Hospice Funding

Paul Holmes Excerpts

Monday 22nd April 2024 Commons Chamber

[Paul Holmes (Eastleigh) (Con)]

I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on their hard work to secure the debate, and on their work on the all-party parliamentary group. I led a Westminster Hall debate on this subject on 14 June 2023. I am pleased that we are having this debate, but disappointed that no further progress has been made on the problems we expressed then, given the problems that hon. Members are expressing this evening.

As has been said, the hospice sector does a remarkable job and plays a pivotal role in our health system, providing care and the support needed to those who watch their loved ones pass away, and wonderful care in those weeks until that point. That happened to me and many of my dear friends upon the passing of my office manager Sue Hall on 30 March 2023. She passed away at the age of 57 from lymphoma, leaving her husband Jerry and her daughters Phoebe and Rosie. She was cared for fabulously by the team at Mountbatten hospice in my constituency. The family and I were able to count on the support of the fantastic staff at that hospice, who not only provided the best care that Sue wanted, needed and deserved, but gave us the wraparound support during and after that period.

Like many hospices, Mountbatten provides 24/7 in-patient and community domiciliary care to Southampton and large parts of Hampshire. It supports around 1,000 families every day. Demand for its services is expected to rise by 40% in the next 18 months. It costs £11.5 million to run every year and relies on fundraising, which equates to around 70% of its total budget. NHS contracting represents around 30% of services delivered. However, the funding models in place are inadequate, with the ICB giving only a 2.4% uplift in the contracting of services, when the real rise in costs requires an 8% uplift. For 2025-26, the Hampshire ICB has once again said that there will be no uplift, which means that Mountbatten will need to find an extra £750,000 just to provide the same services that it does today.

[Simon Jupp (East Devon) (Con)]

Strengthening our local hospices takes pressure off our NHS. My hon. Friend makes a good point that the benefits of fairer funding are plain to see, yet some hospices get no public funding at all from the local NHS. One such hospice is Sidmouth Hospice at Home in my constituency. Dr Sarah Wollaston, formerly of this place and chair of the NHS Devon ICB, still needs to provide a detailed idea of what funding Sidmouth Hospice at Home can get. It does not receive a penny from the NHS in Devon. That is wrong. Does my hon. Friend agree that it cannot be right that some hospice services and charities get funded from integrated care boards—something we should be proud of—while others get nothing at all?

[Paul Holmes]

I agree. In Hampshire we are lucky that 30% of Mountbatten’s services are contracted by the NHS. The ICB—which is in special measures, as my hon. Friend the Member for Isle of Wight (Bob Seely) said—is not doing a good enough job of providing those services. If a hospice wants to explore getting some of that funding from the national health service, it should be allowed to do so, while recognising the independence of spirit of many hospices that choose to go their own way. My hon. Friend is right to raise the work of the hospice in his constituency, and I hope that it will be able to acquire some ICB funding.

It will cost Mountbatten an extra £750,000 just to provide the same services, while the number of people it supports will rise by 200%. The Minister will say that this Government awarded another £1.5 billion for hospice services through ICBs. That is entirely welcome, and I congratulated her on her announcement in my debate last year. But I say now what I said in that debate: the ICBs are not passing on the money for the purposes set out. ICBs—particularly mine in Hampshire—are riding roughshod over the Government’s wishes and are exacerbating a problem in a system that already fails to take into account the varying nature of needs across different parts of the country.

My hon. Friend the Member for Isle of Wight (Bob Seely) and I had a meeting last week with representatives from our ICB. I asked how much of that £1.5 billion had been awarded to the Hampshire ICB. They could not give an answer. I asked how much of that was allocated to hospices in the region. They could not give an answer. I say what I said last June to the Minister, who is doing an excellent job: that money was very welcome but I hope we can look at a better way of holding ICBs to account, to ensure that when the Government put hard-pressed money into our health system, ICBs deliver it to the frontline services for which it was intended. That is no different in Hampshire. The leadership of Hampshire ICB needs to look at that seriously.

Mountbatten also has to compete with the NHS for its workforce. It rightly chooses to pay and award its staff along the same pay guidelines as NHS staff. This year, that represented a 4.8% rise in costs, and will represent a further 5% next year. Again, I thank the Government for awarding an extra £450,000 to Mountbatten, but that will still leave a deficit of £1 million overall this year. It is right that it chooses to pay its staff adequately, but that will mean Mountbatten will have to lay off some of its workforce, harming outcomes for families in my constituency. That will be the case in the rest of the UK if other hospices have the same problem.

The funding instability—which in my case I blame on the ICB, which is leading a review into hospice care—seems entirely one-sided. It will end up costing the NHS more money, as hospitals will pick up the burden of care, and beds will be used by people who should be in hospices. We all know the impact that energy bills and covid had on the sector.

I do not mean to sound depressing to the House, but we must continue to look at this issue. The Government’s investment is extremely welcome, but we need more. I would like to hear from the Minister how the Government and the NHS nationally intend to work together to provide a sustainable long-term funding settlement for hospice care, while retaining that independence that hon. Members have outlined. We need the Minister to review how much money ICBs are passing on to hospices, and to take a stronger line in reviewing the role of ICBs and holding them to account if they are not giving that money to the frontline.

The Government, the hospice sector and the ICBs have a clear choice: a sustainable funding model for our hospices, or more pressure on an already stretched national health service. The hospice staff I have met care and want to deliver on the challenge that many of our constituents face across the United Kingdom, but they need a level playing field in order to provide that care. Let us help them do that and improve hospice care.

[Several hon. Members rose—]