Hospice Funding

Andrew Gwynne Excerpts

Monday 22nd April 2024 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to respond to the debate. We have had a very thorough discussion over the past few hours, so let me start by thanking not only the Backbench Business Committee for granting the time for us to debate this important issue—albeit a week later than most of us had expected—but the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing the debate; I congratulate them on their speeches.

I thank my hon. Friends the Members for Enfield, Southgate (Bambos Charalambous), for Coventry North East (Colleen Fletcher), for Birmingham, Erdington (Mrs Hamilton), for Hammersmith (Andy Slaughter) and for York Central (Rachael Maskell), my right hon. Friend the Member for Hayes and Harlington (John McDonnell) and my hon. Friend the Member for Leeds East (Richard Burgon), as well as the hon. Members for Colchester (Will Quince), for Southport (Damien Moore) and for Eastleigh (Paul Holmes), the hon. and learned Member for Eddisbury (Edward Timpson), the right hon. Member for Basingstoke (Dame Maria Miller), the hon. Members for North Devon (Selaine Saxby) and for Bolton West (Chris Green), the right hon. and learned Member for South Swindon (Sir Robert Buckland), the hon. Members for Loughborough (Jane Hunt), for Isle of Wight (Bob Seely), for West Dorset (Chris Loder), for South Dorset (Richard Drax), for Waveney (Peter Aldous), for St Austell and Newquay (Steve Double) and for Bracknell (James Sunderland)—not forgetting, of course, the hon. Members for Strangford (Jim Shannon) and for Glasgow North (Patrick Grady). I also congratulate all those who took part in the London marathon; I was not one of them.

Let me now turn to the subject that we are here to debate. End of life care is a subject that has touched the lives of most of us. It is a time when our loved ones, and the family and friends who surround them, can be at their most vulnerable and in need of the greatest support. Managed well, it can be a healing time for families to come together, but managed badly, it can leave deep and traumatic scars. I need only look at the experience of my family—the experience that I had during the deaths of my parents to know how this bears out. It was 30 years ago that I lost my mum to ovarian cancer—I was 19. Her final hours were spent at the end of an old Victorian ward with the curtain pulled around her, and she was in immense pain and suffering, which I remember vividly to this day. That was incredibly hard for our family to manage.

More recently, in 2022 I lost my dad following his own battle with cancer. Unlike my mum, he died at home, with my wife and I taking him in for the last few months of his life, and we were supported by a superb army of care staff. In fact, when the time came for my dad to decide whether he wanted to go to the local hospice, Willow Wood, or stay at home with us, the final words that he communicated to me and my wife were, “Stay here.” I come back to the point made by the hon. Member for Colchester about how we talk about death, how we deal with death and the end of life, and the fact that many people want dignified end of life services at home; we should do all we can to facilitate that.

In my dad’s case, the whole system worked. It came together in a way that, as I know from my constituency casework, it rarely does. The hospital, social services, Macmillan, Marie Curie, the GP, the pharmacy, the district nurses and Willow Wood hospice all worked together seamlessly, and my died passed away in comfort, peacefully and surrounded by those who loved him most in the world. We have heard from my hon. Friend the Member for Coventry North East and other Members that we have to get the end of life choice right for people, and hospice at home plays an important role in that.

The sharp contrast between my parents’ journeys emphasises to me, in a deeply personal way, just how impactful end of life care can be. For all of us, death should be about choice and what we want, and we should leave this planet with dignity. We talk about the integrated care boards, and the clue is in the name: they should be integrated, with both social care and other services, including hospice services. In my dad’s case, that worked, but as we have heard from Members across the House, in too many cases the integration just is not there yet. The Government have rightly devolved money to the ICBs for a specific purpose, but it is not being spent as we would want.

Hospices play such an important part in that deeply personal journey for hundreds of thousands of people and their families every year, right across the country. Working in partnership with existing local systems, hospices ensure that people receive the care that is most appropriate for them, considering all their needs. I pay particular tribute to one of my local hospices, Willow Wood hospice in Ashton, Tameside. The tireless work and dedication of its staff was a vital support when we were caring for my dad in his final days. Those staff showed hospice care at its best, and they have my immense gratitude for all that they continue to do. But they, like so many others, find themselves in a perilous financial position; Willow Wood faces a structural deficit of £750,000 this financial year. Without finding a way to plug the gap, its services will have to be reduced.

There is real pressure on all hospices to generate their own income, with Hospice UK estimating that as much as two thirds of income for adult hospices is generated through fundraising, with some, like Willow Wood, having to raise 80% of their funds themselves. Many hospices do incredible fundraising work, with armies of volunteers finding ever more ingenious ways to keep the money coming in, but with the incredibly hostile economic climate that hospices are finding themselves in, including as a result of energy costs, funds are being squeezed more than ever—[Interruption.] Someone put 50p in the meter; obviously the House cannot afford those costs now!

The sector as a whole is on track for a deficit of £77 million for the last financial year, the worst figures for two decades. As a result, hospices are starting to pare back some of their services. As we have heard, there is also a legal requirement placed on integrated care boards by the Health and Care Act 2022 to commission palliative care services in keeping with local need, and we need to ensure that that funding is passported down to the hospices where they need it. We know that delivery is far from consistent, leaving patients in some parts of the country without adequate services in their own community. The clear pressure on the sector shows no sign of letting up, because we are an ageing population and demands on hospice services are set to increase further, with Office for National Statistics data suggesting that a further 130,000 people will die each year in the UK by 2040.

It is clear that we need proper joined-up supportive policies for the hospice sector. We need to ensure that the money that the Government have ensured is there for the hospice sector gets down to where it needs it: at the hospices themselves. We need to focus on creating a health and care system that is genuinely joined up and has end of life care as part of the health and wellbeing policies for each and every one of us. This can no longer be the taboo subject it once was, and the hospice sector underpins so many care pathways that have a tangibly positive impact on patients and their families. End of life care matters. This current Government will have our support in ensuring that the hospice sector is protected and supported.