Hospice Funding

Robert Buckland Excerpts

Monday 22nd April 2024 Commons Chamber

[Sir Robert Buckland (South Swindon) (Con)]

It is a pleasure to speak in this debate, and I thank my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson), and indeed the Backbench Business Committee, for allowing us time to debate this issue. We have heard some powerful contributions today.

Any of us with friends or family who have gone through end of life care will know exactly how the hospice movement plays such an important part in ensuring that death is dignified and dealt with properly, and that the wider family considerations are at the heart of the way in which hospices support people in that position. This is about not just the bricks and mortar of those hospices, but their work in the community; what they do in people’s homes; how they offer domiciliary support; and how with a good plan, agreed between the various agencies of our local health services, death can be dignified and an experience that is entirely fitting, bearing in mind the obvious sensitivities that exist around this issue. We do not talk enough about death in modern society. We rightly talk a lot about sexuality and sex, but we seem to talk more about that than we do about death. The Victorians did it exactly the other way round, being obsessed with death and never talking about sex. We need to get the balance right and talk frankly about death.

As my hon. Friend the Member for Darlington said, this evening is not a time to debate assisted dying—assisted suicide, as I would call it—but it is a time to talk not just about the invaluable contribution of hospices, but the future of our hospice movement and how we strike a balance between the need to maintain their independence, flexibility and character, which reflects the local community they serve, and the support that it is incumbent on the NHS and central Government to provide, especially in respect of commissioned clinical services. That is where the interplay comes between the independent voluntary sector and those vital statutory services—the clinical ones—that government has a duty to provide and the NHS has a duty to support.

I am particularly lucky as the local hospice that serves Swindon and the north and east of Wiltshire is situated almost next door to where I live in my constituency, in Wroughton. Prospect Hospice was founded in 1980, and has grown and thrived due to the generosity and good will of our local community. Some 30% of its income comes from fundraising appeals and activities. Another 31% comes from profit made by its charity shops, which exist throughout the length and breadth of our area. We have many in Swindon; in fact, a new one opened in one of our shopping centres only a few months ago that is already doing very well and serving its local community admirably. Some 11% of the income comes from legacy gifts. I am glad legacy gifts were mentioned by my hon. Friend the Member for Darlington (Peter Gibson), because they are vital. Together with other investment income, the amount raised in those ways comes to about 75%, with about 25% coming from the statutory services provided by ICBs.

We have all talked about the pressure of inflation, which is a reality for Prospect Hospice as well. Costs have increased significantly and the sad challenge we have faced in our hospice is that we have had to halve the number of beds, from 12 to six, and close the day therapy unit. That unit was invaluable. We very much miss the volunteers who worked in it and the support it gave people at end of life. In common with other hospices, covid wreaked havoc on the fundraising ability of Prospect Hospice; last year, it was left with a shortfall of just over £1 million. With the best will in the world, it is getting very difficult to make up that shortfall. This debate is important not just for Prospect Hospice, but for Julia’s House, the children’s hospice serving Wiltshire and Dorset, based in Devizes, which I visit very often. I know the benefits for children who were my constituents.

In this debate, we are talking not just about fundraising efforts, but about the involvement of volunteers in the service. Such involvement brings huge fulfilment and allows many thousands of people to make a difference by offering their time and talent. None of us wants to lose that, but a sense of reality is needed on the funding of commissioned services. There is no doubt that the Government have moved in the right direction—we have moved leagues in the last 10 or so years. The support that the Government gave to the hospice movement during covid was admirable. The introduction of the statutory duty, which we saw for the first time in the Health and Care Act 2022, was a signal moment when the hospice movement came of age, and end of life and palliative care was recognised, quite rightly, as an integral part of the way in which we provide and commission healthcare in this country.

My local ICB has set up an end of life alliance, which is good. However, more work needs to be done to ensure that the coming together of services around patients—clients—results in an avoidance of duplication, rather than the other way around. We need an acknowledgment that without hospices, such as Prospect Hospice, we will fail thousands of people who have come to rely upon this invaluable service.

There is much more that I could say. I pray in aid the excellent submissions and remarks made by right hon. and hon. Friends and Members. We are making a unified clarion call that we want to see our hospice movement thrive. That cannot happen without the input of Government and local health services.