Access to Palliative Care and Treatment of Children Bill [HL] (HL Bill 13)

1 Palliative care and support

(1) In exercising functions in relation to the health service in England, the
Secretary of State must ensure that an NHS clinical services commissioner
must arrange for the provision of the following services to such extent as it
5considers necessary and appropriate to meet the reasonable requirements of
the persons of all ages for whom it has responsibility—

(a) access to specialist palliative care in hospital, in the community and in
places of usual residence;

(b) facilities for the care of patients with life-limiting and life-ending
10conditions;

(c) general and specialist palliative care services consistent with the duty
as to reducing inequalities specified in section 1C of the National
Health Service Act 2006.

(2) Any hospice which is providing palliative care services for adults or children
15is entitled to be treated as if its services were commissioned by a clinical
commissioning group as part of the health service to the extent needed to
enable the hospice to access pharmaceutical services on the same basis as any
other service which is commissioned by a clinical commissioning group to
provide services as part of the health service.

(3) 20An NHS clinical services commissioner, in exercising functions under section
3(1)(c) of the National Health Service Act 2006, must ensure that—

(a) persons in their area with palliative care needs have access to
appropriate health services including, but not limited to, access to
specialist palliative care; and

(b) clinicians providing general palliative care have access to specialist
5palliative care advice at all times.

(4) NHS clinical services commissioners must include the provision of specialist
palliative care and hospice care in any strategic plans to meet the needs of
adults and children predicted to require such services.

2 Treatment of children with a life-limiting illness

(1) 10This section applies where a health service body is considering making an
application to the High Court under the Children Act 1989 or under the
inherent jurisdiction of the High Court for an order which has the effect of
approving the giving or withdrawal of any form of medical treatment for a
child.

(2) 15No application of a type referred to in subsection (1) may be made unless—

(a) the health service body has followed a process of mediation with an
independent mediator in an attempt to resolve any differences between
the health service body and any person who has parental responsibility
for the child or is recognised by the health service body to have an
20interest in the welfare of the child, and

(b) that process has been unsuccessful in reaching substantial agreement
about the medical treatment to be given or not to be given to the child.

(3) Subsection (2) does not apply where either—

(a) the health service body satisfies the court that there is substantial
25urgency and it is in the best interests of the child to proceed to a court
hearing without having a mediation process; or

(b) the health service body satisfies the court that it has made all reasonable
attempts to undertake a mediation process but it has not been possible
to undertake such a process due to the actions or omissions of anyone
30holding parental responsibility or having an interest in the welfare of
the child.

(4) In determining any application of a type referred to in subsection (1), the court
shall assume, unless the contrary is clearly established, that any medical
treatment proposals put forward by any person holding parental
35responsibility for the child are in the child’s best interests.

(5) Nothing in subsection (4) requires, or may be relied upon to require, the
provision of any specific medical treatment to a child by either a doctor or a
health service body which a doctor or a health service body refuses on
reasonable grounds to provide to a child.

(6) 40This section does not apply in relation to court proceedings instituted before it
comes into force.

3 Interpretation

In this Act—

• “child” means a person under the age of 18;

• 45“health service” means the health service in England and services
  provided as part of the health service;

• “health service body” is any service functioning as part of or on behalf of
  the National Health Service;

• “health service hospital” has the meaning given by section 275
  (interpretation) of the National Health Service Act 2006;

• 5“ NHS clinical services commissioner” includes the NHS Commissioning
  Board and clinical commissioning groups as defined in sections 1H and
  1I of the National Health Service Act 2006;

• “palliative care” means care which is delivered to seek to improve the
  quality of life of persons with life-limiting illness or approaching the
  10end of life, through the prevention and relief of suffering by means of
  early identification, assessment, treatment and management of pain
  and other problems whether physical, psychological, social or spiritual;

• “parent” means a person with parental responsibility for a child in
  accordance with the Children Act 1989;

• 15“places of usual residence” includes places where persons in need of
  palliative care may be confined and includes care homes, supported
  residential accommodation, secure mental health facilities and prisons;

• “specialist palliative care” means care provided by multi-disciplinary
  teams of specialists in palliative medicine and palliative nursing and
  20allied health professionals who have undergone specialist training in
  palliative care, and related supportive disciplines.

4 Extent, commencement and short title

(1) This Act extends to England and Wales only.

(2) This Act comes into force on the day on which it is passed.

(3) 25 This Act may be cited as the Access to Palliative Care and Treatment of
Children Act 2020.