Hospital deaths could rise by more than half in the next 20 years if “substantial investment” in community care is not forthcoming.
That is the warning from Highlands and Islands MSP David Stewart, who has described the right to die at home as a “basic human right”.
It comes after Hillswick GP Susan Bowie contacted him about the gap in so-called hospital at home care. Mr Stewart says he has also received similar concerns from other GPs in Scotland.
The party’s shadow public health minister was speaking during a member’s debate on research projections into place of death in 2040.
The debate homed in on research by charity Marie Curie, Edinburgh University and Kings College London, which said that – if trends continue – two thirds of patients in Scotland could die at home, in a care home or hospice by 2040.
Currently, less than half are said to do so.
However, the research states it is “very unlikely” to happen without substantial investment in community-based care, including care home capacity.
Without this investment, it states, hospital deaths could rise to 37,089 over the next two decades.
During the debate Mr Stewart outlined the concerns of Dr Bowie. The Hillswick GP previously told The Shetland Times she had, at one time, organised volunteer help for families in caring for their relatives.
A list of trained people were, on occasion, available to help and to give relatives a break.
However, Dr Bowie said this was later closed in the isles and social care struggled to fill the gap. The upshot was that carers were not available at night or at weekends.
Mr Stewart said the situation had since moved on with Health Secretary, Jeane Freeman, telling him that the current model of on-call nursing in Shetland would be extended to a waking night service using advanced nurse practitioners alongside care staff to support people in the community.
This will start this year.
But the MSP insists there are still insufficient numbers of carers and nurses, especially during evenings and weekends, despite reassurances to the contrary from Shetland Integration Joint Board.
Mr Stewart told fellow MSPs: “This is an issue that has long interested me and has fundamental public health implications for Scotland.
“Having a right to die at home in my view is a basic human right and accords with the European Convention on Human Rights.”
Mr Stewart said parliament had previously been praised for ‘legacy policies’ such as free personal care, the smoking ban and minimum unit pricing on alcohol.
“In my view a right to die at home policy could join the illustrious group of legacy policies that parliamentarians and constituents of the future could look back on with pride.
“Parents have the right currently to have their child born at home and the NHS provides midwives, but we don’t have the right to have carers to enable us to die at home. So, I see a real policy gap there.
“In conclusion there can be fewer more important policy areas in health than one that provides certainty to those suffering from terminal conditions and the choice over place of death, to spend the last days and hours at home with loved ones rather than in hospital with strangers.”
Mr Stewart’s own member’s debate on the right to die at home is set to be heard early in 2020.
The integration joint board has previously argued Shetland has the highest percentage of anywhere in Scotland – 94 per cent – when it came to the last six months of life spent at home.
Health official Jo Robinson previously told The Shetland Times: “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.”