Off Air... with Jane and Fi - Pissed and looking forward to a jacket

Episode Date: November 14, 2024

Jane's cushion saga has led to her having a bit of a moment - It's Thursday, what can ya do! Fi provides a snippet of her AI children's story... could she make a career of it? And, of course, there's more misshapen veg to wrap up the week.Plus, Prof. Irene Higginson OBE, Professor of Palliative Care and Policy at King's College London, discusses the state of palliative care in the UK.Our next book club pick has been announced! 'The Trouble with Goats and Sheep' by Joanna Cannon.If you want to contact the show to ask a question and get involved in the conversation then please email us: [e-mail] us on Instagram! @janeandfiPodcast Producer: Eve SalusburyExecutive Producer: Rosie Cutler Hosted on Acast. See acast.com/privacy for more information.

And I said, oh, did you enjoy it? And she said, oh, yeah, Mum loved it. I mean, I'll be honest with you, it's not realistic. And there was a pause and I said, well, well, no, because it's about a talking bear who somehow obtains a passport and goes with his housekeeper to Peru. This episode of Off Air with Jane and Fee is sponsored by Norwegian Cruise Line. Have you ever thought of taking a cruise?

Well, it's crossed my mind. Tell me a bit more about it. Well, with Norwegian Cruise Line, you can travel to iconic locations across Northern Europe, the Mediterranean and the Greek Isles, unpacking only once and exploring multiple European destinations in one holiday. They offer exclusive go-local shore excursions as well as an immersive program of onboard experiences. I can't lie I'm intrigued by up to 21 dining options on a single ship. Well Jane their fleet has so many unique bars lounges and restaurants they also have fantastic

entertainment shows facilities on board you wouldn't be short of things to do. Plan ahead to discover your dream Europe 2025 cruise it's certainly one way to beat the winter blues. Experience more at sea with Norwegian Cruise Life. For more information call 0333 222 6513. Contact your travel agent or visit ncl.com. This episode of Off Air with Jane and Fi is sponsored by John Lewis Money. Fi, is there anything you can't find at John Lewis? No. As well as all the great bedding, kitchen kit, beauty from brands that we all know and

love, you can pick up cosy cashmere, Christmas decorations and even essentials for your pet. How about a new collar for Nancy? Well, and some sparkly pieces to wear to all those festive get-togethers. Well, quite. They even do money too, Jane. They really do have it all. At John Lewis Money, in-house experts and trusted partners work together to offer money products for real life. From the John Lewis Partnership credit card to insurance and travel money, they can help you think outside the bank. To find out more, search John Lewis Partnership credit card.

That's the spirit. Credit subject to status. 18 plus years, UK residents, T&Cs apply. John Lewis PLC is a credit broker, New Day Limited is the lender. Right, I had to write in my hand today Jane because I had a very long list of things and just keep forgetting them. Would you mind if I just did a couple of parish notices at the beginning so I don't forget towards the end? No, go on. Am I allowed to talk about a charity carol concert? Thank you very much Eve.

Eve has given permission. It is in support of AdFam which is a charity that I've done quite a bit of work for over the years. They're an absolute tiny charity and they look after people who are related to addicts, so it's the family around the addict. And they do such good work Jane because addicts have a pathway, don't they, which I think is quite recognised and if you can access care, you know, it's pretty clear what you might need to do but for families and loved ones of addicts I think it's a nightmare. So if you just imagine the mum of a, you know, it's pretty clear what you might need to do, but for families and loved ones of addicts I think it's a nightmare. So if you just imagine the mum of a son who's got

a terrible drug problem, that's a woman who probably needs quite a bit of support, doesn't know where to turn to, probably has to take loads of days off work and go and help out in emergencies and all of that kind of stuff. So ADFAM just really wraps them up and helps them out and sends them in the right direction. Charity Carol concert, St. Brides. What day? December the 12th. St. Brides is the church for journalists just off Fleet Street. It's beautiful, isn't it? I'm sure you've done many an event there. I don't think I've ever been there. Oh, Jane, you must go. Right.

You must go. It's really, really lovely. It's not, I mean, you wouldn't walk into it and go this is about journalism, but obviously because it's on Fleet Street it became the Church of Journalists. And the choir there is just sensational. So the Christmas carol concert tickets are available. You can go via Eventbrite or AdFam and it would be really, really lovely if people could come along. Once you've bought the ticket you don't have to give any other money unless you want to. You don't really even have to go.

What do you mean? I'm just saying, because sometimes it's that time of year where people get a tickle and you don't want anyone with a persistent cough. In a church, that's true. As long as you've spent the money, I mean, obviously it would be lovely to go and much better if you could go, but you don't need to worry and don't spread your germs. This is just a general message. Okay, well, it's quite a shutdown after I've done quite a long spiel, but absolutely.

I would say very much just give the money and then why bother? But if you wanted to go for the choir and the readings. Which will be lovely. Yeah. And you're doing a charity carol concert as well, aren't you? It's obviously that time of year. Are you sitting on a pew next to a princess again? Yeah, well, I don't think I'll be sitting on the same pew, but I think that is the week before.

It's for the Rainbow Trust at St Paul's Church in Knightsbridge. You can find details online and that will be similarly. The Rainbow Trust is a children's hospice. I mean, obviously they're both great causes. So if anybody has got a bit of money to spare at what is a challenging time of year for lots and lots of people, that would be great. I don't know if you could come to that. And we don't just, I do want people to come to Fees event and indeed to the one that I'm involved with. Actually, I'll tell

you why it's on my mind because Queen Camilla couldn't go to Gladiator 2. I know the premiere. She must have been gutted. Because she said she was going to be coughing. No, she had a chest infection. So that was what was in my head. So I apologise if I sounded unduly negative. Not my intention. And I think we had quite a few emails from people a couple of weeks ago saying they too, like myself, had enjoyed the trailer for Gladiator 2.

But the film's meant to be really, really rubbish. I wonder whether it will stop me from seeing it though. Oh, God. You don't think I should go? Well, I was listening to the fabulous Kevin Marr and I really like his opinions. He's the Times film critic and he also writes a very, very funny column every week. I've come to really trust his judgment and he just said it's so ridiculous. There are there are you know, the the the thing me jiggy What you call it computer generated stuff CGI. Thank you

It's been a long week. It's just it's just not great You know, there are sharks zooming around in the flooded Coliseum. There's a rhinoceros, I would say. Yes, and a rhinoceros, but they're just not terribly convincing. I mean, I know that you're going for different animals and for a different reaction. It just makes me laugh. I was talking to one of my oldest friends last week and she just, she rang up in a very good mood. She'd just taken her mum to see Paddington in Peru. And I said, oh, did you enjoy it and she said oh yeah mum loved it I mean I'll be honest with you it's not realistic and there was a pause and I said well

well no because let's just be honest about this it's about a talking bear who somehow obtains a passport and goes with his housekeeper to Peru that doesn't That doesn't, it doesn't happen. It doesn't happen does it? It doesn't. I mean Paddington is anthropomorphised to within an inch of anybody's sanity. But hugely enjoyable I gather. So there you go. But the Paul Mescal little skirt thing probably will get me there at some point. Have you seen Blitz, the Steve McQueen film? No, and we were facing a little toss-up of choice this weekend, whether to go and see Blitz or to go and see the Elton John biopic. Still want to call it biopic? Documentary. Is that in cinemas?

Yes, yeah. We've gone for Elton John only because the tenor of the news, the timbre of the news of late has just been so dark actually. Jane, I'm just going to have to wait to see a war film. That's just a personal thing for a while. I can't at the weekend genuinely say that I want to sit through it. But I know it's brilliant and he does a brilliant thing, doesn't he, Steve McQueen? He shines a light. Well, it's about, in a way, it's about the triumph of the human spirit, she said, sounding

terrifically grand. But it's also about London and it's a kind of love letter to London and about community and different sorts of people coming together in exceptionally challenging circumstances. Yeah, there are some bits that you find ludicrously saccharine. However, it didn't stop me crying twice. That's all I'll say about Blitz. So if you do, and also it's a film for the big screen, it's not something to watch on your tablet or, no, God forbid, on a phone. You do need to be there. So is it actually uplifting or do you have to sit through the doom for the moments of uplift? Yeah probably you do yeah but look I mean war is really shit.

Yeah and that's what I mean and yeah and you know you can't kind of you you have I think you have to be the right frame of mind to enjoy a war movie and I'm just not there at the moment. I hope people aren't put off going to see it because apart from anything else, it's great to see films made by British people about Britain and about our story and about how challenged we have been and about... Obviously we still have challenges, but anyway, I thought it was really good. So make time for it if you can. Now, I know that you're just about to embark on the emails, one called Rude Donut and Norovirus. And I would say that we're probably the only podcast in the world at the moment where you can send an email entitled that way. But could I just, because I don't want to forget to

do this, can I read you a tiny part of the story that we were talking about yesterday that was generated by ChatGPT featuring Nancy, Skoda and the man with tiny hands. Yes, this is, you asked it to come up with the story and it did. So I won't do the whole thing so it would take too long and Jane would get twitchy but here we go. In a quiet little town where nothing ever happened there lived a greyhound named Nancy who was sleek, graceful and entirely uninterested in running which was a constant source of shame to her owners who had hoped to turn her into a racing champion. Instead Nancy preferred to lounge on the couch, wear sweaters far too tight for her and binge watch reality TV. One day Nancy's owners decided her sedentary lifestyle needed a shake-up. They bought an electric car, an oddly chatty model called Skoda. Skoda was

self-driving, hyper-efficient and had a peculiar habit of narrating its own movements like a sports commentator. Accelerating to two miles per hour, absolute precision! Skoda would announce every time the car moved out of the driveway. The day Nancy met Skoda, she sniffed the bumper and sighed, great, another overachiever. But life was about to take a turn, and to Gary, a man with the smallest hands anyone had ever seen. Gary worked at the local library stamping overdue books but nobody ever noticed his work. They were too busy staring at his hands which was so tiny they made a deck of cards look like a dictionary. And so it goes on. I mean it's really really really not bad and I'll tell you what I thought by the end of it

and it takes about 10 minutes to get through. There's a lovely there are a couple of lovely lovely little payoff lines. Looking good Gary Gary said, snapping a photo with his phone, but his tiny fingers accidentally took 75 pictures of his own thumb instead. With stuff like that. You say so it's quite knowing, isn't it? It's so knowing. And it's written as if the personality of the author

is sarcastic, dry, a little bit kind of, yes, knowing. And you can imagine a celebrity attaching themselves to exactly that kind of children's story. It's got a moral at the end. I mean, literally, it says as it's broken down, the twist, and you get the twist in the story, the finale, and then you get the lesson all explained to you. And I mean, if I was the type of person who ended up, you know, cooking endless roast chickens on Saturday morning TV and making a flying fortune out of that, I just chat GPT my way into the young adult or child's Christmas book market. I don't know what you're saying that? Goodness me. That took no joke.

It poured out of the phone as soon as we put in what we wanted it to do. And remind me again what information you gave it to start with. So we said at the top, Can you tell me a bedtime story featuring a grey hand called Nancy, an electric car called Skoda and a man with very small hands? Please use a lot of detail and make sure it's funny. And out it came. It's 2024 everybody and people will no doubt look back and listen to this maybe in 50 years time and laugh their socks off

because things will be so much better. It was so much better than I thought it was going to be Jane. See I'm constantly taken by surprise. And this is a very small example of something that just happened to me this morning with my, I've got an Apple, an iPhone, and I was messaging my daughter and I was, you know, when suddenly you're offered the chance to use emojis, obviously in families, you occasionally exchange silly emojis. Yes. families, you occasionally exchange silly emojis. It offered me a sticker of a photograph of four attendees at my cousin's 80th birthday party in January and he listened. So yes,

it's you Peter. But I'd never made a sticker of four attendees at his 80th birthday party and suddenly it's an option for me to ping off to somebody in a message. So it's just, I don't, I didn't make it. But spooky but also really useful. Because you, did you use it? Yeah I sent it to her and she said, why have you sent me this? But she was, she was entertained by it, she just couldn't understand why I'd suddenly sent it. Often the gift is in the giving. I just don't, I understand, I did say to my other daughter, I'm already not understanding so much what am I going to be like in 20 years time if I'm spahead. As my late grandmother would have said.

It's just going to be terrifying, let's just be honest. Terrifying but also highly entertaining. Is there not a bit of it where you just go, well that's great, that's terrific. Increasingly I find that I am better able to embrace the joyful parts of our new modern tech world. I do love the map thing and actually getting the places that I want to get to. Getting lost for four hours. That's a boon if you can follow directions. And being able to time my day, you know, to leave at the right time to get somewhere.

Yeah, but I was out in the car the other day going to the tip actually and the map in my car was the wrong way round. We just press re-centre. Yeah, well we had to. It's just, oh and also today, thank you very much for the recommendation about the upholstery company who are indeed going to take on the onerous task of re-stuffing my seat cushions. I'm glad that worked out for me.

But they've asked me obviously to bring the cushions in and I was saying to you earlier, I think you were there weren't you, that I was thinking to myself, I'm going have to go on the tube with these enormous seat cushions, it's gonna be really difficult. And then just as I was leaving the house this morning, I thought, well, you got your stupid back, you don't need to, you just need to take the covers, don't you? I could just fit in a bag. Yes, because you're having them restuck. It's getting them back. Yeah, getting them back, well, that might be an issue, but you know, Ubers are available. Well, they are. And also, do you know what, you're going to find that very useful because

you might then end up in the same part of town as a family member of yours and it will be an excuse to pop in. Well, and you're so, you're close. No, I'm away most of the month. No, you're not. You're not. I just, yeah, but I honestly, I came this close to not working that out and thinking that I would somehow have to travel probably on public transport with two enormous sofa cushions. I would really love to have seen the look on their faces when he struggled into the shop and said, oh, oh.

Shit, I didn't need to bring... Do you know what, you're making me feel really bad now about the time that I actually took my sofa into them. What, your whole sofa? I came and picked it up, you wally. Right. Rude donuts and neurovirus from Anonymous. I have loved listening to you both for a time, a long time. Following on from the veg that looked like genitalia and it mostly being male genitalia, I wanted to share a picture of my mother-in-law's raspberry donut that she was served recently. I do hope it's not too offensive. No, it just looks a little

bit like something with some blood coming out of the end of it and we'll leave it there I think. Anonymous goes on to say, you were talking about norovirus and I did feel at that point a familiar fear as I have struggled with what I now know to be a metaphobia, that is the fear of vomiting for many years. Have you heard of this? I have heard of it and when I read that I did think of you because you can't stand vomit can you. I can't stand it. Do you think you've got that? I think I have. Anyway, Anonymous goes on to say I have had for many years panic and shame every time my children had a tummy bug. I just feel I can't cope. I wanted to run away as far as possible when what they need is me to give them cuddles. You mentioning it today

helped me to recognise how far I've come in giving myself compassion for this part of me and in doing so it has lost some of its power. Anonymous, do you know what? I completely, totally, 100% relate to that. When I became a mother one of the things I was most worried about was dealing with that. And when it comes to it you do deal with it as our correspondent has. But really quite early earlier on this year, one of one of the kids had a terrible bout of food poisoning and it was hard. I mean, I did go.

I mean, I was with her, but it was honestly, I wanted someone to give me a medal afterwards. I wanted someone to say, Jane, you've come through the biggest challenge of your life. And of course, they of course they don don't but years and years ago in local radio she should have done she owes me big time that girl. Is she all right? Yes she's fine. She's in her 20s she's absolutely fine. And it was a night in January as well so it was just really cold. We were in the bathroom all night. Anyway look thousands of people stay up to stay up every night with caring responsibilities. I get it.

So it's not about me, but strangely, I did once interview a psychologist who dealt with phobias and this is a relatively common phobia. And one of the treatments for it, I understand, I don't know whether it's still the case, is that you make fake vomit. You make it yourself. And then you I know it sounds ludicrous, you spend time around it and you realize it is nothing at all to be afraid of. But that was the treatment back in the 90s, maybe it's changed, I don't know. But it's a real phobia and I do feel for anyone who has it.

And it is just a genuine hazard of parenting. Oh, completely, yeah. It's a hazard of life, isn't it? You're never going to be able to avoid it. I was just never, I was really, really hopeless at ever clearing up the sick. So I could hold, you know, my kids' heads over various receptacles and toilet bowls and stuff, but I just couldn't ever deal with it if it had already happened. And to my shame, I just ended up just throwing out a lot of things that have been vomited over or into. I just couldn't deal with that aspect of it at all, which is ridiculous because I've just cleaned up endless poo. I mean,

it's another... That's extraordinary, isn't it? That doesn't bother me at all. Blood doesn't bother me. I couldn't do snot. Just couldn't. You know, some parents are really, really good at just... What are we going to call this podcast? Wiping away with their bare hands. Snot. And somebody once told me also that when you're a baby, you can't get rid of the snot. Some parents actually suck the snot. No!

And I couldn't, I just, I can't do snot. So that maybe that's a fake. Can I just recommend, recommend growing up on the basis that when you're a grown-up, your mother no longer spits on a hanky and wipes your mouth. So that's also really good. Yes, or... Suck snot out of your nostrils. Eve is saying could we please move on and let's, no, let's, let's move on because I think Mike Ward in Ultringham, as put his finger on something and well done for spotting it. I'm a regular listener to both the show. When's the show on, Jane?

It's on between two o'clock and four on Times Radio, Monday to Thursday. Get the Times Radio app. It doesn't cost you a penny. Or just retune your digital radio. It'll turn up in the scan under Times Radio. Mike goes on to say, I'm watching the Queen Camilla documentary about domestic violence on ITVX and we talked to somebody who featured in that documentary on the programme, Diana Parks, whose daughter was killed by her partner. And she's really wonderful actually and just had some really sensible things to say about spotting the early warning signs of coercive control, which can then end in such a tragedy. Mike says it's a tough but ultimately uplifting watch, highly recommended. But I'm appalled that ITV felt it appropriate to schedule a Johnny Depp Sauvage ad in the

ad break. What were they thinking? 100% agree. Yeah. I watched some of that programme, which was good and important. And let's also just acknowledge that we are now a society where the royal family are attaching themselves to causes like this. Now, I mean, we often talk about the Royal Family, they're far from perfect,

but I think that's an incredible step forward. So well done to Camilla for wanting to involve herself and wanting to attach herself to this issue. But I couldn't believe it, that ad was shown on ITVX and also the programme they chose to trail was about a woman being killed by her partner. It was a drama starring acts were Anna Maxwell Martin Oh, then until you kill me. Yeah, exactly. It was called that. Yeah, what were they thinking? Yeah, so well spotted Mike and we're grateful to you for enabling us to have this conversation about it because Every time I see that Johnny Depp advert

I wonder about the logic of people right at the top of that enormously profitable company, sitting in a boardroom going, yeah, that's fine now, you know, it's fine, you can still represent us. And we had that lovely email, didn't we, from the woman who had relegated Sauvage to the fragrance that covers up stinky poos in the downstairs loo and that's the best place for it. Traumatizing home economics memories come in from Kerry. As I walked along the Thames towpath in Richmond this morning, giggling happily to your tales of home economics. Like you Jane, I'm of a 64 vintage and I grew up in the North West.

I went to a very ordinary comprehensive school but was a diligent and hard-working pupil, always eager to please my teachers. Were you? Not particularly. Sadly the home economics teacher... Depended who they were. Never saw this side of me but I like to think that this saved me from being too much for goody two-shoes or heaven forbid a teacher's pet. We were making posh baked potatoes up north, can you believe it? Which was a mystery to me as I'd only ever eaten them straight from the oven a teacher's pet. We were making posh baked potatoes up north, can you believe it? Which was a mystery to me, as I'd only ever eaten them straight from the oven in their skins. When the instructions came to take the potato out of the skin and mash it with the butter

and cheese, I couldn't bear to see the delicious skins go to waste. I sneakily started to rip one of them into pieces and eat it. Imagine my horror. When the teacher then gave the instructions to put the filling back into the skin. I overfilled my one remaining half of the skin but was rumbled as she did the rounds of observation. I was completely mortified and not accustomed to the telling off I duly received." It's a lovely email and Kerry goes on to say, I'm pleased to report that I'm now much more competent in the laboratory and we are all going to call our kitchens laboratories from now on than in those early senior school days. I've got a Guinness cake currently baking in the oven for Mr K's birthday tonight. Lucky man. Doesn't that sound lovely? A Guinness cake, yeah. I wonder what that's like.

And Cari has written in a couple of times on email and do you know what we get so many emails now we do genuinely, genuinely read all of them and if we could then read all of them out we absolutely would but if at first you don't succeed try, try again. Oh you must mention the notebook. Oh my goodness, Karen! So the loveliest, loveliest, loveliest thing came into the office today and Karen, how thoughtful. Karen has gone to one of those specialist little boutique places where you can have a notebook with something personalised on the front and we're going to put it up

on the... Is it up there already? Oh, brilliant. Good work. We've put it up on the Instagram because she has used the terrible experience with the Elon Musk and she has had... Errol Musk. Sorry, with the... We don't want to tar them with the same brush. With the Errol Musk and she has had a notebook made for me saying a woman's notebook just as big as a man's. And it is the most thoughtful very thoughtful lovely funny thing as well so Karen huge huge thanks to you because they're just providing little pockets of joy aren't they they really are uh thank you um i don't know why

it's so ridiculous but they are a comfort they They are, aren't they? So I flick through them, bearing in mind that we've seen them all already. Flicks through them a couple of times a night at the moment. End the day with a cheeky bit of veg. It's the carrot on the chair that gets me every time. The carrot on the chair is very funny, but I mean there was a very cute one today, an aubergine with a nose. It's pathetic really. But anyway, let's elevate us. In fact, we couldn't elevate ourselves any more than

by inviting Steve into the conversation. And he's talking about why we're alone in the universe. Yeah, let's think about that everybody. We are very likely to be alone either in the galaxy or in the parts of the galaxy that we can contact. Now, he says here, not only is the development of the galaxy that we can contact. Now he says here not only is the development of, I'm gonna have to attempt to pronounce this Steve and I'm so sorry if this is wrong, not only is the development of eukacharyotic life much more unlikely than we thought a couple of decades ago, the development of that single cell into intelligent life on a

planet that needs a very stable existence unencumbered by external catastrophes for tens of millennia, the latter is very, very rare indeed. Above and beyond that, if there are advanced civilizations in the galaxy, millions or even billions of years ahead, and the laws of physics are the same everywhere, why haven't we detected their electromagnetic emissions? We've been listening as hard as we can for over 50 years, so if they're there, why haven't we heard them? And there's something rather poignant about that sentence, we've been listening as hard as we can for over 50 years. Earth here, is there anyone else around? It's actually quite sad, isn't it? The universe, points out Steve, is over 13 billion years old. We've been around for less than 200,000 years and

able to travel into space for only 70 years. Why should we expect another intelligent life form to be sharing both the same local cosmic space and the same local cosmic time? We are alone, there's no one else around. Well, I just hope that we never find them because it's the dream that one day you might that keeps so many people going, isn't it? Yeah, this is why we need men like Mosque, you see. Yeah. Well, we did do a feature a while back, didn't we, with a doctor who pointed out that you wouldn't be able to have life on Mars because your kidneys would be fried by the time you got there.

Why doesn't he give it a whirl and see how he gets on on our behalf? Yeah. And as many people have pointed out as well, there has never been a pregnancy in space. So we simply don't know whether or not women will be able to give birth in a different gravity defying space. And so if you couldn't do that, that's not so great, is it? Not really. No, no. Okay, let's rule out going to space

this weekend. I won't be going to the tip again either. You'll just concentrate on your cushions. Got enough going on, love. You're absolutely right. I have got enough going on. That, by the way, is something that people would literally say. It's one of those first world delights. I've got enough going on. I've got cushion covers to be restuffed. This episode of Off Air is sponsored by the National Art Pass. Now, Jane, there's nothing I like better than a trip to a gallery or a museum on a rainy afternoon. And let's be honest, we get quite a lot of those in the UK, don't we? I do feel that looking at a bit of art is more than just kind of looking at a bit of art, if you know what I mean. I think it can really stay with you long after the visit,

kind of feeds the soul. Yeah, you're onto something there, because scientific research suggests that regularly looking at art could help you live longer, plus lots of other well-known benefits to boost your well-being and help reduce stress. So why not get a National Art Pass? It gives you free and half price entry at hundreds of museums and galleries and only costs £59.25 for an individual pass. And there's a reduced price for under £30 and you can also purchase plus one and plus kids add-ons. Free or half price entry and a chance at living longer, I am sold.

The National Art Pass. See more, live more. Get your pass at artfund.org forward slash off air. Professor Irene Higginson is the Professor of Palliative Care and Director of the Cicely Saunders Institute at King's College London, the world's first purpose built institute of palliative care. Now this is always such an important issue, but as the assisted dying bill makes its way through Parliament and a change in the law in this country looks possible, it is more important than ever to hear from the experts about end-of-life care. So it is lovely to

see you, Professor Irene. Thank you very much indeed for coming in. What does good palliative care actually look like? So, well, first of all, thank you very much for coming in and giving some airtime to this topic. It's brilliant that you have. So good palliative care is a multidisciplinary care, that means involving nurses, doctors, sometimes physiotherapists working together

to help support people who are living with a serious illness and it really focuses on trying to help people relieve the symptoms and relieve the stress of the illness for not only the person but also those important to them such as their family and I think the phrase that Cicely Saunders had that you matter because you're you, so it's individual, it's about you and what you want. You matter to the last moment of your life

because we shouldn't give up on people just because they're very poorly. And we will do not only everything we can to help you at the very end of life and die peacefully, but also we will help you to live well until you die. Do the things that you want to do. So good palliative care will often get involved earlier in the course of illness, it will work alongside others, it will try and ensure that you have relief from symptoms, that you can talk about the things that you want, the

priorities that you have in your life, the things you want to do, the bucket list, the families, the things that you want to be with, where you want to be cared for. And it's important increasingly in our society because in our society so many people are living now with more than one condition, particularly in, for older people in later life, but also some children and young adults who've been living with chronic illnesses. So it's important for people with cancer, with respiratory diseases, neurological diseases, heart disease, and often a combination of those.

How many people are experiencing what you've talked about at the best end of palliative care in this country? Well, we don't know. There's no government figure on how many people even get palliative care. We don't know that. There was a survey done last year that was done, led and supported by Marie Curie, one of the charities, and working with a number of other charities including Sicily Saunders International and others and that surveyed relatives and asked about the last three months of life and what that found is that fewer than half of those who died had any contact at all even if it was very late with any palliative care either in the community or a hospital or a hospice or

whatever. Interestingly in the last three months of life in fact only one in five people had contact with a GP and if you look in the community when people are in the community then only about 29% had any contact with a palliative care doctor or nurse. It's very patchy, there are many areas of the country that have very limited access to palliative care. Quite a lot in the community is provided by voluntary led hospices. They raise two-thirds of their money from the local community and only get a third of their money from the NHS and obviously for all sorts of reasons these are patchy up and down the country.

And you provided us with an astonishing statistic that at least 42% more people will need palliative care in England and Wales by 2040. Now that seems like a massive rise. Why so steep so quickly? So there are two reasons for this. The first reason is because we have this thing called baby boomers going through the population. So we do have a swell of a number of people in the population who will be dying. The second reason is a very good reason that we all like. Actually, we probably all like the idea that there's been baby boomers around.

But the second reason is because people are living longer. So what happens is that in previous years actually, and earlier times, the death rate annually fell a bit. And what it's doing now is that people are living longer and so more people are dying in this period of years. It'll carry on going up after 2040, I'm sorry to tell you, that won't be the peak. It'll carry on going up to 2040, I'm sorry to tell you that won't be the peak, it'll carry

on going up to 2060. So this is something that we have to address quite importantly. Yeah and what you said before about that balance between providing palliative care within the NHS and the hospice movement providing the palliative care, how on earth is all of that going to add up? Well it's a problem isn't it? I mean and and and there are other services too to think about so I mean I think for hospices if I recall correctly the the the hospices have to raise about a billion a year from charitable funding. Can I just ask? To be able to keep going? Why were they never brought into the NHS when the NHS was set up in the late 40s? Well they weren't around then.

So they didn't exist at all. I think it's a good question. There weren't many, no, and I think probably dying was very bad then. I mean there was, you know, really difficult use and bad use of many of the medicines and a lot of inappropriate fears about the use of many of the pain medicines that we might use and and I will say now that it's not easy to get the management of pain right and when somebody is very ill they often have a sort of complex web of symptoms and you have to work with all of them the pain, breathlessness, constipation,

fatigue, weakness, sometimes cough. They're all important symptoms that as a palliative care doctor you have to kind of work out what's the best management for all of those symptoms together and one makes another one worse. If you don't sleep your pain will get worse and so on. So you have to kind of work out all of those. That didn't really happen. The first hospice, I think, in the UK was run by nuns and didn't really operate palliative care. So it was only in the kind of 60s and 70s it came in. But a worse statistic for you is that palliative care

was only mandated in the NHS in 2022 by a Lords amendment in the Health and Social Care Bill. So it's only become a required thing that the health service should provide something of in the last two years. Wow. And how do you why would you end up in a hospice and why would you not end up in a hospice when you need end of life care? How is that decision even made? Well, first of all, do you live within a reasonable distance of an inpatient hospice?

I think it's important to say that hospices don't only look after people at the very end of life, and a lot of hospices have community services and daycare as well as inpatient beds, and they might take somebody to sort out symptoms and then get them home, and they might want to stay at home, because actually most people do want to get back home. So one is how far it is and whether you can get there. One is the disease and one is whether the doctors and you have thought about it and raised it and one of the other challenges we have which is why I'm so pleased to come here is because there's a lot of misunderstandings by people about what palliative care is, both in the healthcare professionals, but also in the general public. And I think one of the things that we could

really do with is a better campaign to explain what it is. You know, because some people think that palliative care is killing people. I've had members of my own family, years back, say well that's what you do do isn't it, you kill people and I said well no actually it's what I try, you know, I try to improve their symptoms, that's not my objective and that was very, so those sort of misunderstandings are very common and also... And do you worry Irene that if we don't understand palliative care well enough then actually we're going to make the wrong decision about assisted dying? Well that's a possible risk isn't it? There are many risks. I mean the assisted dying

bill is a kind of another thing in a way. What I really hope and what I would like is that people could have a real choice of palliative care so they would know what it is and it would be available in a much better way than the patchy way it is now. So what would help to make that change? So it needs a proper plan. We don't have in this country a strategy for palliative care. I believe that Ireland for example does, that would be a proper plan. We don't have in this country a strategy for palliative care. I believe that Ireland for example does, that would be a good help. It needs resourcing, it needs training, it needs to be in all sectors, so it needs to be in hospitals, it needs to be in the community,

it needs to be in inpatient hospices and I personally believe that actually hospices services would benefit from expansion but the reliance on charitable funding is quite an inequitable thing because poor areas of the country don't have them. Yeah when West Reading the Health Secretary says you know I'm not sure about the assisted dying bill because of the state of palliative care in this country. It sounds like he's right to have that concern. Do you believe that he is?

Well he's right to have a concern about the provision of palliative care, absolutely. And also the question is what degree of choice at the moment do people have? I would like people to have a choice of a good symptom management and a good life, whatever they want at the very end of their life. And I suppose, you know, with assisted dying, I think it's fair to say that not everybody who had good symptom control would change their mind and not want assisted dying. But my concern is that a number would. And what I'm most worried about is that we actually give people a choice of good palliative care. What are we as a society if we don't do that?

I think that's such a good point to make actually and one that perhaps hasn't been made enough when we are talking about a change in the law. Can we just spend a couple of minutes talking about you and your choices to go into palliative care? Because it is interesting isn't it? I mean in a sense, did it ever feel like you were slightly going against the grain of what medicine is about? When you join the medical profession, presumed it's a desire to keep people alive, to make the body healthy, at what point do you think actually I'm more interested in when the body really fails? Oh that's such a good question. Well first of all I didn't know anything about palliative care and

I didn't, I wasn't taught any at medical school and it's still very patchy about even when it's taught, whether it's taught at medical school now because there aren't enough palliative care people about to teach it properly I mean we try and teach it at King's and so on so that's one challenge. So I didn't know anything about it and I'll tell you the truth is I saw a job advertised and I thought well that looks interesting but I'm not sure about that I don't know what it is so I got a book out the library because I was kind of curious and read about palliative care. And I thought of all the instances in my career where I'd seen bad, as a student,

seen bad pain management by doctors or doctors not even talking to people about the fact that they were ill. And I thought, well actually, I'll go and have a look at what they're doing. So I went and had a look. And that led me to work in North London, in Bloomsbury, in a community palliative care team, and then in St Joseph's Hospice, in Hackney, and then in various other places. And I think what, for me, I think all of medicine has difficult areas, but for me, if I can help somebody at this most important time of their life, that's actually a good thing to do. Have you seen that What's App from Sean? Because I think that's interesting.

Oh, I've got it here, don't worry. Palliative care, he says, and you can challenge this, Irene, but Sean says palliative care is assisted dying. That's exactly what it does. It assists people as they die. Medicine recognizes in palliative care, there's nothing further that can be done to cure a patient, but they can live as well as possible as their health declines.

So does he have a point that palliative care is assisting dying, if not assisted dying? Well I think it's assisted living, while somebody happens to be dying rather than causing the dying. That's how I'd respond to that remark. I mean, the way he puts it in the WhatsApp sounds to me like he's implying that we try and assist the dying bit. What we try and do is assist the comfort and the living bit. It's a good and interesting question and I can understand where his point is coming from but I think you know what you try and do it comes back to Cicely's words live until you die. We try and assist the living, the symptom, the being with the family, being alert enough and pain-free, the symptom, the being with the family, being alert enough and pain free enough to talk to the family and that's the fine balance of the drugs, not just putting in drugs sort of willy-nilly as people are dying because that's not helpful

actually and it can cause bad adverse effects and make somebody suffer more. So that would be my response. So I don't think, I think the answer is no, I don't think it is that, having thought through the question. I think it is about assisting somebody to live while they happen to be dying. Right. Final thought from Malcolm who texted us earlier, he is a former doctor who says I'm also concerned that we overestimate how accurately doctors can predict how long someone is likely to survive with an illness. I've seen people who have firmly stated that they wanted to die and then later change

their minds. I'm aware of the horrific situation some people face towards the end of life. It is appalling that hospice care is so dependent on charitable provision. If we want as a society to consider assisted suicide, I think we should wait until we've ensured that everybody is guaranteed rapid access to high quality palliative care first. It's exactly what you're saying isn't it Irene? I think he makes an interesting point about the difficulty in knowing how long people have left to live. I mean I have a huge amount of sympathy for somebody and I've heard people

talking with Parkinson's disease about their wish about the assisted dying bill although they're not actually happy with the bill because it wouldn't work for them because they can probably live too long for it and so they'd want it changed immediately it would come in as far as I can see. But I think the challenge is that, you know, knowing how long somebody's got left to live is a difficult thing to estimate. It gets easier as somebody gets closer to death, so when they've only got a few hours or days.

And we often talk as sick enough to die. But to give a definite six month, or likely to die in six months is quite a difficult art for this particular purpose in the law. Professor Irene Higginson, we would love all of your thoughts about that actually and I think as we were saying either on air or on the podcast sometimes the two things merge in my head Jane. The assisted dying bill going through Parliament at the moment has enabled so many people to have conversations within their family that haven't

been had before about what your dying wishes should be. And that seems extraordinary. We shouldn't need a prompt for what is the inevitable. But so many people don't know what their loved ones would actually want to happen to them until it becomes really, really difficult for them to tell you or difficult for you to imagine. So thoughts come into Jane and Fiat Times. Radio, one final email from me which comes from Lisa who wanted to add the last word on the jacket spud subject. So here we go, pay attention everybody, this is the end of what's proved to be a very, very fruitful theme. When you don't have time to cook, check your oven timer settings for end at function. Load the oven with spuds before you go to work, adding temperature, cooking length and

the time you need it to be ready. At this time of year, we love to scuttle off to the pub in the afternoon, knowing we can return at 5pm to a wonderfully warm and delicious smelling home, Crispy Spuds ready for buttering. So I suggest that you and I do that and we go to the pub instead of doing the show and we will have Crispy Spuds ready and waiting for us. No job, no money, no future. So what? We'll be pissed and we'll be able to look forward to a jacket. And we'll be full. Thank you Lisa. Congratulations, you've staggered somehow to the end of another Off Air with Jane and Fee. Thank you.

If you'd like to hear us do this live, and we do do it live, every day, Monday to Thursday, 2-4, on Times Radio. The jeopardy is off the scale, and if you listen to this you'll understand exactly why that's the case. So you can get the radio online, on DA DAB or on the free Times Radio app. Off Air is produced by Eve Salisbury and the executive producer is Rosie Cutler.