Hospice Services: Support

Liz Kendall Excerpts

Wednesday 14th June 2023 Westminster Hall

[Liz Kendall (Leicester West) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Nokes. This has been a really important and good debate; we do not always say that about debates in this place. I thank the hon. Member for Eastleigh (Paul Holmes) for securing it. He spoke with great passion and personal insight, and I am sure Sue’s family and friends will thank him for what he said. I also thank all hon. Members who spoke about their personal experiences. It is not always easy to do that here, but they have shown great courage.

Many Members thanked the amazing hospices in their constituencies. I hope they will forgive me for also paying tribute to LOROS Hospice in Leicester West, which I have visited many times. I am blown away by the care and compassion there, and the complete humanity shown to others. I am very grateful for that.

The argument I want to make today is that we need a much bigger, more serious debate about what makes for a good death, in the words of the hon. Member for Strangford (Jim Shannon). Policy really needs to change across the board. When the welfare state and the NHS were created, average life expectancy was 63. Now it is over 80, and one in four babies born today is going to live to 100. Back then, most people died of infectious diseases or accidents. Now, it is long-term chronic conditions. That means we are now experiencing death in a very different way. Often, death is not sudden; it may be long and difficult, both physically and emotionally.

Hospices—including hospice at home, because that is where many people want to die—need to be seen as an essential part of our health and care system, not an optional extra, a luxury or an add-on, as part of that much bigger debate about what makes for a good death. “A good death” is not perhaps a great campaigning slogan for any political party to focus on, but it is the truth of what we face, and politics needs to keep up with the changes in society. We need to start looking at that. The vital role of hospices and the need to properly plan a funding system, our workforce, training and how we link services and support is the context within which I see today’s debate. Quite frankly, people do not want to die in hospital. They want to die in the community and at home, with integral support for family and friends. That is our vision; that is what we need to deliver.

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the shadow Minister for giving way. I completely agree with the points she has raised. I thank the hon. Member for Eastleigh (Paul Holmes) for bringing the debate forward and for sharing his personal story, as have others in this room. It is not easy to share those stories, but it is important that we do.

I have seen first hand how hospices play a vital role in communities. They go over and beyond, and are truly heroic. I am patron of Greenwich and Bexley Community Hospice in my constituency; I have seen how they provide compassionate end of life care. Does my hon. Friend agree that it is vital that the Government recognise the issues hospices face, particularly during the pandemic and with the cost of living crisis?

[Caroline Nokes (in the Chair)]

Order. I remind the Member that interventions should be short.

[Liz Kendall]

I absolutely agree with my hon. Friend and will come on to many of the points she raises.

I want to touch on about five issues, as part of shifting us to a different position on how we ensure people have a good death in the 21st century. The first issue, which I hope the Minister will comment on, and which all right hon. and hon. Members have spoken about, is the real need to review how hospices in England are funded, so that this absolutely critical sector has certainty and security in the months and years ahead. That was a key recommendation of the all-party parliamentary group for hospice and end of life care.

Many Members have spoken about the huge financial pressures on hospices: food prices, energy costs, the costs of NHS pay settlements. As Sue Ryder says, most hospices have seen a 10% increase in their costs, but only a 1% increase and in some cases no increase at all in NHS funding from integrated care boards, creating a perfect storm. ICBs have a statutory requirement to meet palliative care and end of life needs of their populations, but where is the funding? I hope the Minister will say whether the Government will institute the review because, without that, we will not have security for the future.

My second point, which has not been discussed in this debate but which I care passionately about—I would like to hear the Minister say something about this—is inequalities in access to hospice, end of life and palliative care. We know from the Parliamentary Office of Science and Technology that the pandemic exacerbated inequalities in accessing good palliative and end of life care for minority ethnic groups, and there are also socio-economic inequalities in access to hospice care. We know from Sue Ryder that there are also inequalities in access to bereavement support. We want to see everybody have fair access. Will the Minister say something about that?

The third issue relates to help to die at home, something I have campaigned on for many years as a Member of Parliament. There are still at least 10,000 people a year dying in hospital when they want the choice of dying at home. They are not getting the fast track NHS continuing healthcare support that they are supposed to get within 48 hours so that they can die at home. Our brilliant hospices have all sorts of support that they want to give, so I ask the Minister: why is that still a problem and what are we doing about it?

My next issue, which has been raised by many Members, concerns children’s hospices. Rainbows, the sole children’s hospice in the east midlands, wrote to me to express its concern about the children’s hospice grant potentially being wound up. As recently as 22 May, the Government replied to a written question:

“Funding arrangements for children’s hospices beyond 2023/24 have not yet been agreed.”

We cannot have children’s hospices not knowing what is happening to their grants. We have to be able plan ahead better.

Fourthly is something that my hospice, LOROS, has raised with me, but also lots of care homes. Bear with me on this. Many care homes are now essentially providing a lot of end of life care because the level of need that people have when they go into a care home is so great that that is what they need. But the staff might not be properly trained, and LOROS has said that it could work with care homes to make sure the staff are trained. That is one specific ask, so perhaps the Minister could meet me and LOROS to look at what hospices could do to better support our care homes.

Last but by no means least is workforce shortages. Sue Ryder stated:

“The Government must plan for the workforce as a whole system across health and social care”

and charitable providers. That is really important. We have to stop seeing all those different bits of the system as separate. We Labour Members have set out our plans for the biggest expansion in the NHS workforce’s history and for fair pay agreements and for social care staff. We urgently need to see the Government’s workforce plan, and I would like to see that covering all the issues.

In conclusion, we have heard today about the manifold pressures on hospices. I do not think I have ever been in a debate where so many Members have spoken so powerfully and positively about a part of the health and care system and what it does. It shows the strength of feeling and support, but I ask everyone here to think about how we as a Parliament can put achieving a good death as a big thing that we can make progress on and continue this campaign in future. I look forward to hearing the Minister’s comments.