An opportunity to reset end of life care

This is the second of a series of three posts about the right to die, end of life care and its legislation. The first post can be seen here.

Many rapid changes were made to prevent the NHS’s urgent services being swamped by Covid-19. Whilst we wait for population immunity- preferably through a successful vaccine – and hope there is no second wave, the NHS now has to adjust to the new normal. The NHS needs to start to deliver the routine care, the scans, the operations and cancer care that are now backlogged. This will require new ways of working and thinking or prolonged rationing of services will be a reality. There is now a real need and opportunity to reset how we manage Health and Social Care.

Now is the time to be thinking of end of life care, as even amidst the sad news of the thousands of care home deaths and the concerns raised about Covid-19 and Do Not Resuscitate orders, there was one silver lining – the importance of talking about death, advanced care planning and end of life care was brought sharply into focus.

UK end of life care, in parts, is exceptional. But many do not get the care they need, and live in fear. Services are patchy, disjointed, and not available all the time. This is unsurprising given that state funding of hospice care is woeful and that when any one part of a complex web of inter-related services struggles, patients and service users easily fall through the gaps. When Jeremy Hunt, posted his slightly sinister tweet “Every older person should die with dignity and respect…” he did have a point.

Person centred end-of-life choices can be transformed through the development of a national Care at the End of Life Service sitting within a joined up Health and Social Care system. Properly funded, and funded for the long term, we can deliver services:

  • Centred around the needs of the individual, their families and communities, and to national standards.
  • Available 24/7, with rapid access to urgent care, particularly pain, symptom relief and distress in all care settings.
  • That are easily accessed, having one central coordination point for ALL needs.
  • In the place of the persons choosing.
  • In rural communities and urban centres to the same standard (no post code lottery).
  • Responsive to the needs of people who report a poorer quality of end of life care.
  • That provide bereavement support and counselling.
  • Which enable partnership working at a strategic level between all stake-holders.

There is one other important benefit to developing a national Care at the End of Life Service that Liberal Democrats should consider. Is having a choice over how we wish for our life to end, not the last great liberal debate, the last human right, and one Liberal Democrats should support? I would argue that the Liberal Democrat goal of humane, secure “Right to Die” legislation can only ever be achieved if we have a national Care at the End of Life Service that supports everyone through every step of their last journey to help, respect, care for and protect individuals at the end of their lives.




* Dr David Harding is a Lib Dem member, and a former Lecturer and NHS Consultant

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This entry was posted in Op-eds.


  • Harriet Clough 14th Jun '20 - 9:26am

    And adequate protections built-in against abuse of the system. Right to Die has to mean Right to Live, too. It has to mean disabled people not being forced to fight DNR orders because people don’t believe their life is worth living.

  • david harding 14th Jun '20 - 6:10pm

    Harriet, absolutely. Every person should have the same rights, and stringent protections are a necessity.

  • David,

    Thank you so much for these pieces, and particularly for putting the right to die alongside decent and properly-valued end-of-life care.

    There should be no conflict here: treating our citizens at end of life with respect and dignity requires us to do what we can, as a society, to give them the best possible palliative care, the best achievable quality of life, and meaningful choice as to the manner and timing of their own deaths.

    The right to choose to let go is only meaningful if it is set alongside the right to choose to carry on.

    As a society, we should never force either choice upon anyone, and we should have rigorous safeguards in place to defend that right.

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