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Sinn Féin Assembly debate - Delivering Choice for the Terminally Ill

9 December, 2007


Sinn Féin Health Spokesperson Carál Ní Chuilín is calling on the Minister of Health Michael McGimpsey set up a pilot programme to ensure that cancer patients and their carers get the support they need throughout the palliative care period.

The Assembly will debate a motion from Mc Ní Chuilín tomorrow, Monday 10th December, on 'Delivering Choice for the Terminally Ill'.

Ms Ní Chuilín said:

"In the North of Ireland almost 4,000 people die every year from Cancer. Yet, out of the 64 % of terminally ill people who would choose to die at home, only 25 % are actually able to do so. After meeting with Marie Curie I sought this debate because terminally ill people will continue to be unable to die in their place of choice unless action is soon taken.

"We desperately need a 'Delivering Choice' programme which will address this inequality and pioneer a new approach to the provision of palliative care for terminally people, making the wish to die at home a reality.

"Cancer is a very difficult illness to live or cope with and there is no doubt that this scheme can relieve the incredible pressures put on individuals and their families suffering from the illness. I would appeal to all MLAs who have ever known anyone who has suffered from cancer, a friend or a loved one to take a moment and think about the differences that a Delivering Choice programme, which delivers palliative care can make.

"I passionately believe that the introduction of a Delivering Choice pilot programme will vastly improve the Belfast's Hospice ability to provide the provision of palliative care.

"In the majority of cases people who are terminally ill don't even know that they have a choice as to where they die. Professionals are often reluctant to support end of life home care and services are often not sufficiently well developed to ensure patients can be cared for safely in the community. It is my belief that if people genuinely want to die at home, the individual and their family should have access to the services needed to make this feasible.

"In the Lincolnshire pilot 66 % of the terminally ill patients expressed a desire to be cared for at home, even if they required complex palliative care. Not only is a home death the preferred option but patients who are cared for at home or by specialist palliative care teams have received similar or better symptom and pain control and a better physical quality of life than those who received conventional hospital care.

"On top of these social benefits the Delivering Choice programme also offers economic benefits. It has been shown in Italy, Spain and across the United States, that spending in this area can release money which could be used elsewhere in the Health Service. It can also address issues related to the ambulance hours, hospital waiting lists and bed blocking." ENDS

Note to Editors

Motion - Delivering Choice for the Terminally Ill

That this Assembly expresses concern that 75% of terminally ill people are unable to die in the place of their choice, whether in their own home or the home of a family member; and that many terminally ill people are admitted to hospital on multiple occasions, unnecessarily, during the final weeks of life, causing stress to their families and carers; welcomes the positive results emerging from the 'Delivering Choice Programme' which Marie Curie Cancer Care has operated in Britain; and calls on the Minister of Health, Social Services and Public Safety to provide the necessary resources for a pilot programme aimed at ensuring that patients, and their carers, receive the necessary support throughout the palliative care period.

[Ms C Ní Chuilín]

  1. The first Delivering Choice pilot project was launched in October 2004 in Lincolnshire. Well into Phase 3 this project has gone to great lengths to improve service provision so that greater choice can be extended to a wide range of terminally ill patients wishing to die at home.
  2. Marie Curie Cancer Care is presently undertaking economic research to realise the precise extent of these savings but Marie Curie Cancer Care believes that in the medium to long term for every £1 invested £2 will be released to go towards hospital services.
  3. In Lincolnshire the Rapid Response Team prevented more than 550 unnecessary hospital admissions in its first year. Not only does this help to achieve the wish of the patient but also helps to ensure that ambulance hours are not wasted and freed up approximately 3,000 occupied hospital beds with a monetary saving of £900,000 in the acute sector.
  4. Research has shown that an individual who spends the last fortnight of their life in hospital may be estimated to require £4,200 worth of services compared to a spending of £2,500 for an intensive community support package for the same period of time.

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