Contribution
I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, and I draw the House’s attention to my entry in the Register of Member’s Financial Interests. I am an officer of the all-party groups on carers, and on housing and care for older people, and I was formerly chief executive of the Centre for Ageing Better.
As ageing is a subject close to my heart, I decided to check out my latest personal life expectancy projection according to the Office for National Statistics life expectancy calculator, and it turned out that I have a one in four chance of living to 95. Many people would think, “Oh, how fantastic!” Yes, we all want to live longer, but not everybody will enjoy that same life expectancy. We know that there is a significant gap—about 19 years—in life expectancy between the most and the least deprived. That gap is reflected across the country, as well as in my own constituency, between Wharfedale and Windhill and Wrose.
Despite the tech bros trying to defy ageing and death through all sorts of techniques, in reality we are mortal and we will all face death at some point. More of us will die at older ages because of increased life expectancy. To be honest with hon. Members, death is a boom industry, and if they have not already invested in a funeral director, that might be something to look at. The post-war baby boomers are now in their 60s, 70s and heading into their 80s, so more of us will be dying in the coming decades.
Society needs to change in a number of ways to respond to our ageing society. Departments across Government are looking at related issues, including working for longer, which is a matter for the Department for Work and Pensions, and ensuring that we build new homes that are accessible. I will be speaking to the Minister for Housing and Planning, who summed up in the previous debate, about bringing in new regulations to make homes more accessible.
In addition, we need to reform end-of-life care. By 2050, it is projected that an additional 147,000 people will die per year, bringing the total to 745,000 per year. As the hon. Member for Strangford said, the people who miss out on end of life care are more likely to be older, from black and minority ethnic communities, from lower socioeconomic communities or to have a non-cancer diagnosis. There is a lot to do to close the gap in access to palliative and end-of-life care, particularly for older people.
An example of really good practice in Bradford is the REACT model—the Responsive Emergency Assessment and Community Team model. If you have not already visited, Madam Deputy Speaker, you may wish to do so. It is a partnership between the Marie Curie hospice and Bradford Royal infirmary. A palliative care doctor is embedded in A&E, so when people who are at the end of life are hitting the accident and emergency department, they get an intervention, assessment and referral back to a proactive multidisciplinary community-based team. The results are staggering in reducing the number of hospital bed days that people at end of life experience.
As we have heard, most people do not want to die in hospital. I commend the shift that this Government are looking to make from hospital to community, which I hope is as true around end-of-life care as around other services. However, there is a huge lack of consistency between integrated care boards in how and what they commission. There is much to do to support better care in the community, including providing better support to GPs, particularly those with a specialist interest in end-of-life care; having district nurses working more closely with primary care teams and embedded within the new neighbourhood health teams; more examples of hospice at home and multidisciplinary community teams; more training for care home managers and staff; and the innovative use of unused hospital wards to provide hospice services in hospital, where appropriate.
As has been mentioned, we must ensure that there is a 24/7 hotline for patients and, importantly, for their carers, so that when they find themselves in crisis at home, they can get access to the advice that they need. The National Institute for Health and Care Excellence has said they should have had access to such advice since 2011, but according to Marie Curie, only one in three areas has such a 24/7 hotline.
While there are examples of good practice, there is much to do. It is good news that more of us are living longer, but society has to adapt. I am pleased that we are doing things as a Government—we have a pensions commission and the Casey review looking at social care—but I say to the Minister: now is the time to have a national strategy for palliative and end-of-life care. We are an ageing society and we need that, along with reform of continuing healthcare. In his response, I hope he will set out how we ensure that everybody dies well in old age and has a good death.