“However, 58 per cent of us end our lives on a hospital ward, regardless of whether or not we need to be there.  Death is one of the few things that we all share but also one of the things we try hardest to avoid discussing, but we must not let our squeamishness about death deter us from making sure that people can die without pain and with the dignity and respect they deserve.”

“Unfortunately, it appears that Primary Care Trusts are as reluctant to talk about death as the rest of us.  This has led to patients’ wishes not always being communicated effectively and a lack of basic training in end of life care for health and social care staff.  This needs to be put right, because nobody deserves to spend their last days stuck needlessly on a hospital ward because of a bureaucratic logjam.” 

“70 per cent of independent hospices are on pathetically short NHS contracts and, for 97 per cent of hospices, the funding they receive doesn’t cover the services they are expected to provide.  This is just wrong.  The NHS should not short-change hospices but should give them the funds they need to continue to provide first-class end of life care.” 

Mr Bacon, a member of the Commons public accounts committee, was speaking as the committee published its report on end of life care.  End of life care services seek to support those with advanced, progressive, incurable illness to live as well as possible until they die.  People approaching the end of their life often require a complex mix of health and social care services provided in hospitals, care homes, hospices and their own home.

The report finds that most people would prefer not to die in hospital but in 2006, only 35 per cent  of people died at home or in a care home and 58 per cent of deaths occurred in an acute hospital, ranging from 46 per cent to 77 per cent across Primary Care Trusts.  A lack of NHS and social care support services means that many people die in hospital so when there is no clinical need for them to be there. There is also a lack of training in basic end of life care amongst frontline staff, many of whom will at some stage come into contact with people nearing the end of their life.

The voluntary sector has made, and continues to make, a huge contribution to end of life care.  Some 70 per cent of independent hospices, however, have contracts with Primary Care Trusts for one year only and, in 2006–07, the funding received from the NHS by 97 per cent of independent hospices did not fully cover the costs of the NHS services they provided, or the cost of relevant overheads.  By May 2008, only 56 per cent had agreed funding for 2008–09.  Such contractual arrangements leave hospices with no firm, long-term base for developing and expanding their operations.