Hospice Funding

Patrick Grady Excerpts

Monday 22nd April 2024 Commons Chamber

[Patrick Grady (Glasgow North) (SNP)]

I congratulate the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on securing the debate and bringing this vital issue to the Floor of the House after a series of Westminster Hall and other debates.

In the context of the spring Budget, at the start of a new financial year and with a general election on the horizon, this is an incredibly timely debate. It also coincides with the publication of Hospice UK’s report, which estimates a deficit across the UK hospice sector of £77 million, and for Scotland of around £16 million, for the financial year 2023-24—perhaps the worst financial outturns for the sector in nearly 20 years. The same report suggests an 11% increase in payroll costs to hospices, representing around £130 million. People who work in hospices have every right to expect a decent competitive salary that allows them to ensure that their own households are safe and warm, but that is a challenge being driven by the wider cost of living crisis, which is itself having an effect on the hospices.

Heating, food, drink and other consumables are not discretionary expenditure. Hospices must run 24 hours a day, seven days a week. They have to maintain a comfortable temperature. They have to provide nutritious, high-quality food. All that comes at a time, as the hon. Member for Bracknell (James Sunderland) just said, when the demand for such wonderful care has perhaps never been higher. People are living longer and dying at later ages. That means an ever-greater need for palliative care. The Office for National Statistics estimates that in Scotland an additional 10,000 people a year might be expected to seek access to palliative care by 2040.

We have heard some very moving individual testimonies from Members across the House. The hon. Members for Coventry North East (Colleen Fletcher), for West Dorset (Chris Loder) and for Leeds East (Richard Burgon) all spoke of personal experiences of the hospice movement. The hon. Member for Birmingham, Erdington (Mrs Hamilton) made some very worthwhile points about hospices being a place where people can really live the final days of their lives. The hon. Member for Eastleigh (Paul Holmes) has been very passionate about the issue for reasons he explained about his former chief of staff. We echo the condolences that have been paid.

I am incredibly grateful for the love and care shown to my good friend Melanie, who passed away in the Highland hospice just over a year ago. I was proud to be one of the runners yesterday in the London marathon in her memory and in aid of that hospice. I congratulate the hon. Members for Walsall North (Eddie Hughes) and for Enfield, Southgate (Bambos Charalambous), who ran for their local hospices, and the hon. and learned Member for Eddisbury (Edward Timpson) and the hon. Member for Colchester (Will Quince), who also took part in the debate and ran for other worthy causes. I understand that in a few weeks’ time, the hon. Member for Lancaster and Fleetwood (Cat Smith) will take part in the 40-mile Keswick to Barrow walk through the Lake district in aid of St John’s hospice in Lancashire. I pay tribute to the work of the Marie Curie hospice in Glasgow, which has provided care at the end for other friends, particularly some I have known through the SNP. In recent weeks, close friends have had reason to be grateful to everyone at St Vincent’s hospice in Renfrewshire in very sad and difficult times.

Those personal experiences are what help to inspire the incredible generosity that allows the hospice movement to continue its work. As we have heard, around two thirds of adult hospice income comes from voluntary fundraising. At the same time, the Sue Ryder charity estimates that the hospice sector actively saves the NHS nearly £600 million a year by freeing up bed space, or even avoiding hospital admissions in the first place. The hon. Member for South Dorset (Richard Drax) gave some examples of exactly how that can work.

From all the evidence we have heard today, it seems that the current model for hospice funding is increasingly unsustainable. Some have even used the word “existential”. Healthcare is devolved, so it is not for the Scottish National party to determine how the Minister or her shadow on the Opposition Front Bench prioritise their spending decisions, but if the UK Government were to find new or additional funding for the hospice sector in England, that would have consequentials for the budget available to Scotland’s Government. The current 2024-25 budget for Scotland provides over £19.5 billion for NHS recovery, health and social care, which is a real-terms uplift despite the austerity we are facing.

The Scottish Government have also established a new strategy steering group to oversee the development and delivery of a new palliative and end of life care strategy and associated work programmes. That work aims to ensure that everyone in Scotland receives well co-ordinated, timely and high-quality palliative care, care around death, and bereavement support based on their needs and preferences, including support for families and carers, to ensure that Scotland is a place where people and communities can come together to support each other, take action and talk openly about planning ahead, serious illness, dying, death and bereavement.

There are other actions that the UK Government could take that would continue to help hospices across these islands. Energy costs remain stubbornly high, but the Government are bringing many of their energy support schemes to an end. As I said earlier, energy is a fixed cost for hospices, not an area in which savings can readily be made. In this context, the hon. Member for Darlington spoke about the situation of Ardgowan in Inverclyde. Many of the reforms to the energy market and energy price support that the SNP and others have called for would make a difference in the hospice sector, as in many other parts of the economy and society.

Regrettably, the Government’s approach to immigration is also having an impact. How many nurses, doctors and other specialists have arrived in the UK—some, perhaps, on small boats or by other irregular means—but have been denied the opportunity to work? How many more are not even coming in the first place now that the Government have decided that they cannot bring family members, or are massively increasing the costs and thresholds for visa applicants? How many might have come from Europe, or might have stayed, had it not been for Brexit? Every country in the world is having to face up to the legacy of covid and the impact of conflict in Ukraine and elsewhere, but the UK Government have been making deliberate policy choices in many of these areas that are exacerbating those challenges rather than mitigating them, and the impact of that could have long-term consequences.

If the hospice sector does have to make radical savings and scale back service provision, the costs of palliative care and supporting people at the end of life will still have to be met; they will just have to be met elsewhere, which could mean increased costs for the NHS, for social services or, worse still, for individual families and households—not just in financial terms, but in emotional and psychological terms—if they are denied that support at the end. People will always want to give and to raise funds for hospices, but if we want collectively to be able to rely on hospices to be there for individuals and families when they are needed most, we cannot expect the hospice movement simply to rely on the good will and efforts of voluntary fundraisers.

A number of important suggestions have been made during this debate, in the motion, and in the evidence given by hospices themselves and by the all-party parliamentary group about how the Government can put the sector on a more sustainable footing for the future. I hope that the Minister will be able respond positively, in the spirit of consensus that we have observed this evening, and that the Government will work with their counterparts and with service providers across the United Kingdom to ensure that the hospice sector is given the support that it needs so that everyone who works for hospices can focus on what they do best, and continue to provide love and care for those who need it at the end of their lives.