Hospice Sector: Fiscal Support and Cost of Living

Patrick Grady Excerpts

Thursday 2nd March 2023 Westminster Hall

[Patrick Grady (Glasgow North) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Paisley. I warmly congratulate my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) on securing today’s very important debate and on her powerful opening speech.

The debate is particularly timely as yesterday Marie Curie launched its annual great daffodil appeal and, as my hon. Friend said, the all-party party parliamentary group on hospice and end of life care launched its significant report, “The Lasting Impact of Covid-19 on Death, Dying and Bereavement”. I particularly congratulate the hon. Member for Darlington (Peter Gibson) and Baroness Finlay of Llandaff on their work in producing that report. I note that the report is dedicated to the memory of the late member for Birmingham, Erdington, Jack Dromey, who chaired the APPG for many years with great passion, but did not live to see the report published.

Death is a fact of life; the mortality rate of the human race is 100%. More people are living longer, which means more people are dying later in life, and they are dying of more complicated and longer term conditions, which require more intensive care and support. That is often where the hospice movement comes into its own, because it provides a range of services to people, including respite care and wider support not just for residents, but for their families and friends. As the hon. Member for Twickenham (Munira Wilson) noted, the increasing complication in medical conditions is also true for those who lead shorter lives, and the children’s hospice movement does incredibly important work. As she said, children’s hospices are experiencing many of the challenges outlined today.

We have heard a number of moving stories and testimonies that speak to the value of the hospice movement today. Almost everybody will know somebody who has spent time, and perhaps passed away, in a hospice. I think of the late Liz Quinn, a tireless activist for the Scottish National party in Glasgow and real mentor to me over the years, who spent her final weeks, just before the 2017 election, in the care of the Marie Curie centre in Glasgow. Another close friend, Melanie, whose experiences I have shared in this house before and who has advocated for Marie Curie’s #DyingInPoverty campaign, has been living with terminal cancer and is now in the incredibly wonderful, compassionate care of the Highland Hospice in Inverness. I cannot speak highly enough of the support the hospice provides, not just to her but to her family and friends, such as myself.

I have not yet had the privilege of visiting the new Prince and Princess of Wales Hospice in Bellahouston Park in Glasgow, but a few years ago I visited its old facility on Carlton Place. The sense of peace, care and compassion was almost tangible. Many people in the west of Scotland also know the dedication of staff and volunteers at the St Margaret of Scotland Hospice in Clydebank. All this work builds on a tradition that dates back to the pioneering work of Dame Cicely Saunders in the 1960s, further to the work of Jeanne Garnier in 19th century France.

The specialist services provided by hospices come with specialist and specific costs. As everyone who has spoken already has said, energy is the first and foremost of those costs. Medical equipment needs to run 24 hours a day, seven days a week, and residents need to be kept warm and comfortable—that is one of the key aspects of palliative care. The steep increases in energy prices are having an immediate and significant impact. The Hospice UK briefing speaks of some hospices facing up to fivefold increases in energy bills.

Wider inflationary pressures are also having an impact. Food and nutrition are crucial in providing holistic care, helping people to maintain their strength as they live through what is often their final illness. Hospices need to be able to provide residents with nutritious meals of the best possible quality, but those costs are spiralling as well, potentially costing the sector as much as £100 million a year extra. On top of that, staff have to be properly remunerated. Hospice UK estimates that 71% of costs are related to staff. Every staff member will be feeling the individual and household pressures of the cost of living, and organisations want to be able to pay their staff a fair and decent wage. At the same time, as the hon. Member for Enfield, Southgate (Bambos Charalambous) drew out, there is a risk of a squeeze on fundraising and traditional sources of donations because of the financial pressures that many people are experiencing.

My hon. Friend the Member for North Ayrshire and Arran was not wrong to say that this is becoming an existential issue for many hospices around the country. If hospices cannot provide the service that they do, the cost will be borne elsewhere. It will have to be borne by the NHS more directly—people staying in hospital for longer, and patients not getting through as quickly as they might—or local care services will have to provide more intensive support for people in their own homes. Of course people should be supported to die in their home if that is what they want, but that is not done without cost, and that cost has to be met from somewhere. If it is not met by the local authority, the NHS or the hospice sector, it will be met by households, which in turn will lead to a further spiral.

Even when there are pressures on funding, we must think about the preventive elements of spending efficiently and effectively, whether it is the Department of Health and Social Care or the Treasury. The Treasury ultimately holds the purse strings, and Members were right to say that it would have been useful to hear from the Treasury, but I am sure that the Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O'Brien), is capable. The Government speak with one voice, and I am sure he will pass all this on.

There has to be a recognition of the stark financial situation and action to address it. As others have said, hospices are not pubs or restaurants—they do not pass their costs on to customers. The next phase of the energy bills discount scheme has to recognise that and provide targeted support for organisations that need it most. The hon. Member for Twickenham is right: zoos, museums and botanic gardens play incredibly valuable and important roles for society and the economy, but it seems incongruous to say the least that they should qualify for more support than the hospice sector does under the Government schemes.

The Government must also think about how they can address staff and skill shortages. They do not like to hear it, but the reality is that Brexit has caused a black hole in labour supply in the United Kingdom. The Government have to invest both in medium and long-term training and skills development, so that hospices provide attractive careers for people who already live in the United Kingdom. It is inspiring to see the care that is provided in the hospice sector, and people should want to make that a career. It is a privilege to support people at the very end of their lives, but we cannot expect people to do that for free. They have to be rewarded, have their skills recognised, be paid a decent wage and be trained to an appropriate level, so the Government must invest in that area.

The Government also have to address short-term challenges, which means they have to be far more generous with their visa regime. They might even think about some of the asylum seekers, who may or may not have come here on small boats, who are currently sitting in cramped and crowded hotel rooms, playing cards and watching TV, who have qualifications and training in nursing and medicine. They want help the country that they have come to. They have fled persecution and want to make their homes here. I meet such people all the time, not just in my constituency but around the country. Perhaps the Government should think about allowing those people to contribute to our society, particularly the hospice sector.

The Government should think about what lessons they can learn from the Scottish Government’s approach. My hon. Friend the Member for North Ayrshire and Arran spoke about the investment that they are making in the hospice sector. They had a strategic framework for action and are now developing a strategy on palliative and end of life care. They are also providing £7 million a year to the Children’s Hospices Across Scotland movement. Parking places at hospices will be exempt from workplace parking levies, and there is an ambition to create a national care service that will ensure consistency and fairness at national level with services that are designed and delivered locally.

I want to end on the note of consensus that has come through in the debate so far by paying tribute to the incredible work of the hospice movement, which supports people through some of the most difficult times of their lives. I recognise that hospices are experiencing their own difficult times, so we have to do everything we possibly can to support them.