Covid-19: Charitably Funded Hospices

Lord Bethell Excerpts

Wednesday 28th October 2020 Lords Chamber

[Lord Addington]

To ask Her Majesty’s Government, further to the impact of the Covid-19 pandemic, what action they are taking to make sure that charitably funded hospices have sufficient funding to continue to operate.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, hospices play an often unseen but hugely valuable role in providing patient care. That is why we provided more than £150 million of extra funding to hospices during the first peak, when hospices across the nation cared for 170,000 patients, thereby helping to protect the NHS and continuing to provide high-quality end-of-life care. We recognise that the second wave presents challenges for hospices. We thank Hospice UK, Marie Curie and all the other groups for their engagement on this important challenge.

[Lord Addington (LD)]

My Lords, it is nice to hear the Government thanking the hospice movement. Some 80% of hospices think that they will have to make redundancies. The voluntary sector takes on more than 75% of hospice treatment. If the Government are not going to fund hospices, will they take on the work themselves or are we just going to let people suffer at the end of their lives?

[Lord Bethell (Con)]

The noble Lord is entirely right. Some £1.54 billion is spent on hospices each year. Of that, £1.2 billion is charitable; I pay tribute to those from the hospice movement who were recognised in the recent Birthday Honours List for supporting that fundraising. Let me assure the noble Lord that the challenge he describes is recognised in the department. The Minister responsible will meet key hospice stakeholders, including from Marie Curie, Sue Ryder, Hospice UK and Together for Short Lives, on 4 November when the challenge that he describes will be discussed.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I am a long-standing supporter of Birmingham St Mary’s Hospice. If the current restrictions stay the same as now, the hospice estimates that, by the year’s end, fundraising and retail income will be down by more £1.5 million—and by more if we have a more severe lockdown rule. This is a massive amount for a small charity to make up. The Minister has referred to the support received from the Government via Hospice UK. That was hugely welcome, but the hospice movement needs an immediate second injection of funding, and it needs to know when that will happen. Hospices cannot wait much longer.

[Lord Bethell (Con)]

My Lords, I completely recognise the note of urgency in the noble Lord’s comments. I also recognise that, as we go into a Covid winter, the hospice movement, which has contributed so much to our response to Covid and brought valuable capacity to the care of the elderly and the vulnerable during the first wave, needs answers. I recognise the funding gap that he describes, in particular the collapse in retail income that many depend on, but I assure the noble Lord that the meeting on 4 November will have these issues on the agenda. The movement should look forward to that meeting as an opportunity to discuss the issues he describes.

[Lord Goddard of Stockport (LD)]

My Lords, in my home town of Stockport, St Ann’s Hospice is about to celebrate its 50th anniversary. It is one of the largest and oldest hospices in the country. It has been looking after people across Greater Manchester for half a century, delivering world-class specialist palliative and end-of-life care for thousands of people. St Ann’s Hospice must raise £20,000 every day from voluntary contributions to top up the value of the clinical commissioning group contracts, which provide only a third of the funding. What will the Government do to ensure the levelling up of fair funding in the contract arrangements with local clinical commissioning groups while protecting the all-important charitable status that hospices value so much?

[Lord Bethell (Con)]

My Lords, the noble Lord is right that 70% of hospices are funded through charitable income with only 30% coming from CCGs. That is why we put in more than £150 million during the first wave and why we have a discussion about future support on the agenda. I reiterate absolutely the points that he made about the contribution of hospices during the first wave and the innovation that many of them brought to the response. I have before me tributes paid to the Mary Ann Evans Hospice in Warwickshire and the St Elizabeth Hospice in Ipswich, which were case studies in bringing in fresh thinking and changes to work practices to support people during the Covid first wave.

[Lord Howard of Lympne (Con) [V]]

My Lords, I declare my former interest as the chair of Hospice UK. Does my noble friend the Minister agree that, even in the crude terms of value for money, because of its extraordinary ability to attract a huge amount of volunteer effort, the hospice movement is almost certainly the most effective sector in our entire healthcare system? Can he assure me that the Government will give full weight to that factor when they consider the urgent need of hospices for further support during this crisis?

[Lord Bethell (Con)]

I completely endorse my noble friend’s comments. Hospices are often the hubs for huge community efforts to raise money and to create volunteer support for those who are at the end of their lives. They are hugely valued in the healthcare system. The challenge that they face at the moment is recognised and we will meet our responsibilities to them.

[Baroness Butler-Sloss (CB) [V]]

I am the vice-president of Hospiscare Exeter. I will follow on from what the noble Lord, Lord Howard, just said. Despite what the Minister has been saying to us, I wonder whether Her Majesty’s Government are sufficiently aware of the extent to which hospices relieve the NHS and social care of the need to look after many terminally ill people by looking after them at home. Hospices dramatically need more financial support to continue with this terribly important initiative.

[Lord Bethell (Con)]

I assure the noble and learned Baroness that we understand absolutely the contribution of hospices, the value for money that they represent, the role that they play in communities and the incredible sensitivity with which they handle end-of-life and palliative care. I pay tribute to the contribution made by the noble and learned Baroness to the Living Well Dying Well charity and to Hospiscare. It is the contribution of people such as the noble and learned Baroness to the hospice care movement that has made it such a powerful and sensitive supporter of people at their time of most urgent need.

[Baroness Thornton (Lab)]

It will be quite clear to the Minister now that virtually every single Member of your Lordships’ House has a local hospice to which they are attached. Mine is St John’s Hospice in St John’s Wood, which has just launched an appeal to recoup a £1.3 million shortfall during the pandemic. Because hospices are being asked to take on more and more patients that they do not have the funding to cover, I hope that the important 4 November meeting will be based on an assessment of the need for continuing support for the sector for the remainder of 2020 and into 2021. Also, what plans do the Government have to ensure that everyone who needs quality palliative and end-of-life care will continue to receive it through and beyond the pandemic?

[Lord Bethell (Con)]

The noble Baroness will know through her work as a lay member of the NHS Camden Clinical Commissioning Group that hospices are much valued by the healthcare system. I assure her that the agenda for 4 November will include an assessment of the ongoing support that hospices will need through the winter.

[Lord Jones of Cheltenham (LD) [V]]

Today the director of my local Sue Ryder, told me that she faces a budget shortfall of 43%—almost half—in this financial year because fundraising from shops and other means has fallen. She has already had to make redundancies. However, demand is increasing and she is expecting a tsunami of new patients who missed an early diagnosis of their condition because of the Covid crisis. What are the Government going to do about this both now and in the long term?

[Lord Bethell (Con)]

The noble Lord is entirely right to cite the challenge being faced by Sue Ryder and other hospice charities that depend on retail income. They face a most difficult and challenging problem; it is one that we acknowledge and recognise. The question of misdiagnosis leading to a bump in arrivals in hospices is not one that I have been conscious or aware of, but I am grateful to the noble Lord for flagging it up for me. I will take that back to the department and, if it is something that we should be focused on, I will write to him accordingly.

[Baroness Stuart of Edgbaston (Non-Afl)]

My Lords, the manner of our going is as important to the human condition as the good life lived. Hospices have played an important role, in particular those hospices that care for children. The provision for children’s hospices is very patchy across the country, as is their need. At the meeting on 4 November, will the Minister pay particular attention to hospices caring for children and providing the necessary outreach work to families?

[Lord Bethell (Con)]

The issue raised by the noble Baroness is one that I am aware of. Who can think of a more moving cause than hospices for children? This will be definitely be on the agenda for 4 November and I will raise the issue with my honourable friend the Minister for Social Care.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed, which brings Question Time to an end.