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The Minister for Social Care (Helen Whately)
It is a pleasure to serve under your chairmanship, Mr Sharma. I thank my hon. Friend the Member for Torbay (Kevin Foster) for securing this debate about hospice care in South Devon. Like many of us, he has personal experience of the wonderful work of hospices. He spoke of his mother Linda and his step-daughter. I remember my grandmother being cared for in a hospice that was also in the south-west, just outside Yeovil. It made such a huge difference to the end of her life, not only for her but for family members like me. I remember going to visit her there. Whether the care is given in the hospice or at home, hospices are so important to our constituents.
Even though the debate was short, we had contributions from other Members, including my hon. Friend the Member for Totnes (Anthony Mangnall). He asked that Ministers come to the south-west to see hospice care for ourselves. Perhaps slightly ironically, today I was meant to be visiting a hospital in Devon, but instead I am responding to this debate. I will reschedule the visit, and will see what more I can do in the area at the same time. We also heard from my hon. Friend the Member for Darlington (Peter Gibson), who is chair of the all-party parliamentary group on hospice and end-of-life care. He does important work lobbying on behalf of the sector in that role. He spoke of the importance of ICBs effectively commissioning end-of-life and palliative care services.
It was wonderful to hear from the hon. Member for Strangford (Jim Shannon); it would not be a Westminster Hall debate without a contribution from him. He spoke of the importance of the work of fundraisers and volunteers in hospices. That clearly applies in Northern Ireland, but it is also important in England. The hon. Member for Tiverton and Honiton (Richard Foord) referred to hospice care at home, and made the point that although the traditional hospice model involves people being cared for in a hospice building, a significant and increasing proportion of what hospices do involves caring for people in their home.
Taking a step back from the situation in south Devon, thousands of people across the country are receiving palliative and end-of-life care at the moment. We have an ageing population, and many people live with complex health conditions. Around 600,000 people die every year in the UK, so it is a demographic fact that the number of people who will need palliative and end-of-life care is likely to increase in the years ahead. That care is so important; care during the hardest times makes an unquantifiable difference. As my hon. Friend the Member for Torbay said, it is not necessarily about extra days of life, but adding life to the days. It can make what seems to be unbearable somehow bearable, and it makes a difference not only for the individual being cared for, but for all those around them.
The majority of palliative and end-of-life care is provided by NHS staff and services, but hospices are an important part of our end-of-life and palliative care system; they support over 300,000 people with life-limiting conditions each year, in addition to providing bereavement support. As hon. Members have said, hospices are independent, charitable organisations that generally receive funding not only from statutory sources but, substantially, from communities and charitable donations. That range of funding, and the important role that hospices play in communities, are real strengths. As a Minister with hospices in my portfolio, I strongly support that, and want hospices to continue to play that important role, which gives them such strong local support.
In south Devon, the services reflect the national picture: there are significant NHS palliative and end-of-life services, including a specialist NHS team, community nursing care and a Marie Curie night care service. There is also Rowcroft hospice, which my hon. Friend the Member for Torbay mentioned. Given that my portfolio includes the oversight of dementia care, I was interested to hear about the hospice’s ambitions to develop its services further into dementia care; that sounds like a truly exciting proposal. Department of Health and Social Care officials are due to visit Rowcroft in the coming weeks to find out more, so I look forward to hearing from them. My hon. Friend also invited me down to see it for myself.
My hon. Friend mentioned the role of integrated care boards, which are responsible for commissioning end-of-life and palliative care services to meet the reasonable needs of their local population. In the Health and Care Act 2022, palliative care services were added to the list of services that an ICB must commission to ensure a more consistent national approach, and to support commissioners in prioritising palliative and end-of-life care. Back in July 2022, NHS England published statutory guidance on palliative and end-of-life care to support commissioners with that duty. The guidance refers to the need to ensure sufficient provision of specialist palliative care services and hospice beds, and to ensure future financial sustainability.
On financial sustainability, I acknowledge that, as my hon. Friend mentioned, hospices contend with significant financial pressures, including rising energy costs. Charities, including hospices, have already benefited from the energy bills discount scheme. Furthermore, hospices may be entitled to a reduction in VAT from 20% to 5%, and to exclusion from the main rate of the climate change levy on the energy that they use for non-business purposes, should they meet the scheme criteria.
On the question about the funding for pay uplifts for staff on “Agenda for Change” contracts, as my hon. Friend will know, his hospices are independent, charitable organisations that employ their staff themselves. They have the freedom to set salary rates and other terms and conditions at a level that reflects the skills and experience of their staff. Given the difficult economic context, the Government are providing additional funding on this occasion to support one-off payments to eligible staff employed by non-NHS organisations, where those organisations employ their staff on dynamically linked “Agenda for Change” contracts. Details for hospices that believe themselves to be eligible for that scheme are outlined in guidance published this week by NHS England. I encourage hospices in the south-west—and in fact around the country—to consider whether they are eligible, and to apply for the scheme if they are.
Kevin Foster
I will keep it fairly brief. I welcome some of the comments made. It is worth remembering that while the hospices are independent, paying a nurse or qualified medical personnel less than the NHS would is clearly not going to work. Rowcroft is one of the best sponsors of skilled worker visas, but of course, as the Minister will know, it is obliged to pay the equivalent of the NHS rate if it recruits internationally via that route.
Helen Whately
I cannot say, as I stand here, whether Rowcroft would be eligible for the support that I mentioned, but I would encourage it and others to look at whether that route would help it to address the point raised by my hon. Friend.
My hon. Friend spoke about hospice care for children and young people. NHS England recognises the importance of quality palliative and end-of-life care for children and young people; it has already confirmed that the £25 million children’s hospice grant is being renewed for 2024-25. I can assure him that NHS England will communicate details of that funding allocation in the coming weeks; that is far as I can go on that point. I cannot comment on the future of the children’s hospice grant beyond that financial year, but I can pick up briefly on my hon. Friend’s broader question about the future of palliative care. We recognise that demand for it is expected to grow. I reiterate the point about ICBs’ responsibility to plan to meet the needs for the local population’s palliative and end-of-life care.
At the national level, our NHS long-term workforce plan sets out how we will ensure that we have the necessary healthcare workforce for the future. For the first time ever, it looks 15 years ahead. It also recognises that we will need an increasing number of staff in community settings, providing people with care out of hospital and helping people with long-term conditions to live more healthily and independently. The plan recognises that people want to live in their own homes for as long as possible, and we know that many people would much rather die in their home as well.
To sum up, as I watch the clock, I fully agree with my hon. Friend on the important role of hospices in our community in palliative and end-of-life care. I can assure him and other hon. Members that I will continue to work closely with NHS England to ensure that ICBs deliver on their responsibility to commission palliative and end-of-life care in every area of the country. I thank my hon. Friend for his invitation to see the hospice care in his constituency for myself. As I will be rescheduling my Devon visit, I will do my very best to see if I can come his way.
Question put and agreed to