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What the new UK Government means for people at the end of life

Author: Stephen McCauley
12 July 2017

Stephen McCauley, Policy and Advocacy Manager at Hospice UK, explains what the outcome of the last general election means for people in hospice care, and what will happen next.

The new UK Government recently announced its legislative priorities in the Queen’s Speech.

The Conservative manifesto set out the Government’s plans for health, social care and supporting carers.

However, given the result of the general election and the parliamentary reality of a minority government, many of the party’s more controversial policies are either up for negotiation or have been dropped entirely.

There are manifesto pledges relevant to people living with terminal and life-shortening conditions that we expect to be taken forward, as well as a new Minister, Jackie Doyle-Price (MP for Thurrock) with responsibility for end of life care in the Department of Health.

As health is a devolved responsibility, much of the Government’s plans for people in need of hospice care apply only to England.

Manifesto priorities

  • End of life care

The Conservative manifesto made the following commitment to improving end of life care in England:

“We will fulfil the commitment we made that every person should receive attentive, high quality, compassionate care, so that their pain is eased, their spiritual needs met and their wishes for their closing weeks, days and hours respected”.

This pledge refers to the National Commitment on end of life care – the government’s response to the Review of Choice in end of life care – published in July 2016.

As part of the coalition of end of life care charities, we support the aims of the Commitment, but have serious reservations about the ability of Government to deliver on these promises when there is no additional funding. In particular, the lack of support for community based care is a serious omission.

  • Carer’s leave

The party’s manifesto made a pledge to strengthen employment protections for working carers of people approaching the end of life across the UK:

“As the majority of care is informally provided, mainly be families, we will give workers a new statutory entitlement to carer’s leave, as enjoyed in other countries.”

This pledge was made largely thanks to Hospice UK’s lobbying efforts over recent months. Carers play a crucial role in caring for someone approaching the end of life – we see them as co-deliverers of hospice care. In the context of increasing demand for hospice care the role of carers will only increase.

For the carers themselves, this role can be very demanding and many people who care for a spouse or other family member with a terminal illness or life-shortening condition are leaving the workforce as their caring responsibilities grow. This can have long term negative financial and labour market impacts.

We have been campaigning for the government and employers to do more to support working carers of dying people, including strengthening flexible working arrangements and introducing carer’s leave – allowing defined periods of leave of absence with a guarantee to return to a job.

We believe being able to return to a job will mitigate many of the financial and employment difficulties experienced by carers.

We are currently working with the government to ensure that this manifesto commitment is implemented in the current Parliament.

  • Health reform

The Conservative manifesto chapter on health set out how further responsibility and accountability would be given to NHS England to organise and deliver care, including for the STP process:

“We will also back the implementation of the plan [the Five Year Forward View] at a local level, through the Sustainability and Transformation Plans, providing they are clinically led and locally supported.”

For the NHS, service change is now more difficult. NHS England has made clear that it wants STPs to press on with reconfigurations this summer. Given the political context it is unlikely there will be much appetite for controversial service change.

In the meantime, we are continuing to monitor progress on STPs across England. The NHS England Programme Board for End of Life Care will soon be publishing a range of resources aimed at encouraging STP leads to reflect end of life care within their plans.

Parliamentary reality

The law of parliamentary arithmetic means that controversial legislation will be more difficult to pass in a hung parliament.

With a minority Conservative government supported by the Democratic Unionist Party (DUP) on a confidence and supply basis, it was therefore no surprise that many manifesto commitments were dropped from the Queen’s Speech, or turned into consultations, including on social care. In the end, the speech was dominated by eight Bills on Brexit

With a preoccupied Parliament and a minority Government it is difficult to predict what will happen next. This may mean limited scope for legislative change in health and social care, but could just as easily mean concessions will need to be made. Watch this space!

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