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Health / MSPs and local GP raise the right for full care to die at home

Dr Susan Bowie and Highlands and Islands Labour MSP David Steward in the garden of the Hillswick surgery.

THE RIGHT to have full care at home for a patient’s last few days of life is being raised in the Scottish Parliament by Labour MSP David Stewart.

Stewart, who represents the Highlands and Islands and is the Scottish party’s shadow public health minister, is seeking cross-party support for his motion for a member’s debate on the issue.

He has the support of Shetland GP Susan Bowie who raised her concerns with him on a recent visit to the islands.

Dr Bowie stressed that 70 per cent of the population in Scotland wished to die at home and many Highlands and Islands-based GPs were trained in palliative care supporting that wish.

Shetland, however, does not have charities or carers who provide ‘hospital at home care’ and the Hillswick-based GP believes that other areas of Scotland may also be in the same position, especially in rural and remote areas.

The GP and the MSP say there should be an automatic right for people to have full care at home day or night for their last few days of life, so that they can have their wish fulfilled to die at home.

Stewart said: “Susan raises an important point, that you have the right to be born at home and the NHS provides midwives, but we don’t have the right to carers to enable us to die at home.

“I am worried that people in Shetland are being treated differently to those in the rest of Scotland due to lack of carers who can go in and support patients for their final few days.

“Often relatives are unable to do this, or just need a break from caring for their loved one, during a very stressful period.”

Dr Bowie said in the past when someone wished to die at home, she was able to organise help for families in caring for their relatives, as children often find it difficult to take care of their parent’s personal needs.

“This was in the form of ‘hospital at home’ here in Shetland, a list of trained people who would be available occasionally to help if required, and to give relatives a break. It was a great low-cost service,” said the GP.

“However, this was closed in Shetland years ago, but social care cannot fill the gap. Apparently, they are not available at night or at weekends.”

NHS Shetland said in response that the health service was in the process of developing an overnight nursing and care service that would allow more people to die at home.

Josephine Robinson, joint NHS Shetland and Shetland Islands Council’s interim director of community health and social care, said: “Figures from information services division Scotland show that in 2018/19 Shetland had a percentage of 94 per cent of time in the last six months of life spent at home or in a community setting.

“This is the highest percentage of anywhere in Scotland, and consistently the highest percentage in Scotland since 2013/14.

“However, the health board recognises the desire for even more people to be supported to die at home. We are in the early stages of developing an overnight nursing and care service to enable more people to stay living at home and to die at home should this be their choice.”

Stewart’s initiative to establish the right to die at home has received the support of his Highlands and Islands Labour MSP colleague Rhoda Grant.

She said: “The Scottish Government will say we have the choice but without the right to care at home in the last few days of life, and social care or the NHS providing that care, it can’t happen easily especially if someone just has a few relatives.”