Palliative Care Bill [HL]

My Lords, I agree with the right reverend Prelate about the importance of the Bill. I commend the noble Baroness, Lady Finlay, for introducing it to the House, because it provides a rare opportunity for us to note and act on the most unusual alignment of profound moral principle and serious political objectives. The Bill’s title, ““Palliative Care””, should be foremost in our thinking, in particular the word ““care””. I suspect that if we asked any person outside Parliament and government what were the most important aspects of their life over its passage, they would say the health of themselves and their family, and care when in need. That is a basic human desire, and the establishment of the National Health Service after the war provided, to the extent that it economically could, the means of trying to satisfy that need. I hope that in the subsequent debate—and, I am sure, in the Minister’s reply—we will not convert this into a question of economic necessity and availability of means, serious though those issues are. I propose to invite the House to consider the importance of the concept of palliative care, the commitment that it requires from us as legislators and its value to our society. I shall start with the commitment that it requires. Human life is not to be treated like some socio-economic commodity, the value of which relates to age, utility, the cost of medical treatment or the available finances. It relates to none of them. When, after the war, my party introduced the National Health Service Act, it did so to reflect a concept of human dignity. That human dignity was reflected in helping another person in need. Over time, medicine has developed and palliative care, which the noble Baroness called a young part of the medical profession, has refined its skills. It illustrates that the human need—the legislative purpose of looking after the healthcare of our people—can always change, but will never end. I sincerely hope that human dignity is not forgotten, because the Bill seeks to meet a need for the terminally ill person and his family that is potentially desperate and agonising, when their dependence, which is nearly always acute, is on someone else. The extent of that commitment must be considered seriously. Clause 7(b) includes a word that is rarely used in a legislative context, as the right reverend Prelate noted. In it, palliative care is defined as including, "““psychological, social and spiritual help and support””." ““Psychological”” and ““social”” are difficult concepts to meet analytically and financially, but they exist and are fundamental parts of medical treatment. ““Spiritual”” is not used religiously in this context; it refers to the relationship between one human being in need and other human beings who want to give care to the suffering person. That is a spiritual matter as well as a strictly medical one. It would be thinking overcome by intellectual hubris that did not recognise that spiritual context in palliative care. Why do I labour this point about the word? I do so because the intent of the Bill reflects the best values and moral principles of our society. In dealing with the extent of our commitment to palliative care, we must look at it holistically. Lastly, what is the value—not simply the economic value—of palliative care to our society? Clause 1 is a declaration of principle. Nobody could enforce it by judicial review; it repeats Clause 1 of most of the National Health Service Acts. It declares a national intent to help those who are ill. In determining its value beyond that, we must be careful to avoid the following line of thinking: terminal illness leads to palliative care, which is not precisely definable in financial and medical terms, so we move to the utilitarian analysis of whether it is worth it and to the economic factor—it costs so much—and we are driven over time to the conclusion that it is simply an economic question, which it is not. I think that the Bill is so important because those outside and those in my party who were little interested in the Licensing Act and were probably dismayed by the Gambling Act would certainly wake up to parliamentary action to look after them at their time of greatest need. It is the mark of a civilised society and, for my party, it is a mark of our commitment to our basic ideals.