Hospice and Palliative Care Debate
Full Debate: Read Full DebateJim Dickson
Main Page: Jim Dickson (Labour - Dartford)Department Debates - View all Jim Dickson's debates with the Department of Health and Social Care
(2 days, 10 hours ago)
Commons ChamberHospices provide vital care for adults and children with life-limiting conditions, offering end of life care, pain management and bereavement support to families, but despite being this essential part of healthcare, the hospice sector has challenges due to inadequate Government funding and the taxes that they are putting on it, and to workforce shortages. That is all compounded by rising costs and economic uncertainty.
Before I became a Member of Parliament, I have to confess that I had, perhaps fortunately, very little contact with the hospice sector, despite having worked in health and social care for the majority of my career and being a local government councillor for 17 years. During the election campaign, I was invited to the Shooting Star children’s hospice, which has been mentioned by numerous Members across the House. I visited Christopher’s, which is its in-house care facility in Guildford. I think it is actually in the constituency of my right hon. Friend the Member for Godalming and Ash (Jeremy Hunt)—I am sure that the hon. Member for Guildford (Zöe Franklin) will correct me if I am wrong. There I saw the true meaning of selfless day-to-day acts of kindness and care, with people looking after some of the most vulnerable children and their families. They are the absolute exemplar of people providing dying well.
I also have the Phyllis Tuckwell hospice in my constituency, which is currently going through a multimillion-pound rebuild funded by donations from people who have either used or care for our hospice in Farnham. When it is open—hopefully by the end of the year—it will provide 18 new palliative care beds alongside rehabilitation and services for the families as well, along with therapy sessions. Both are shining examples of what dying well should look like.
As other hon. Members have mentioned, the one good thing to come out of the assisted dying debate has been a much greater focus in this House, and indeed across the country, on what it means to die well. I echo some of the comments we have heard: let us get palliative care and hospice care right first, before we start thinking about whether or not we should be allowing people to kill themselves.
Despite the Government’s announcement just after Christmas, which I would be churlish not to welcome, the reality is that adult hospices and children’s hospices are almost totally reliant on charitable donations. The rest comes through the integrated care boards and, as the hon. Member for Scarborough and Whitby (Alison Hume) just mentioned, it is a complete postcode lottery.
I am grateful to the hon. Member for Wimbledon (Mr Kohler) for securing the debate, and he mentioned the significant variation in per person funding depending on where they are in the country and at which hospice they are being treated. The children’s hospice sector is the starkest example, with some places funding just under £30 a head, whereas others fund over £500 a head. This inequity in care clearly leaves some families worse off.
The Government really have not made it easy for the hospice sector. It is still not clear to me that the Health Secretary and the Department of Health had any clue that the national insurance contribution changes were coming down the line. If they were aware, had they allocated this funding beforehand? Was this in their plan, or have they been scrabbling to try to make up the difference since they heard this announcement? Despite asking questions, I have not heard an answer.
We also have not heard whether the Government will cover the costs of the national insurance contribution rise. My personal view is that they must, because the hospice sector, alongside so much of the care sector, is vital not just to the people who use it, but to the wider health economy. Underfunding and taking money from hospice care will have a significant cost impact on other parts of the health service.
The hon. Member seems to welcome the additional £100 million for the hospice sector and, indeed, the additional investment in the NHS that have come out of the Budget, but he seems not to welcome the way in which that revenue is being raised. How would his party raise the revenue needed for the NHS and the hospice sector?
Well, the simple fact is that what the hon. Members and his Front-Bench team are doing is ensuring that the NHS is worse off, because raising the money will have a greater impact on the rest of the service. [Interruption.] The Minister for Care is shouting at me from the Front Bench, and I am sure that, in his response to the debate, he can outline whether he and his team knew about the national insurance contribution rises and whether they planned for them.
The other part of this is the workforce, who have been touched on briefly. There is a real shortage of qualified healthcare professionals. Vacancy rates for hospice nurses have risen to nearly 19%, and the corollary is that staff morale is low. Again, the Government need to make sure that the long-term workforce plan that they and the NHS are rolling out includes how we will ensure that hospice staff are part of the long-term funding. Hospice UK has warned, seriously, that without urgent action, some, indeed many, hospices may be forced to close their doors in the next 12 months.
I have some requests of the Government. First, as the hon. Member for Birmingham Erdington (Paulette Hamilton) said, we need them to commit to a long-term sustainable funding model for hospices. That is not to say that hospices should be brought into the central NHS—I personally believe that the innovation of the hospice sector is down to its independence from the NHS—but they need multi-year funding to understand where they stand.
Secondly, as has been mentioned, we need to scrap the postcode lottery that comes from the integrated care boards. Some kind of ringfenced funding, particularly for children’s hospice grants, would prevent a lot of the delays and inequities in the service. As I said, we need to make sure that hospice staff are integrated into the NHS long-term workforce plan and are paid in parity with similar NHS roles.
I thank the hon. Member for Wimbledon (Mr Kohler) for securing this debate and for his excellent and moving opening speech. Hospices across the country care for hundreds of thousands of people living with conditions that limit their lives or mean they face their lives coming to an end.
I wish to put on record my thanks to two hospices that provide crucial services for people in my area. Ellenor is a specialist palliative care provider for adults and children based in the constituency of my hon. Friend the Member for Gravesham (Dr Sullivan). Since 1985 it has been providing hospice care for those who need it most, and it recently opened a new wellbeing centre, which is a hugely welcome addition to its facilities. I also pay tribute to Demelza, which has children’s hospices in the constituencies of my hon. Friends the Members for Sittingbourne and Sheppey (Kevin McKenna) and for Eltham and Chislehurst (Clive Efford). Demelza supports families who are going through what I can only imagine are some of the most difficult circumstances I can possibly think of, where children are facing serious or life-limiting conditions.
Given the importance of such services, I understand the high degree of concern from the sector before the Government’s announcement of further funding last month, with the NHS England children’s hospice grant not having been confirmed at that point for 2024-25. I therefore join hon. Members who have welcomed the 19 December announcement by the Secretary of State for Health and Social Care of £100 million in funding improvements for hospices, such as updated IT and improved facilities for patients and visitors. I also very much welcome the news that hospices for children and young people will receive £26 million in revenue funding for the next financial year. Hospice UK has welcomed that funding, saying that it will
“bring clarity to critically important services for children with life-limiting illnesses.”
What does the hon. Member think about the many hospices that do not need the capital but are desperate for the income? I would be interested in his answer.
I thank the hon. Gentleman for his question. The capital funding will be of immense help to a wide variety of hospices in ensuring that they can upgrade their operation so that they are less reliant on revenue funding from the charity sector and from the NHS. We need a sustainable funding model, and I know the Minister will come back on that at the end of the debate. Finally, let us wish Hospice UK, individual hospices, and our NHS every success with their amazing care for all who need their services, and hope that they will be able to find a sustainable financial future as a result of the Government’s work.