Hospice Funding

Caroline Ansell Excerpts

Monday 22nd April 2024 Commons Chamber

[Steve Double (St Austell and Newquay) (Con)]

Thank you, Madam Deputy Speaker—it is becoming a bit of a habit for me to be the warm-up act for the wind-ups, although I gather I will not get that honour this evening. It is a great privilege to speak in this debate, with heartfelt contributions from across the House, and I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on securing it.

Most of us hope we never need to experience hospices at first hand, but when we do experience them because a loved one needs their care and support, we realise how important and valuable they are. I am incredibly proud and privileged to have two exceptional hospices in my constituency. Mount Edgcumbe hospice, which is part of Cornwall Hospice Care, was opened in 1980 and was Cornwall’s first hospice. It has recently been rated as outstanding by the Care Quality Commission, which highlighted the caring and personal nature of the service provided by the staff, who are responsive to the needs of the patients. I did not need the CQC to tell me that. Indeed, my family and I know that first hand, because back in 2007 my mother died from cancer at Mount Edgcumbe hospice. She lost her second battle with breast cancer, and the care and support that we received as a family was outstanding. I place on record my huge thanks to them.

I am also greatly privileged to have Little Harbour, which is part of Children’s Hospice South West in my constituency. It opened in 2011, and its state-of-the-art facilities are some of the very best in any children’s hospice in the country. Having visited a number of times, I can testify that the atmosphere there is truly amazing, and one cannot help but be moved by the place. It supports children and young people up to the age of 21, including the youngest babies who need its care. The CQC praised the staff for their personalised care and support. That reinforces the important point that it is not just about the bricks and mortar or equipment that the hospices provide; it is the staff and volunteers who work there who make our hospices the amazing places they are.

We are lucky in mid-Cornwall to have those two excellent examples out of some 200 hospices across the country. Both are supported by amazing people—volunteers, fundraisers and donors—who play such an important part in ensuring that those hospices can continue. It is not just about the care that the hospices provide to the people who are sick; we have heard many times in the Chamber today about the wraparound care that hospices provide to families and friends, which is so important and valuable.

[Caroline Ansell (Eastbourne) (Con)]

My hon. Friend is making a moving and powerful speech, and he makes me recall my experience at Chestnut Tree House, which provides hospice care for children across Sussex. It is striving hard to meet all the demands on services. One group that we have not mentioned is those who the hospice may yet reach. It knows that many more families would benefit from its care, and it is working hard on that. Has my hon. Friend also found that in his constituency?

[Steve Double]

I am grateful to my hon. Friend for that intervention; she makes precisely the point that I was coming to. It is clear that there will be a growing need for hospice care in our country. We feel that incredibly acutely in Cornwall; our elderly population has grown by more than 50% in the past 10 years. Cornwall is at the point where almost one in four of our population is over 70 years old. That proportion will only grow in the years ahead, and it will simply mean that there is more demand for hospice care in our country. That is why it is so important that hospice care is properly funded.

I believe that it is best for our hospices to stay in the independent sector as charities. They gain most of their support from the public; I have seen that time and again for the two hospices in my constituency. Being independent from the NHS gives them a special place in our communities. People feel a great connection to them. They feel that they have a personal stake in the work that hospices do, particularly if they engage in fundraising for them. I fear that that would be lost if hospices were effectively nationalised. It is so important for our hospices that we continue that situation.

However, the Government need to better recognise the important role that hospices play. We have heard several times about the postcode lottery for NHS funding for our hospices. I tell the Minister that we need to address that. Cornwall Hospice Care, I am told, has the second lowest funding of any hospice charity in the country. Just 9% of its funding comes from the NHS, which means that 91% is raised through fundraising, donations and legacies. That cannot be right. I am all for donations playing a significant part in the funding of hospices, but the NHS should step up, particularly in Cornwall, and provide more funding to our hospices. We need to look at regional variation. Funding must be based on need for hospice facilities in each region. I urge the Minister and the Government to look at what more can be done to provide a level playing field on NHS contributions to our hospices.

We have all heard that the past few years have been difficult for our hospices, with the growing pressure of rising costs and demand. One thing we could do for the hospice sector is provide more certainty about funding through multi-year funding settlements, so that hospices can plan far better, and at least know what funding is coming from the NHS. With that certainty, they could plan accordingly.

In summing up, I place on record my huge thanks to those in every hospice in our country for the incredible work that they do—to the paid staff, the volunteers and the fundraisers. They work so hard, and are so generous in providing this vital service to our communities, particularly the two hospices in my constituency. There has been real consensus across the House this evening. Although we value and celebrate all the work that hospices do, more needs to be done to provide them with fairer funding, so that they can continue to play a vital role for our communities.

--- Later in debate ---

[Helen Whately]

I will pick up on a few of those points.

On the NHS providing palliative and end of life care, I have heard a misunderstanding in some speeches, both this evening and on other occasions, that all end of life and palliative care is provided by hospices. It is more mixed. Integrated care boards do, indeed, commission hospices to provide care, but hospices also provide care independently, and NHS services do so, too. These teams also work together collaboratively. That diversity is a strength.

In seeking to address inequalities, ICBs can look to hospices to do more in underserved areas, for instance. At other times it may be more appropriate for them to look to NHS services. It will vary by area, which is one reason why these decisions should be localised, rather than made by somebody sitting in my place saying, “This is how it should be done across the whole country.”

Although I do not agree with centralising hospice funding, I am working on the transparency and accountability of ICBs to their communities and hon. Members, as representatives. That is why I have regular meetings with NHS England leads on palliative and end of life care, and it is why I am pleased to have secured NHS England’s commitment to including palliative and end of life care in the topics discussed at its regular performance meetings with ICBs. It is also why I am pushing NHS England and ICBs to improve the data they collect on the access to and quality of palliative and end of life care.

NHS England has developed a palliative and end of life care data dashboard to help ICBs understand the needs of their populations and then address and track inequalities in access to end of life care. This is progress, but I want the transparency to go further so that we all have the data we need to assure ourselves that our ICBs are commissioning the care that our constituents need.

I have heard the calls for more funding for hospices and the stories of some fantastic fundraising efforts, from the “star trek” night walk and the “Santa sprint” to the magnificent marathon runners who have joined us in the Chamber tonight fresh from yesterday’s London marathon. I congratulate those who ran, and particularly those who did so on behalf of hospices, which is timely for this debate.

That said, I disagree with the hon. Member who said that people running a marathon for hospices is “sad”—it is not; it is a wonderful thing. It is a sign of the tremendous support that hospices have in our communities and that people are willing to choose to fund hospices, not just when the taxman comes along; they are choosing to have a hospice providing services to people in their area. It is a good thing because that fundraising gives hospices an independent funding stream, the freedom that goes with that to serve their communities as they see fit, and the strong ties with their communities and with all those people who fundraise for their hospices.

[Caroline Ansell]

My hon. Friend is so right in what she is saying. In my constituency of Eastbourne, people are not just prepared to run for the St Wilfrid’s Hospice, but they will walk over coals for it. Will she congratulate them on their outstanding work?

[Helen Whately]

I do congratulate those people on their fundraising efforts; although I hope their feet are all right!

As hon. Members know, the Government have provided dedicated additional funding to hospices; in the pandemic, when I played a part, we were helping them with energy bills and through the children’s hospice grant, which the NHS has confirmed will go to hospices for this financial year too.

Looking ahead, I fully appreciate the ask for longer-term certainty of funding—of course I understand that. However, funding for hospices, end of life care and many other things beyond the current financial year depend on a future spending review. I am sure that all hon. Members will understand that I cannot pre-empt such a review, and ICBs similarly will not know their funding until that review. Although committing funding beyond the spending review period is not in my power, I am pushing for our healthcare system to encourage and enable more advance planning by individuals to consider and set out what they want at the end of their life. Inevitably, some of us will die in hospital, and for some of us that will be the right place, but given a choice many people would rather die at home. We should all be setting out a plan that includes our preference of place of death and what sort of treatments we do and do not want. As my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland) and my fabulous health colleague my hon. Friend the Member for Colchester (Will Quince) said, we should talk more about death and plan for it.

To conclude, there are no easy answers to the questions raised this evening—there rarely are. I do not have a pot of money otherwise going unspent for hospices; neither do ICBs and nor does NHS England. I will, however, continue working with NHS England to ensure that palliative and end of life care is given the attention it deserves and needs so that it is considered important, just as we consider services that prolong life important, and that the NHS is held to account for doing that. I will continue to agree with hon. Members on the importance of hospices and the important work they do. I see this as a Minister, as a constituency MP and from my own family experience; I will never forget saying goodbye to my grandmother in a hospice near Yeovil, and I will always be grateful.