Hospice Funding

Colleen Fletcher Excerpts

Monday 22nd April 2024 Commons Chamber

[Colleen Fletcher (Coventry North East) (Lab)]

I thank the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson), as well as the APPG, for securing this hugely important debate on the Floor of the House.

In Coventry, we are extremely lucky to have Myton hospice. Like other hospices across the country, Myton is a critical part of the healthcare system and plays a vital role in providing care for people from the point at which their illness is diagnosed as terminal to the end of their life, while also supporting the needs of their families. The services that Myton provides are a crucial part of palliative and end of life care in Coventry. The work it does and the services it provides not only ease pressure on the wider health and care system in our city, but ensure that patients receive exactly the care they need when and where they need it. Without Myton, patients might find themselves unnecessarily relying on A&E or other hospital departments, which would massively increase the burden on, and costs for, the NHS.

I know at first hand how important Myton is to our city and local communities, because my husband, Ian, received end of life care there. Diagnosed with leukaemia in 2014, he had a stem cell transplant and was fighting his way back to reasonably good health when, three years later, he became ill with an aggressive secondary cancer and was diagnosed as terminally ill in 2018. He wanted to die at home, but we were advised that domiciliary end of life care was “clunky”. Those are not my words, but the words of the NHS care team who were advising and talking to us. That meant that we could not be sure of a timely home visit if my husband needed more pain relief—and he was on a lot of pain relief. He was on a pain driver and I could give him liquid morphine, but that shot, which only a district nurse could give him, might not have been there immediately and he might have had to wait an hour or two hours for the nurse to come. He decided to go into Myton hospice, which is only a stone’s throw away from where we lived, so it was very local to us. He went into Myton hospice, and I stayed with him until he passed peacefully away just one week later. It was a tranquil, respectful place, where all his needs were met, and ours. We were grateful for that real quality time together.

Just before Christmas, I went to an event at Myton hospice where I met staff, the loved ones of those who had received palliative and end of life care there, and the people who fundraise to help ensure that Myton can continue to provide its vital services. It takes just moments when speaking with people at such an event not only to understand the importance of the hospice sector, but also to recognise the huge funding challenges it faces. We know that the hospice sector’s reliance on fundraising for much of its income brings with it significant risks, and those risks have been compounded in recent years, first by the pandemic and now by the cost of living crisis. As a result, the hospice sector is facing a perfect storm, with the cost of delivering services increasing, while charitable donations are volatile and NHS funding is falling in real terms.

Take Myton Hospices as an example: just 20% percent of its funding comes from the NHS, and in real terms that is decreasing every year. That comes at a time when its costs are consistently increasing year on year. For the financial year 2024-25, its running costs will be £14.3 million, and it will need to raise £11 million of that in voluntary income. That is compared with running costs of £13.25 million and raised voluntary income of £10.5 million last year. Those funding challenges inevitably increase pressure on and access to services. I know that more people need a hospice bed than ever before, and demand for beds at Myton has increased by 25% over the last year. As a result, over 70% of people accepted for a bed at Myton will not be able to access one straightaway and will have to join a waiting list. Sadly, three out of four people waiting for a Myton bed will die before they can access one.

Although I understand the funding pressures that Coventry and Warwickshire integrated care board is operating under, that certainly raises questions about whether it is meeting the requirement to commission palliative and end of life care to meet the population’s needs. Indeed, I know that with funding for just four more nurses, Myton could open eight more beds and eliminate its waiting list completely, ensuring that everyone in Coventry and Warwickshire gets the palliative and end of life care that they need and deserve. Those funding challenges are certainly not unique to Myton, and most—if not all—hospices are facing similar problems. This needs to change. If we are to ensure that demand for hospice care is met, both in in-patient units and in the community, and eliminate the inequality and postcode lottery of services, we need hospice funding to be sufficient, resilient and sustainable.

I asked those at Myton hospice what steps they believe need to be taken to ensure we have a thriving hospice sector, with long-term sustainability at its heart. They told me they believe there needs to be a tariff-based approach to funding that reflects the core services provided, so that funding is based on what each hospice provides against clear criteria. They also felt that essential hospice services, including doctors and nurses, should be funded by the NHS. We must ensure that all patients with a terminal illness receive the right care to meet their needs, that that care is delivered with dignity, respect and compassion, and that the end of their life is valued as much as the beginning. To achieve this, hospices must be funded fairly and sustainably.