Too many people are dying at home “in squalor” because they are not
getting the social care support they need, MPs said last week in a
critical report on palliative care.
The report by the health select committee says that too much
emphasis has been placed on personal care by social services
departments, and calls for a review of the place of domestic
support – notably aids and adaptations – in the service
“We do not believe that it is acceptable for people who choose to
die at home to find they are doing so in increasingly squalid
surroundings,” says the report.
Chair of the health select committee David Hinchliffe said that the
right to a good death should be fundamental.
Lack of carers is another key concern, and the committee’s report
calls for new legislation to allow relatives a period of paid leave
to look after people with terminal illnesses.
Too many patients are falling into the chasm between health and
social services, the report adds.
While more than half of terminally ill patients wish to die at
home, only one in five do so because of barriers to NHS continuing
The report recommends setting national eligibility criteria and an
end to the practice of strategic health authorities funding only up
to an “anticipated time of death”. “Unseemly arguments about who
should pay for different elements of a care package are especially
abhorrent in palliative care,” the report points out.
The MPs described hospice provision as patchy and confined to the
more affluent areas of the country.
They are calling for hospice patients to be covered by the
Community Care (Delayed Discharges) Act (2003), as delays in
discharging this group could be “catastrophic”.
Social workers in the palliative care field welcomed the report.
“People want to die at home but most die in hospital because
services are not available,” said Sue Smith of the Association of
Hospice and Specialist Palliative Care Social Workers. “People are
dying before their assessments are done, and there are big battles
about who pays. Continuing care is a nightmare. Why should a cancer
diagnosis open every door but not any other terminal
– Report available from