Palliative Care Bill [HL]

My Lords, I join everyone here in welcoming this profoundly important Bill and in congratulating the noble Baroness, Lady Finlay of Llandaff, on her far-sighted determination to create a Bill that has the potential to bring real care and comfort to the people of our country. When I was a parish priest I had the privilege of being involved in the work of a local hospice. To be with patients, families and staff as individuals made their journey towards death was humbling and deeply moving. Years later, I can bring particular individuals to mind. I think, for example, of a very senior military figure dying in that hospice. Suddenly and unexpectedly, all his terrible experiences of the Second World War erupted. He was very perturbed. In that hospice, the provision of physical, emotional and spiritual care meant that he ultimately went to his death in peace. I think of an Austrian woman with no family whatever, who described the hospice as the best trade union she had ever belonged to, because she discovered a sense of human solidarity there—remember: no family, no relations, no one but herself. Now that I am a Bishop, I have the privilege of being patron of a number of hospices in Hertfordshire and Bedfordshire. I witness palliative care of a high order in each, based upon a number of implicit and explicit beliefs. First, each human being has absolute worth and value, and must therefore be treated with compassion, respect and love. Secondly, dying can, paradoxically, be part of a healing process for the person who is dying and for their family. Thirdly, the attention given by society to the dying is usually a measure of how it treats the living. Fourthly, each individual’s spiritual and religious needs should be accorded as much attention and care as their physical and emotional needs. I shall briefly concentrate on that last point. It seems to me that every one of us, whether we practise a religious faith or not, has an indefinable but irreducible core for which the word ““soul”” is the most appropriate description. If we do not treat people’s inner beings, their souls, seriously, we are failing to treat them with that respect and compassion which is the inalienable right of all human beings. For those of us with a religious faith, of course, our spirituality is shaped by and given expression through that faith, but when I use the word ““soul”” I refer to every human being whether they have a faith or not. Religion and spirituality are not necessarily the same. If what I have said is true, it follows that we cannot talk of palliative care being adequate or good if it does not take seriously the spiritual and religious needs of each one of us. I join with others in welcoming the Government’s creation of an end-of-life strategy group; though that seems the kind of title George Orwell would have given anything to create. In its initial remit and the make-up of the board, however—with the greatest respect to all its members—there seem to be some gaping holes. In defining its task, the strategy group uses almost exclusively mechanistic language. There is much talk of ““leavers””. In Professor Richards’s letter to his colleagues, just over a single side of A4, the word ““leaver”” occurs no fewer than four times. It is of course accompanied by talk of ““underpinning”” and ““delivery””. I understand such language, but can someone please tell me why the word ““spirituality”” is not mentioned in a strategy devoted to improving palliative care? Language is always significant, and if we use only mechanistic language to shape our thinking about palliative care, we shall end up treating human beings like robots. I hope I have not got this wrong, but I have been told that there is not a single member of the hospice movement in this end-of-life strategy group. The group, quite rightly, includes someone to ensure that racial equality issues are not overlooked. Can someone please explain why there is no one from the hospices? Why has that movement, which has thousands upon thousands of dedicated volunteers and totally devoted, experienced and professional palliative care personnel, been overlooked? I suppose I would say this, but if it is true, as I have said, that every single human being has a soul, why is there no representative from the fields of spirituality or religion? In common with other priests in this country, I have sat with dying people time after time. I have heard the confessions of the dying. I have taken hundreds of funerals. Does that have nothing to contribute to a group looking at end-of-life strategy? The Bill is so important because it will deeply affect our entire nation. It is based implicitly upon the value and worth of every single human being, and implicitly desires for each one of us the best and most peaceful death. But it will be in the implementation of such a Bill that the real test of this proposed legislation will be found. We shall need to keep a careful eye on that implementation process, to see whether the dominant metaphor is of human beings as machines, or as living souls. I, no doubt along with everyone else here, warmly welcome the Bill. We have before us the opportunity to ensure the best palliative care pathway for everyone in our country, but its potential will be truly fulfilled only if the values implicit within it are made explicit in its application.