Hospice Funding

Martin Docherty-Hughes Excerpts

Monday 22nd April 2024 Commons Chamber

[Bambos Charalambous]

My hon. Friend makes an excellent point. Fundraising is hard enough; inflationary costs make it much harder for fundraisers to do their excellent job of bringing an enormous amount of money together to make sure that all our hospices are run adequately.

Many hospices, like North London Hospice, will continue to operate a deficit budget for 2024-25, with the shortfall being met from reserves. Indeed, Hospice UK estimates that the sector is on track for a £77 million collective deficit for financial year 2023-24, the worst end of year figures in around 20 years of tracking. This funding model is simply unsustainable, and will undoubtedly lead to hospices cutting back essential services for patients. The issue is becoming increasingly urgent. We need to look at how hospices are funded in this country. They provide essential support; they should not be a voluntary service that is topped up by whatever fundraising is available. An integral part of our healthcare system is reliant on charitable donations. No other services are funded in that way; it is unthinkable that it would be left up to charities to plug shortfalls in maternity services, for example, so why is end of life care reliant on the kindness of strangers? It is really worrying. We need a far more secure, long-term model of funding that protects our hospices and partners them with the wider health and care system. If we do not properly support our hospices, we are in danger of losing them.

[Martin Docherty-Hughes (West Dunbartonshire) (SNP)]

I appreciate that funding models are different across the UK, but the hon. Gentleman has raised a point that I have a bit of concern about. There are two hospices in my constituency, one of which, St Margaret of Scotland, is the largest and oldest in Scotland. The voluntary capacity on the board of management has allowed it to develop and increase its palliative care provision. Does the hon. Gentleman agree that we should maybe look at parity of esteem between the voluntary hospice sector and our different NHS structures, in order to have equity of approach and investment?

[Bambos Charalambous]

The hon. Member makes an excellent point. We need to look at what models work best for each region. I do not know about the model he talked about, but we need to look at the long-term funding of hospices, and what works best for each hospice and region.

I am pleased that today’s debate has shown the strength of feeling on this issue, and that Members have highlighted the need for greater support and funding for hospices in the UK. That point was made clearly in the excellent speech by the hon. Member for Hastings and Rye, as well as in interventions. I look forward to hearing from the Minister on the Government’s response to the challenges that have been outlined. Finally, I once again thank everyone at North London Hospice for all their amazing work in my community and beyond, and I also thank Hospice UK for all its advocacy on these issues and its excellent briefings ahead of today’s debate.

--- Later in debate ---

[Peter Gibson]

I am very grateful to the Chairman of the Select Committee for his intervention, and for his continuing engagement with me on this important topic. He raises a really important issue. As I will come on to say, this is not simply about each ICB meeting its own challenges. We need national and Government attention to resolve the issue.

There is a very mixed patchwork picture across the country. During covid, the Government stepped up to the plate, acted decisively and provided much-needed financial support to the hospice movement. That support not only prevented many hospices from failing and collapsing, but ensured that much-needed palliative care could continue to be delivered around the country. The picture today, however, is one of immense challenges for our hospices. Many have failed to receive increased support under their contracts with ICBs to meet the rising costs of energy and staffing. At the same time, our hospitals face increased pressure for beds. It is a fact that one night in a hospice costs less than a night in a bed in hospital, and while there are reasons why a person may need to remain in hospital, better palliative care can be delivered in the more appropriate surroundings of a hospice.

Just last week, I met the chief executive of Sue Ryder, Heidi Travis, who also serves as a commissioner for Cambridgeshire and Peterborough ICB. It was interesting to learn that work is being undertaken to explore ways in which hospices can do more with the same funding, or in some cases less. However, if we are to explore creative new ways of delivering hospice care, either through hospice-at-home models or virtual wards, full and frank conversations need to be had between hospices and their integrated care boards to truly explore the art of the possible.

In the Tees Valley, I have been pleased to be able to bring together, on multiple occasions, St Teresa’s in Darlington, Alice House in Hartlepool, Butterwick hospice in Stockton, and Teesside hospice in Middlesbrough. They work collectively with all eight Members of Parliament covering the Tees Valley, so that there is a collective voice for the region, and so that we can be a beacon of excellence in the provision of palliative care in the north-east. The uplift in funding for those four hospices under the North East and North Cumbria integrated care board is simply not enough, but the fact that they are working together and meeting the ICB is a sign of improving relations, and there is hope for the future.

I wish to touch on the work of our children’s hospices, which a number of Members have mentioned. They are an integral part of palliative care across the country, and I am grateful for the engagement I have had in recent weeks and months with Together for Short Lives. The NHS children’s hospice grant of £25 million from the Government is gratefully received by the sector. However, that funding should be guaranteed for a minimum of three years to enable those hospices to plan properly and commission services, and the amount should be uprated in line with inflation each year. Furthermore, the money must be ringfenced, so that when it is passed on through regional ICBs, the entirety of the money flows to the frontline—to those children’s hospices. I ask the Minister to address that point in her summing up.

In preparing for today’s debate, I asked for information and evidence from Hospice UK about hospices in each of the four nations of our country. Saint Michael’s, a hospice of which I am a trustee, is the local hospice care charity supporting people affected by terminal illness and bereavement across Harrogate. Each year, the vital care it provides costs almost £6 million to deliver. Of that, just 17% is funded by the Government; that equates to a little over £1 million of its total running costs. That leaves over £5 million to be raised through the generosity of its supporters and community. The rise in inflation has put additional strain on its finances, but has been met with a funding increase of just 1.2% from the ICB.

Shalom House in Pembrokeshire needs to raise around £288,000 to keep running, which is equal to £24,000 per month. It receives only £5,000 per month from its health board, and this amount has been halved in the last five years from £10,000. It has not received an uplift for at least the last four years. It anticipates that funding ending in September 2024, when the new commissioning model in Wales comes into effect. Without a cash injection, it is in danger of closing within the next 12 months, as its reserves are low. While Shalom House is small, the impact on the community, like that of all hospices, is huge.

In Scotland, Ardgowan in Inverclyde is, despite a very generous community, facing a deficit of £100,000. It expects this to rise to £172,000 for the next financial year. In the last 18 months, it has seen utility costs rise by 67% and insurance costs by 10%. It needs increased support.

In Northern Ireland, 65% of the funding for Foyle hospice in Londonderry comes purely from fundraising. It is unable to plan ahead or reconfigure services because of the uncertainty about statutory funding, including the outcome of the recent day hospice review. It has received some non-recurrent funding through the cancer charities relief fund, but may be unable to provide those highly valuable services when that funding runs out in March 2025.

We are a compassionate and wealthy country. We have a national health service that, despite some of its challenges, does incredible things, but so too do our hospices—be they based in buildings or in patients’ homes. Our hospices really must be seen as an integral part of our national health service.

[Martin Docherty-Hughes]

I want to push the hon. Gentleman on the point I made to the hon. Member for Enfield, Southgate, because I have heard this notion of symbiosis with the NHS, but they are two very distinct approaches to care. From my perspective, the palliative care sector is at its best when it is run as a voluntary local body. Would he expand a wee bit more on what he means by that kind of convergence with the NHS? There is a fear among those in the voluntary hospice sector that what they are doing to push palliative care forward could be held back by more physical integration in the NHS.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Before the hon. Member continues, I just remind everybody that there is quite a bit of interest in this debate. If we could ensure self-discipline in the length of speeches, that would be very helpful.