Rev Dr Robert Coulter, the Ulster Unionist Party Assembly member for North Antrim and UUP Stormont Commissioner, has called for a ‘family first’ approach to helping terminally ill patients.
Assemblyman Dr Coulter, who is also UUP Health Spokesman, issued his plea during a Stormont debate calling for a study into care facilities for terminally ill in the Province.
He added: “I fully supported the motion that the Assembly expresses concern that 75% of terminally ill people in Northern Ireland are unable to die in the place of their choice, whether in their own home or the home of a family member.
“The motion, which was successfully passed, also expressed concern 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.
“I also welcomed the positive results emerging from the ‘Delivering Choice Programme’ which Marie Curie Cancer Care has operated in Great Britain, and supported the calls to Health Minister Michael McGimpsey 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.
“The care of patients must always be at the heart of the Health Service; without that guiding principle, it becomes a matter of simple economics, which leaves the patient aside. That principle must apply to the palliative care of terminally ill patients, just as it applies to waiting lists and hospital cleanliness.
“Patient care must not be simply an objective of the Health Service: it must be an intrinsic part of its culture.
“Of all Departments, the Department of Health, Social Service and Public Safety touches areas to which no easy cost can be affixed, and the care of terminally ill patients is one such area. However, the use of robust health economics models for the home-based management of terminal illness has begun in the public domain.
“The Sheffield School of Health and Related Research was commissioned to develop such a model in 2003. Evidence from the USA, Spain and Italy suggests that a home-based terminal model may lead to cost savings.
“For that reason, the Health Minister should consider the commission of his own study to establish the real situation and to create financial and health economics models to address it.
“Too many of the available studies relate to outside the UK, let alone Northern Ireland.
Almost £400 million is spent on palliative care in England. We must establish the overall figure for Northern Ireland to give a ballpark figure to work towards; within that provision, there is a broad range of services to consider.
“The indications are that the uncosted value of informal carer inputs to the system is approximately £2,500 per carer.
“The community certainly admires the work of the Marie Curie nursing service. I praise those who have gone into that service in order that people who are terminally ill may be cared for properly; I also take into account the contribution of many family members.
“Marie Curie Cancer Care estimated that end-of-life care at home would double its existing spend; a fact that may give us a handle on what is involved.
“Whatever the facts, they will be satisfactorily collated only by a specialist ministerial working party that will give us real, practical and logical figures from which to work.
“Of one thing we may be sure: we must always take into account the wishes of those who are coming to the end of the journey of life.
“In my experience in another life as a full-time Presbyterian minister, I found that one of the things that touched me most was the despair that one sees sometimes in a hospital bed in a patient who cannot be at home among family to end the journey of life.
“With that in mind, I fully support the call for a pilot study so that we can put the care of the patient and the family first and ensure that a person who is coming to the end of their life is given some peace of mind and good care,” said Assemblyman Dr Coulter.