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Mr Robin Walker (Worcester) (Con)
I congratulate my hon. Friend the Member for Eastleigh (Paul Holmes) on securing this debate, and everyone who has spoken. We have heard some fantastic speeches.
Hospices provide a vital public service, but it is important to recognise that they are not, and do not want to be, part of the publicly funded NHS. Their flexibility as independent organisations helps them to meet the many and varied needs of people at the end of their life and with life-limiting conditions. They do a fantastic job of fundraising to support their activities so that they can deliver impact way beyond the value of the small public contributions they receive.
I am fortunate to have two brilliant hospices in my patch—St Richard’s Hospice and Acorns Children’s Hospice. I remember the first time I visited St Richard’s, and there was a sense of trepidation. It is a place where people go to die; would it not be a sad and depressing visit? Not a bit. I was amazed at how uplifting and positive it was. A few months later, I sadly got to know the hospice much better. Just a month after I was elected, my father was admitted to St Richard’s Hospice, and it provided amazing care and incredible support to my family. I echo the hon. Member for Bolton South East (Yasmin Qureshi), who talked about people dying with dignity with their loved ones around them. That is what the work of adult hospices should be, and is, all about.
St Richard’s tells me that only about £700,000 of its £12 million income comes from the NHS and the public purse. It has been offered an uplift of 1.8% by our local ICB, which would be worth about £40,000. A 1% pay rise for its staff would cost about double that, and matching the NHS 5% increase would cost about 10 times as much. I will not ask Ministers to take over funding for hospices, or the NHS to take a much larger share of hospice funding, but it is fair to ask them to provide help when inflation and the Government’s own pay increases are driving up costs for hospices. The ask from Hospice UK is for £30 million of Government funding to offset the increase in energy bills and £102 million for hospices in England to help them to keep pace with NHS pay rises in the next year. That is not unreasonable.
Children’s hospices also do an amazing job. They are also uplifting and inspiring places, as we have heard from many Members. I am fortunate to have Acorns in my patch, which has already been mentioned by my right hon. Friend the Member for Aldridge-Brownhills (Wendy Morton). It has a new CEO and it is about to celebrate its 20th anniversary. I want that to be a successful moment, and certainty about the children’s hospice grant would be incredibly helpful in that respect. The grant has sustained children’s hospices—it has kept them going year after year—but its short-term nature has become a problem for them.
We recently saw some welcome news from the Government about sports funding in schools—they have finally provided a multi-year settlement after many years of not being able to do so—and I hope they consider doing the same for children’s hospices. A multi-year settlement would make a massive difference, and giving some certainty that the grant will be renewed is essential.
The Minister for Social Care (Helen Whately)
It is a pleasure to serve under your chairmanship, Ms Nokes. I thank my hon. Friend the Member for Eastleigh (Paul Holmes) for securing this debate on hospices, and I thank all hon. Members who have contributed. Both the number of colleagues in the room and the passion of so many contributions show the strength of feeling and level of support for hospices in all our communities.
We have heard from so many colleagues this morning: my hon. Friends the Members for Darlington (Peter Gibson), for Aberconwy (Robin Millar), for Bolton West (Chris Green), for Torbay (Kevin Foster), for North West Norfolk (James Wild) and for Worcester (Mr Walker), and the hon. Members for Blackburn (Kate Hollern), for City of Chester (Samantha Dixon), for Bolton South East (Yasmin Qureshi), for Westmorland and Lonsdale (Tim Farron), for York Central (Rachael Maskell), for Barnsley East (Stephanie Peacock), for Lancaster and Fleetwood (Cat Smith) and for Strangford (Jim Shannon). In addition, many other hon. Members have contributed by intervening. In the course of today’s debate, many fantastic local hospices have rightly been praised for what they do for our communities.
My hon. Friend the Member for Eastleigh spoke about the Mountbatten hospice in his constituency and how it cared so wonderfully for his friend and colleague Sue Hall. Many hon. Members spoke about their personal experiences, which often involved family members, and the amazing ways that hospices have helped family members and themselves through difficult times. I, too, remember the amazing care that my granny received in her local hospice in Dorset when I was in my twenties. I still hold in my head the experience of visiting her there—the tranquillity of the hospice and the amazing care that she was clearly receiving, which made the last weeks of her life as bearable as possible. I remember the kindness and peace that I felt there in that hospice. I, too, have that personal experience and appreciation of what hospices do.
A theme of this debate has, rightly, been the importance of dying well—dying with dignity and dying with the right care in the place where a person wants to die, which is very often at home. Dying well depends on good end of life care, for which we in this country rightly have a good reputation. Most end of life care is provided through NHS services, but hospices are an important part of end of life and palliative care in our communities. As we know, hospices provide care in their facilities, but increasingly and very importantly they provide care to people in their own homes towards the end of their lives, and also support families through those difficult times and through bereavement.
Stephanie Peacock
The end of life care that I spoke about in my contribution, which is so important, remains closed at Bluebell Wood Children’s Hospice; it is the one part of the hospice that has been unable to reopen. Will the Minister commit to doing everything that she can to support the hospice to reopen, so that it can continue to provide end of life care, and not just all the other services it provides to families that need them so much?
Helen Whately
As the hon. Member mentioned earlier, we have indeed met and spoken about the hospice to which she refers. I have also met with several other hon. Members. I am grateful to them for coming to me to talk about the specific difficult situations faced by some of the hospices serving their communities.
That brings me to exactly what I was coming to talk about: the financial pressures on hospices, which have been a strong theme of the debate. I know very well, not just from this debate but from conversations with hospices, about the financial challenges that hospices are facing. In fact, financial challenges are being faced by many organisations that provide care in our communities, whether NHS organisations or care homes, as the hon. Member for Leicester West (Liz Kendall) mentioned. In particular, there are the extra pressures of energy costs—such organisations often use substantial amounts of energy—and the higher costs of staff pay. We know that many hospices pay their staff in alignment with the NHS agenda for change pay scales.
An additional difficult context for hospices at the moment is fundraising. That was clearly hard during the pandemic, but since then many households have been affected by the higher cost of living and therefore have found it harder to contribute to fundraising efforts in their communities, including those organised by hospices. I know how hard that context is for our hospices.
On energy costs, many hospices have been able to benefit from the Government’s energy bill relief scheme, which ran to 31 March. Eligible organisations, including hospices, will continue to get baseline discount support for gas and electricity bills under the energy bills discount scheme, which is running from 1 April 2023 to 31 March 2024. In addition, last year NHS England released £1.5 billion of extra funding to integrated care boards in recognition of the extra costs arising from inflation in the services they commission. ICBs have been responsible for distributing that funding according to local need, including to palliative and end of life care providers in our communities, whether they are NHS organisations or hospices.
Tim Farron
Of course, ICBs are not elected, but the Minister is. She heard what the hon. Member for Lancaster and Fleetwood (Cat Smith) and I had to say about the 0% increase that the Lancashire and South Cumbria ICB has granted—or not granted—our hospices. Will she directly get involved in that to fix it so we do not have to have the 10% cuts that St Mary’s Hospice thinks we will have to deliver?
Helen Whately
I will not commit to getting involved in a specific conversation between a hospice and an ICB. That would not be the right thing for me to do as a Minister. The hon. Gentleman and I have had several conversations over the years that I have been a Minister, so he will not be surprised to hear that I have been seeking transparency about the extent to which the funding has or has not gone to hospices. I have been seeking data on whether the rates being paid to hospices have or have not gone up so that we have transparency about the extent to which the funding that has gone to integrated care boards to support with inflation is getting through to the services that need support.
Peter Gibson
Although I acknowledge and appreciate everything the Government did to support hospices during covid, it is simply not the case that every ICB across the country is passing the right amount of money to the hospices from which it commissions services. Will the Minister commit to publishing information about which ICBs are stepping up to the plate and fulfilling their statutory obligations, and which are not?
Helen Whately
I commit to continuing to dig into getting visibility on the extent to which extra funding is going through to hospices. Of course, there is a balance to be struck when giving integrated care boards the freedom to do what we want them to do, which is to understand fully the needs for care in their populations, and make good decisions about how they fund care for their populations. None of us believes that a Minister in Westminster has the answers about what should happen and exactly how funding should be distributed in every single one of our communities. I will continue to get that visibility, because it is important that we know the extent to which our hospices are getting support for the extra financial pressures that we have been discussing.
Helen Whately
I will make a bit of progress, because I am conscious that the clock is ticking.
Integrated care boards are responsible for ensuring the provision of the end of life and palliative care that is needed in our communities across England. In addition to the funding, I am working with NHS England to ensure greater visibility relating to what that means in practice and what is being commissioned.
The shadow Minister’s point about inequality of access was very important. We know that there is inequality of access to palliative and end of life care. Some communities are much better served than others, in part due to the fantastic legacy of our hospices: where there is a really good hospice, there is often much better access to end of life and palliative care around it. We want to improve equality and reduce some of the disparities in access to end of life care. As part of that, people should be able to do what most people want—to die at home with the right support in place.
I want to talk about the funding for children’s hospices, which several hon. Members brought up. Recognising the importance of palliative and end of life care for children and young people, NHS England provided £25 million specifically for that, via the children’s hospice grant during this financial year. I have, of course, heard the calls for that grant to be continued, and for greater continuity and visibility of funding further out. I cannot say more on that today, but I can assure hon. Members that I have been speaking to NHS England about that funding beyond this year. I do expect further new to be communicated about that shortly, appreciating the level of concern among hon. Members and children’s hospices in their communities.
Rachael Maskell
I am grateful to the Minister for giving way. The Health and Care Act 2022 put a responsibility to fund palliative care on the statute books. Will the Minister set out what has changed, to enable that funding to come forward? We know there are people in our communities who are not receiving that care, although they need to now under the law. The funding needs to be in place for them to receive the care that they need at the end of life.
Helen Whately
That alludes to exactly the point I made a moment ago. As flagged in that 2022 Act, ICBs have responsibility for commissioning that care, using the budgets they receive through NHS England. I am working to ensure the visibility of the commissioning, to be assured that that is taking place, so that we can be assured about the availability of end of life and palliative care for our communities.
I want to make a final point as I close; I am looking at the clock ticking. Against the backdrop of financial concerns, which I of course recognise and which we are discussing, is the strength of hospices in their communities, and the importance, as mentioned by hon. Friends, that they are not solely financially dependent on the state and the NHS for funding. They receive some NHS funding, but it is important that hospices are successful in fundraising and gaining support from our communities. That is one of the strengths of their model, and I want to continue to support that.
I pay tribute to all the volunteers and those involved in fundraising, including many hon. Members this morning who mentioned the fundraising efforts that they are personally making for hospices in their communities. I wish very good luck to my hon. Friend the Member for Eastleigh for his forthcoming skydive. All credit to him for having the courage to jump out of an aeroplane. I sincerely hope that he is successful.
Helen Whately
I wish him very good luck; it is fabulous that he is doing that for his own hospice. I also commend the efforts of many other hon. Members. I conclude by thanking all hon. Members for coming today and for their contributions to this important debate.