As MPs return to debate the Terminally Ill Adults (End-of-Life) Bill, conversations about assisted dying will once again be taking place across Parliament, the media and around kitchen tables.
These conversations are complex and deeply personal. People will hold different views, often shaped by their own experiences of illness, caring, loss and bereavement.
At St Margaret’s Hospice Care, we maintain a neutral position on assisted dying. Whatever the outcome of the parliamentary process, our focus remains the same: supporting people across Somerset who are living with a life-limiting illness to live as well as possible, for as long as possible, with the care and support they need around them.
But the renewed debate also brings another important issue into focus: whether everyone who needs high-quality palliative and end-of-life care can access it.
Hospice UK has warned that hospice services nationally are under increasing pressure, with services shrinking at a time when demand for care continues to grow. Its Chief Executive, Toby Porter, has argued that nobody should ever find themselves considering their choices at the end of life because they are worried that the pain relief, care or support they need will not be available.
That principle matters. For choice at the end of life to be meaningful, people need to know that excellent palliative care is available to them – care that helps manage pain and other symptoms, but which also recognises the emotional, practical and spiritual needs of each person and those close to them.
And perhaps the clearest way to understand what that care can mean is to listen to the people who experience it.
Yvonne, who has been supported by St Margaret’s, described how her understanding of hospice care changed when she began receiving our support:
I thought hospice care was just about dying. Instead, it’s about helping me keep living.”Yvonne
Her words capture something that can sometimes be lost in national conversations about the end of life. Hospice care is not simply about someone’s final days. It is about helping people live with a life-limiting illness, maintaining their independence and quality of life, managing symptoms and making the most of the time that matters to them.
Everyone who could benefit from that care should have the opportunity to experience it.
The funding of hospice care cannot be separated from this conversation.
Here in Somerset, St Margaret’s provides specialist care and support to people in their own homes, in the community and at our In-Patient Unit in Taunton. Our care is free to patients and their families, but last year it cost around £15 million to provide that care, and the cost continues to rise.
Only a proportion of that cost is met through NHS funding. The rest must be raised through the generosity of our local community, our shops and other charitable income. We are enormously grateful for that support. But charitable giving should not have to compensate for an unsustainable national model for funding essential end-of-life care.
This is why St Margaret’s stands with Hospice UK and hospices across the country as together we continue to advocate for a fairer and more sustainable approach to hospice funding.
Hospices have an important role to play in the future of health and care. By providing specialist support in people’s homes and communities, they can help people remain where they want to be, support families and carers, and reduce avoidable pressure elsewhere in the health system.
But to fulfil that role, hospices need the certainty to plan their services, support their workforce and respond to the growing number of people who will need palliative and end-of-life care in the years ahead.
Keeping people at the heart of the debate
There will continue to be strongly held views on assisted dying, both in Parliament and across our communities. And we respect that. Our role at St Margaret’s is not to tell people what they should think. It is to advocate for the care, dignity and support that everyone facing the end of their life should be able to expect.
We support informed choice and respectful dialogue. We also believe that access to outstanding palliative and end-of-life care should be equitable – not determined by where someone lives, their circumstances, or the financial pressures facing their local hospice.
Whatever happens next with the Terminally Ill Adults (End-of-Life) Bill, that challenge remains. Everyone deserves the opportunity to live as well as they can, for as long as possible, and to receive compassionate, expert care when they need it. Ensuring hospices have the sustainable funding to provide that care must remain an urgent national priority.