be exempted from social care charges to allow them to die in their preferred place.

This recommendation was made by the government-commissioned Palliative Care Funding Review, which reported in 2012. On the review’s recommendation, the government set up eight pilot projects to test its proposed funding model. The pilots last two years and are ending in March.

Lamb determined on free care

Lamb said it would be “daft” to make policy decisions on palliative social care before getting the evidence of the pilots. He said: “Obviously, I want to see the evidence and we have to be aware of the financial consequences, but I am determined that that will happen.”

Lamb said that any decision to remove the social care means test at the end of life could be introduced through regulations under clause 14 of the bill, which covers service user charges. This would allow the government to prohibit charging in certain “specific areas”.

He said he was also “determined” to move towards people being able to choose where they are cared for at the end of life, and that a review this year would determine when such a choice could be feasibly introduced.

He said the issue of free end-of-life social care was “inextricably linked” to that of choice because “it is the financial incentives that currently mess around with and undermine proper choice at the end of life”.

Lamb added that NHS England wanted to expand the use of electronic palliative care co-ordination systems (EPACs)—which allow people to register their end of life wishes—to increase national coverage form 30% to 70% by 2015. He said in places where EPACs were established, 80% of people died in the place of their choice. Wollaston said she was “absolutely delighted with the minister’s assurance” on free end-of-life social care and would not press the issue to a vote.

Backing from charity

Macmillan Cancer Support, which has long campaigned for free end-of-life social care, welcomed Lamb’s comments.

“We are very encouraged by Norman Lamb’s comments during last week’s Care Bill debate and his assurance that he’s determined to introduce free social care at the end of life,” said Gus Baldwin, head of public affairs at Macmillan Cancer Support.

“We look forward to discussing this further with the minister with the aim of making quick progress as soon as the Palliative Care Funding Review pilots looking at this issue have ended in March.”

Preth Rao, head of policy and campaigns at charity Sue Ryder, said: “Sue Ryder has been calling for free social care at the end of life alongside a coalition of other charities. We believe that this will be critical in ensuring that the last months, weeks and days of a person’s life are as stress-free as possible and that they will have the care and support that they need to die where they wish and receiving the care that they wish. This is at the heart of a good death. We therefore welcomed this amendment to the Care Bill from Dr Wollaston and urged other MPs to support it.”