Hospice Funding

Debate between Bambos Charalambous and Munira Wilson

Monday 22nd April 2024 Commons Chamber

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I thank the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing this important debate.

Hospices do incredible work. In communities across the country, they hundreds of thousands of people every year with essential palliative and end of life care. The services that hospices deliver are absolutely crucial to improving the quality of life for people in their final weeks and days, helping to provide a dignified, comfortable and compassionate end of life. That support is vital not just to people at the end of their lives, but to their family and friends. End of life care impacts not just the patient but all their loved ones, and the specialist support that hospices provide patients in their final stages of life, and their families who are watching them pass away without suffering or pain, is immeasurable. It is why hospices are so important.

In my Enfield, Southgate constituency, we are lucky to have a facility of the incredible North London Hospice, which has been caring for people since 1984. Its health and wellbeing centre in Barrowell Green helps to enable the best of life at the end of life for people across the boroughs of Enfield, Haringey and Barnet, providing tailored care, including physical, emotional, spiritual, wellbeing and bereavement support for patients, friends, carers and loved ones. I must also mention those in the wonderful North London Hospice photography club, who support each other and take amazing pictures, which they sell to raise funds for the hospice.

I remember hearing from a constituent of mine, Joy Watkins, who was receiving care and support at the hospice. Joy has sadly now passed away, but her words about the importance of the hospice and the care that she received were incredibly moving. Joy spoke about going to something called a death café—an informal space for people to talk about end of life, share their concerns and listen of others express their thoughts, hopes and experiences of death. She said that going to the death café enabled her to make choices about the end of her life. She could make choices about who to spend time with and about the finances that she would make use of at the end of her life. It transformed the way in which she viewed and handled the end of her life.

The way in which we talk about and approach dying matters, and Joy’s words have really stuck with me. Indeed, they were one of the reasons I introduced my private Member’s Bill—the Terminal Illness (Provision of Palliative Care and Support for Carers) Bill—back in 2018. Next month, Hospice UK will be promoting its campaign for Dying Matters Awareness Week, and I look forward to supporting its efforts on that important initiative. Honest and timely conversations about death and dying are essential to good end of life care, but barriers including lack of confidence, taboos around discussing death, and confusion about who should be having these conversations all too often mean that patients, carers and families may not understand what is happening or get all the information and support that they need. That is where hospices and their brilliant staff come in. More recently, a close family member of mine received support from North London Hospice, and although Gabby sadly passed away, I am so grateful for the hospice’s specialist care.

Yesterday I and about a dozen hon. Members ran the London marathon. I was proud to do so to raise money for North London Hospice. When pounding the streets of London in such a wonderful festival of community yesterday, I was struck by how many runners were, like me, raising money for their local hospices. That demonstrates the sad reality of inadequate central funding for hospices. I have been trying to bang the drum for North London Hospice since I was first elected, and although it took me a few years to muster the courage to put on the running vest and put my knees on the line, as each year passes it feels as if the challenges facing hospices grow greater and more acute.

As we know, hospices are an integral part of our health and social care system. They work in partnership with local health and care systems, helping to reduce the pressure on our NHS by caring for patients who would otherwise be directly supported by NHS services. As a community, we are reliant on hospices—they are important parts of the communities that they serve—but they are also reliant on us for support, through fundraising and donations, because they are largely charitably funded. On average, around two thirds of adult hospice income is raised through fundraising such as charity shops and marathons, and the figure is higher for children’s hospices, which must raise around four fifths of their income.

[Munira Wilson]

On children’s hospices, Shooting Star in my constituency, which I have already mentioned, is very grateful that the Minister has committed to the children’s hospice grant for 2024-25, which comes centrally from NHS England. The problem is that that is a year-to-year commitment, which does not help hospices such as Shooting Star to plan for the long term. Does the hon. Gentleman agree that a ringfence should be placed around that funding and that it should be pegged to inflation year on year so that children’s hospices can plan properly?

[Bambos Charalambous]

The hon. Member makes an excellent point. Long-term funding is absolutely essential if hospices, particularly children’s hospices, are to be able to plan ahead.

North London Hospice is reliant on donations from the community each year to fill its £10 million funding gap, as only a small proportion of its costs are funded by the NHS. Of course, the cost of living crisis continues to eat away at people’s finances, which directly impacts on our communities’ ability to provide the vital charitable support that hospices rely on. The reality of the current state of funding is that hospices are struggling to keep up with inflation and rising costs, which is leading to services being cut. However, demand for palliative care continues to grow—for North London Hospice, it has grown at a rate of 5% year on year. The costs of running hospice services, including energy bills and the cost of paying staff a fair wage, also continue to rise rapidly.

Hospices recruit from a small pool of staff in the NHS and care sector, but they are not provided with the same Government funding to meet NHS pay levels, meaning that many hospice staff are doing the same job as their NHS colleagues but being paid less for it. As a result, Hospice UK’s figures suggest an 11% growth in payroll costs this year, which means around £130 million of additional spending that is not met by increased statutory funding. As I have mentioned, those costs are not met with additional uplifts from NHS funding or contracts, and despite a legal requirement for ICBs to commission palliative care services that meet the needs of the local population, the funding that hospices receive from ICBs varies significantly across the country and means that charitable donations make up much of their income.

Human Rights Protections: Palestinians

Debate between Bambos Charalambous and Munira Wilson

Thursday 20th April 2023 Commons Chamber

[Bambos Charalambous (Enfield, Southgate) (Lab)]

I begin by thanking the hon. Member for Dundee West (Chris Law) for securing this timely and important debate. We have had an excellent debate and covered a wide range of issues concerning human rights violations against Palestinians, ranging from the targeting of journalists, which was raised by my right hon. Friends the Members for Hayes and Harlington (John McDonnell) and for Islington North (Jeremy Corbyn), to checkpoints and permits.

This has been one of the deadliest years for Israel and the Occupied Palestinian Territories, with 98 Palestinians having been killed by Israeli forces, including 17 children, and 17 Israeli civilians having been killed so far, including three British-Israelis. That point has been made by my right hon. Friend the Member for Islington North, my hon. Friend the Member for Leeds East (Richard Burgon) and many other hon. Members. Each life lost is a tragedy, and every Palestinian and Israeli deserves a just solution to this conflict, but we cannot deny that the ongoing occupation of the Palestinian territories has led to significant human rights violations against the Palestinian people. It is in that context that we consider the human rights protections for Palestinians.

I will focus on only three areas, because many points that I wished to raise have been covered by other hon. Members. The first area is the treatment of children in the Occupied Palestinian Territories. Under the UN convention on the rights of the child, children have special protection and must be protected from violence at all times. Every action necessary must be taken to keep children safe. According to Save the Children, last year alone 34 children were killed by Israeli security forces and settlers in the Occupied Palestinian Territories. The use of violence against children can never be justified. I ask the Minister to condemn its use and to tell the House whether he supports the calls from the British consulate general in Jerusalem for thorough and transparent investigations of the deaths of children killed by the Israeli security forces.

[Munira Wilson (Twickenham) (LD)]

In November, I visited the occupied west bank with the Council for Arab-British Understanding and with Medical Aid for Palestinians; I refer the House to my entry in the Register of Members’ Financial Interests. We heard eyewitness accounts in the south Hebron hills of the demolition of a school in Masafer Yatta. Israeli forces threw in stun grenades while children were inside. We saw videos of children and teachers trying to get out. The school was rebuilt as a temporary school; a few weeks later it was demolished again. The Israeli Government are currently threatening to demolish 58 Palestinian schools in occupied territory. I hope the hon. Gentleman will join me in condemning the proposed demolitions, and I hope the Minister will comment that it is not right even to threaten to demolish schools.

[Bambos Charalambous]

The hon. Lady makes an excellent point. I condemn any demolitions of schools, an issue that I will come to later in my speech. It is harrowing to hear her testimony and her account.

The treatment of children who are detained and held in the Israeli military detention system, often in solitary confinement and with limited access, if any, to lawyers when interrogated, is also deeply concerning. That point was made eloquently by my hon. Friend the Member for Hammersmith (Andy Slaughter). In its 2019 report, Save the Children found that child detainees

“face inhumane treatment such as beatings, strip searches, psychological abuse”.

Last year, three parliamentary colleagues and I visited the military courts at Ofer in the Occupied Palestinian Territories; the hon. Member for Meon Valley (Mrs Drummond) spoke today of her experiences visiting those courts and gave a vivid description of what she saw. We attended a bail hearing of a teenage boy who had been shot and had been questioned without a parent or guardian present. Several colleagues have made the point that Israel is the only country in the world that routinely tries children in military courts, a clear breach of international law.

The next area on which I wish to focus is forcible evictions and demolitions. Paragraph 2 of article 17 of the United Nations universal declaration of human rights states:

“No one shall be arbitrarily deprived of his property.”

Despite that, Israel seems to be pursuing a policy of forced evictions and demolitions. More than 1,000 Palestinians face eviction in Masafer Yatta in the south Hebron hills. Palestinians in the Silwan and Sheikh Jarrah districts of East Jerusalem and Khan al-Ahmar—which the shadow Foreign Secretary, my right hon. Friend the Member for Tottenham (Mr Lammy), visited last year—face a similar fate. So far this year, there have been 63 demolitions in East Jerusalem alone. In area C, 58 schools are under threat of demolition because it is claimed that they do not have building permits, which I understand are almost impossible to obtain for Palestinians.

After demolition, land is often used to expand or develop settlements, which is illegal because international law requires occupying powers not to move their civilian populations into occupied areas, as my right hon. Friend the Member for Birmingham, Hodge Hill (Liam Byrne) mentioned. He also pointed out that settlements are a risk to a two-state solution. They make it much harder.

In 2019, the then Foreign Secretary, the right hon. Member for Esher and Walton (Dominic Raab), described Israel’s settlement expansion as an “effective annexation”. It would be a very serious development in international law if it were found to be so. The Minister for the Middle East, Lord Ahmad, visited Masafer Yatta in January and tweeted:

“The UK continues to urge Israel to desist demolitions and evictions that cause unnecessary suffering and are illegal under IHL”—

international humanitarian law—

“in all but most exceptional circumstances.”

However, it seems to have had little effect on the Israeli Government’s actions, so what steps do the Government intend to take to ensure that demolitions and evictions do not carry on at pace, as they have since the start of this year?

The final area on which I wish to focus is the imposition of restrictions preventing Palestinians from moving freely in the Occupied Palestinian Territories. The permit system operated by the Coordinator of Government Activities in the Territories limits the ability of Palestinians to travel freely and creates uncertainty and additional layers of bureaucracy and delays, whether people are trying to access medical care in the Occupied Palestinian Territories or to work, study or travel abroad. That point was raised by my hon. Friend the Member for Bradford West (Naz Shah), who made a very passionate speech.

Similarly, there are visa restrictions on those coming from abroad to work in the Occupied Palestinian Territories, such as academics. Israel will argue that a permit system is necessary for security purposes, but the way in which the system is applied can be seen as punitive and unjust. A report published last year by Breaking the Silence, an organisation established by former soldiers in the Israel Defence Forces, described Israel’s military permit system as “bureaucratic violence” used on occasion as “collective punishment”, when an entire family’s travel permits can be revoked, which denies them access to work and to medical care in an instant.

All those human rights violations are a result of the occupation. The solution to these problems must be a two-state solution, with a thriving, prosperous Palestinian state alongside a safe and secure Israel, but sadly we have seen little progress towards that for the past eight years. The onus should be on both sides to get around the table and start talking, a point made by my hon. Friend the Member for Birmingham, Selly Oak (Steve McCabe) at the start of his speech. I fear that if this does not happen there will be an escalation in the violence, given the steps already being taken by the Israeli Government, such as giving Finance Minister Bezalel Smotrich control over much of the Israeli civil administration, the military body that administers the occupied west bank. That was mentioned by my hon. Friend the Member for Middlesbrough (Andy McDonald) and by my hon. Friend the Member for Bradford East (Imran Hussain), who also referred to last month’s raid on the al-Aqsa mosque.

However, the UK is resisting efforts to hold Israel to account within international institutions. The 2030 road map makes no reference to a two-state solution, and contains commitments that raise concerns about the Government’s willingness to apply diplomatic scrutiny to breaches of international law and their support for the role and independence of international legal institutions such as the ICJ and the ICC. The UK’s capacity to be an honest and consistent diplomatic interlocutor with credibility on all sides relies on a consistent approach to the application of international law. There needs to be more accountability, and the UK Government should be challenging human rights abuses wherever they occur. I therefore ask the Minister these questions. What steps are the Government taking to bring about a two-state solution? Does he support the call for thorough and transparent investigations of the deaths of children killed by Israeli security forces? What further steps will the Government take to put pressure on Israel to stop the evictions and the demolitions?

I began my speech by saying that this had been one of the deadliest years so far in Israel and the Occupied Palestinian Territories. Let me end by saying that unless urgent action is taken, there is a real risk that the situation will become much worse over the months ahead. The time for action to de-escalate the violence and protect human rights is now.