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Janet Street-Porter: Why can't we treasure those close to death?

Thursday 30 November 2006 01:00 GMT
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This will be the last column I'm going to write about my sister Pat's ghastly experiences dying on the NHS - her funeral was yesterday, and since her diaries were published in The Independent two weeks ago I have been inundated with e-mails and letters from readers whose relatives and partners have experienced exactly the same distressingly shoddy standards of care in NHS mixed wards.

Pat was lucky enough to be rushed to a hospice for the very last day of her life - and we managed to get a glimpse of another, far more considerate and sensitive side of the NHS, in an environment where the needs of the patient are paramount.

If Patricia Hewitt can do one single thing to restore ordinary people's confidence in the NHS (given that she has been lambasted throughout the press and on the Today programme as a result of Pat's treatment) it would be to end the practice of placing terminally ill patients in mixed assessment wards after they have been taken to A&E departments.

Terminally ill people often have bad turns during their final few months or days, which can mean they are rushed to hospital and resuscitated - but to send them on to a mixed ward is to condemn them to yet another unnecessary bit of suffering.

Terminally ill people deserve the right to be treated as especially important NHS clients, not irritants to be swept into a cost-effective master plan. Ms Hewitt should ask NHS Trusts to explain why so few hospice beds are available - and why the extra £50m funding allocated for hospices and palliative care is not reaching the people who need it.

The National Council for Palliative Care said this week that, because of the funding deficits in the NHS, about one in five independently run hospices has not managed to reach an agreement with their local Trust about what level of funding they might expect this year, and were having to beg for charitable support to keep going. The NHS cash crisis has meant that about 60 per cent of voluntary hospices are experiencing a shocking cut of up to 17 per cent in funding.

Placing terminally ill patients in hospices removes pressure from general wards, and allows them specialised care in a far more humane environment - but the NHS funds only 50 per cent of the cash needed to run the network of 450 hospices in Britain. Why? The Government pledged to spend more on palliative care, but the cash allocated was not enough, nor was it ring-fenced, allowing local Health Care Trusts to siphon money off into other areas in an attempt to balance their books.

Patricia Hewitt should guarantee that in future all terminally ill patients who do not wish to die at home will be allocated places in a hospice as an unassailable right - and then order NHS Trusts to make this a priority. She should also increase funding to hospices, recognising that with an ageing population ravaged by cancer, Aids and Alzheimer's, these are the right places for people to spend their last days, not in the pot-luck environment of a mixed-ward, with one nurse to 28 patients, where they won't get fed, or helped to the bathrooms when they need it.

In Japan, old people are designated "living treasures". It's about time our government realised that our dying are "living treasures" - people who have paid their taxes and their NHS contributions and who have every right to be treated with love, care and respect, not utter disdain because they have the misfortune to be terminally ill in Britain in 2006.

Christmas lunch à la Nigella

The festive season has arrived, and with it tons of printed catalogues encouraging us to buy ethically correct gifts. Is it possible to enjoy Christmas without buying a single present, sending a pointless greeting card, and making one extra shopping trip? On television, normal schedules are junked in favour of seasonal specials - Nigella Lawson dresses in gorgeous scarlet for her Christmas Kitchen on BBC2, surely knowing that not one viewer in a million will bother to cook anything she enthuses about - but they'll be writing in to know who does her hair and where she bought that dynamite red satin frock. Once the two sad chaps in Men Behaving Badly made jokes about watching Cindy Crawford's exercise video after a drunken night down at the pub - now Nigella fulfils the same urgent need.

* Lindsay Lohan is a young actress more famous for her ability to party than her skills in front of the camera. We are quick to condemn young black kids for their obsession with knives and their warped sense of values - but is Ms Lohan really any different? Like teenage muggers, she is a product of her time, and is richly rewarded for nothing more than her appearance and iconic status (to other young women) as a clothes horse. Writing a letter of condolence to the legendary director Robert Altman's family, she ended an illiterate stream of drivel with the words "be adequate". Apart from the fact the grammar is painful and the sentiment insulting, why are we surprised? The only amazing fact is that she thought her stream-of-consciousness babble was so important that she decided to release it to the press. The notes and cards I've received since my sister's death have been a tremendous source of comfort - and thankfully no one has asked me to be anything, adequate or inadequate...

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