The ‘Review of Palliative Care Services in Scotland’, which was published today by Audit Scotland, found that the availability of specialist care varies significantly across Scotland with the number of specialist staff per 100,000 people ranging from 4.1 in NHS Ayrshire and Arran to 11.2 in NHS Highland.

The report, which is the first overview of activity, costs and quality of specialist and general palliative care in Scotland, also found that specialist palliative care remains primarily cancer-focused, with 90 per cent of specialist palliative care delivered to patients with cancer despite cancer accounting for less than 30 per cent of deaths.

More than 55,000 people die in Scotland each year, many of whom need different kinds of palliative care such as help with pain relief, nausea, depression and emotional and spiritual support. While the report states that the total cost of providing palliative care is unknown, it says that around £59m was spent on specialist palliative care in 2006/07, almost half of which came from the voluntary sector.

Caroline Gardner, the Deputy Auditor General for Scotland, said: "More than 55,000 people die in Scotland each year. Palliative care should be an integral part of the support given to patients and their families and carers during the last months, days and hours of their lives.

"In many areas of Scotland the voluntary sector and the health service provide excellent and much appreciated care. But access to good quality palliative care varies across the country.”

Gardner also called on the Scottish Government to address these issues in its National Action Plan for Palliative and End of Life Care in Scotland, which it is due to launch on 2 October.

Commenting on the review, Jackson Carlaw MSP, Shadow Minister for Public Health, drew attention to the report’s finding that best practice guidelines for palliative care are not being applied, saying that following best practice when caring for terminally ill patients “should not be optional.”

He said: "Sadly, evidence that health service guidelines are not being implemented has become something of a running theme of late. Caring for terminally ill patients is one of the most important roles our health service has to fulfil, so following best practice in this area should not be optional. Government and health boards must act to ensure compliance.”

He added that he was also pleased to see the role of the voluntary sector in providing palliative care acknowledged in the report.

"People all across Scotland are justifiably proud of their local hospices and the care they provide in often difficult circumstances. I therefore hope that in my own region, NHS Greater Glasgow & Clyde takes note and ends the uncertainty that has dogged St Margaret of Scotland Hospice for too long now."