Social Security System: Terminal Illness
Working through the best approach to terminal illness for our new social security system in Scotland has been the most challenging thing I’ve faced as a government minister. It is both sensitive and difficult because a diagnosis of terminal illness brings with it a significant impact on the individual and their family and implications for the care and management of their condition and the choices they may make about how they live their lives. The medical practitioners who have to take these difficult decisions are very mindful of these implications, which go much wider than access to benefits – and I am conscious of the responsibility that places on them and the vital role they play.
So when this issue was initially raised, alongside consideration of the impact on people who would receive benefits I was also concerned that the clinicians and those with the professional experience who must make these difficult decisions were consulted on their views.
The response from the British Medical Association, the General Medical Council, the MND Clinical Network, and the discussions I had with the Chief Medical Officer and the Chief Nursing Officer for Scotland was clear. Because of the complexities involved, they believe 2 years was too long a timescale not to risk negative consequences for the individuals involved, but they and I also know very well that the UK Government’s current 6 month limit excludes some people who should receive the support from social security that they need.
As a result I want to focus on the importance of clinical judgement and move away from only having a time limit – because any definition that only has a time limit will always exclude some people who need our support. Having continued to listen, I will now act to remove any time limit from the legislation on social security and let clinicians do the job only they can do, focusing as they will on the individual patient they have in front of them.
This will allow clinicians provide a diagnosis in a way that will minimise any unintended consequences, while enabling those who need social security support to access the maximum award that they are entitled to – quickly and with no assessment process.
There will be ‘special rules’ for people with a terminal illness written into our legislation. These will include no assessment requirements, benefits from the day of application at the latest and provision of the highest level of financial support that a person is eligible for.
I am very grateful to the professional clinical bodies, to the third sector organisations and to all those MSPs who have discussed this with me for their very considered and thoughtful approach to this complex issue. I know we are all determined to get this as right as we can for those who need our support at the most difficult time and for our medical practitioners charged with making very difficult decisions.
I believe that this approach will deliver support to those who need it, quickly and with the dignity and respect they and our medical professionals deserve and I hope all MSPs will support this when they vote on this landmark legislation on Wednesday.