Hospice Funding

Debate between Stephen Kinnock and Rachael Maskell

Tuesday 8th April 2025 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I thank the hon. Member for Beaconsfield (Joy Morrissey) for securing this important debate. I wish to take this opportunity to thank all those who work or volunteer in the hospice and palliative care sector for the care and support that they provide to patients, families and loved ones when they need it most.

This Government want a society in which every person receives high-quality, compassionate care from diagnosis through to end of life. We are determined to shift more care out of hospitals and into the community, to ensure that patients and their families receive personalised care in the most appropriate setting. Palliative and end-of-life care services, including hospices, will have a vital role to play in that shift.

In England, integrated care boards are responsible for the commissioning of palliative and end-of-life care services to meet the needs of their local population. To support ICBs in this duty, NHS England has published statutory guidance and service specifications. Although the majority of palliative and end-of-life care is provided by NHS staff and services, we recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at the end of life, as well as to their loved ones.

Most hospices are charitable, independent organisations that receive some statutory funding for providing NHS services. The amount of funding that each charitable hospice receives varies, both within and between ICB areas. This variation is dependent on demand in that area and on the totality and type of palliative and end-of-life care provision from both NHS and non-NHS services, including charitable hospices within each ICB footprint.

This Government understand the financial pressures that hospices have been facing, which is why we have announced the biggest investment to hospices in England in a generation. We are ensuring that hospices in England can continue to deliver the highest quality end-of-life care possible for patients, and for their families and loved ones. We are supporting the hospice sector with a £100 million capital funding boost for adult and children’s hospices, to ensure that they have the best possible physical environment for the care they give.

We are pleased to confirm that the Government have released the first £25 million tranche of the £100 million capital funding, with Hospice UK kindly allocating and distributing the money to hospices throughout England. An additional £75 million will be allocated in the coming weeks for use in the 2025-26 financial year. The £100 million capital funding will help hospices to provide the best end-of-life care to patients and their families in a supportive and dignified physical environment. Funding will help support hospices and will enable much-needed improvements, including refurbishments, the overhauling of IT systems and improvement of facilities for patients and visitors.

We are also providing £26 million in revenue funding to support children and young people’s hospices. This is a continuation of the funding that, until recently, was known as the children and young people’s hospice grant. ICBs will once again administer the funding to their respective children and young people’s hospices on behalf of NHS England. This is in line with NHS devolution policies, and it promotes a more consistent national approach by supporting commissioners in prioritising the palliative and end-of-life care needs of their local population. I am pleased to confirm that NHS England has now communicated the details of the 2025-26 funding allocation and dissemination to individual hospices.

I do accept that there is unwarranted variation and inequality in access to, and quality of, palliative and end-of-life care in England, but we are working to reduce these variations. NHS England has published statutory guidance and service specifications to support commissioners in prioritising palliative and end-of-life care. It has also developed a palliative and end-of-life care dashboard, which brings together all relevant local data in one place. The dashboard helps commissioners to understand the palliative and end-of-life care needs of their local population, enabling ICBs to put plans in place to address and track the improvement of health inequalities and to ensure that funding is distributed fairly, based on prevalence.

NHS England has also published the ambitions framework, which sets out our vision to improve end-of-life care through partnership and collaborative action between organisations at a local level throughout England. Additionally, NHS England has developed an assurance system with specific steps and deadlines to ensure the timely dissemination of the £26 million revenue funding to children and young people’s hospices, because we know that there were some quite significant problems last year with the transmission from NHS England through the ICBs to hospices. These steps include regular oversight sessions with ICBs, regions and hospices and giving ICBs a hard deadline within the first quarter of the financial year by which they are expected to disseminate the funding to hospices, including escalating to NHS England if any ICB is unable to meet the deadline. If the deadline is missed, NHS England has put steps in place to ensure that all hospices receive the funding within the timescales outlined.

We, alongside key partners and NHS England, will continue to engage proactively with our stakeholders, including the voluntary sector and independent hospices on an ongoing basis to understand the issues they face. In fact, I recently visited Katharine House hospice in Stafford and heard from staff how important our record investment has been to them. More widely, in February I met key palliative and end of life care and hospice stakeholders in a roundtable format to discuss long-term sector sustainability in the context of our 10-year health plan.

I recognise the concerns that hon. Members have raised about funding and employer national insurance contributions. In July last year we inherited public finances in their worst state since the second world war, and we took the necessary decisions to fix the foundations in the public finances at the autumn Budget, enabling the spending review settlement of a £22.6 billion increase or uplift in resource spending for the Department of Health and Social Care from 2023-24 out-turn to 2025-26.

I gently point out to the Conservative party that while I believe it has welcomed that unprecedented settlement, to my knowledge it has been silent on its preferred means of generating that revenue. I gently say that Opposition Members cannot have it both ways. They cannot welcome the £22.6 billion on the one hand but, on the other hand, condemn the way in which the money is to be raised without coming up with their own plan and proposals for how they would raise those funds.

[Rachael Maskell]

We have to recognise that the hospice sector is in quite a difficult place financially. However, if there is good advance care planning, money currently spent in secondary care could be invested in the hospice sector and in more community provision. Surely that must be a first step that would not only get better clinical outcomes but be better for the whole of the palliative care pathway.

[Stephen Kinnock]

My hon. Friend speaks with tremendous and deep knowledge of the sector. I welcome the work that she is doing on the commission on palliative and end-of-life care, and we very much look forward to seeing the outcomes and results of that.

My hon. Friend is right that if we are to make the three big shifts at the heart of our 10-year plan—the shifts from hospital to community, from sickness to prevention, and from analogue to digital—the delivery of that will require a left shift in terms of both funding and reform. It is absolutely right that we take a hard-headed look at funding across our NHS and ensure that funding is going to where it is needed. She will know that the share that hospitals get of overall NHS funding has gone up dramatically since the early 2000s, to the detriment of primary care, community care and palliative care—all the things that happen outside hospital. That is something that we must address and shift upstream, because we will never solve the considerable challenges that our NHS is facing until we make that left shift.

I note that the funding announcement was warmly welcomed by the sector. Toby Porter, chief executive of Hospice UK, said:

“Today’s announcement will be hugely welcomed by hospices, and those who rely on their services. Hospices not only provide vital care for patients and families, but also relieve pressure on the NHS. This funding will allow hospices to continue to reach hundreds of thousands of people every year with high-quality, compassionate care. We look forward to working with the government to make sure everyone approaching the end of life gets the care and support they need, when and where they need it.”

I hope that the measures I have outlined in my response to the hon. Lady will go some way to reassuring all Members of this Government’s unwavering commitment to the sustainability of the hospice and wider palliative and end-of-life care sector.

--- Later in debate ---

[Stephen Kinnock]

The exemption was given to 100% full-time workers within the NHS; in essence, hospitals. As regards GPs, dentists and care providers, ENICs are being levied on those other parts of the health and care sector. Every aspect of my portfolio is therefore seeing ENICs being levied.

[Rachael Maskell]

A suggestion to the Minister would be to integrate the staff working in hospices into the NHS payroll. It would be that simple to exempt them from those national insurance increases.

World Stroke Day

Debate between Stephen Kinnock and Rachael Maskell

Tuesday 29th October 2024 Commons Chamber

[Stephen Kinnock]

I am a little wary of generalising too much, because I know that so many decisions have to be made in real time by our skilled ambulance drivers and paramedics and the many others involved, but my hon. Friend makes a valid point. In a general sense, he is absolutely right that stroke needs to take priority. The red thread going through this entire debate is the need for speed. It is all about prioritising and acting quickly; he is absolutely right about that.

In the past year, we have seen a 30% increase in the number of thrombectomies delivered in England. Alongside that, our 20 integrated stroke delivery networks are looking to optimise care pathways. The General Medical Council is addressing critical workforce gaps through its thrombectomy credentialling programme, and our national optimal stroke imaging pathway is improving information sharing.

I am aware of the reconfiguration in the constituency of the hon. Member for Glastonbury and Somerton. NHS Somerset integrated care board has decided to close the hyper-acute stroke unit at Yeovil hospital and to establish a single hyper-acute stroke unit at Musgrove Park hospital in Taunton to provide 24/7 emergency treatment. All service changes should be based on clear evidence that they will deliver better outcomes for patients. A high bar is set out in guidance for intervening in contested reconfiguration cases, and the reconfiguration of services should be a matter for the local NHS. I would expect all avenues of local resolution to have been exhausted before a call-in request is made. The Department has received a formal request to call in NHS Somerset ICB’s decision, and Ministers will make a decision on whether to use their call-in powers in due course.

Unfortunately, there is still significant variation across the country in access and outcomes in relation to stroke. For example, the percentage of suspected stroke patients who received the necessary brain scan within an hour of arrival at hospital varies from 80% in Kent to only around 40% in Shropshire. That variation needs to change, and we need to bring the best of the NHS to the rest of the NHS. That will be one of the central challenges for the Government going forward.

The Government have a profound ambition to improve the lives and health outcomes of people who survive a stroke. At this point, I would like to pay tribute to my hon. Friend the Member for Stratford and Bow (Uma Kumaran) and to the man in the Public Gallery for what they have been through and for their fortitude. It was certainly not easy for my hon. Friend to come to this place and to have to go through the extremely difficult situation that she did. I also pay tribute to all the key partners and stakeholders who worked with her and her family to get through it. That really is a tribute to the immensely important work they do.

[Rachael Maskell]

As well as looking at acute triage to rapidly diagnose people who have had a stroke, it is important to invest in rehabilitation—something I did for 20 years in the NHS. I would be grateful if the Minister could set out how he proposes to have integrated rehabilitation teams that not only see people through the immediate aftercare, but continue to provide a top-up for them so that they do not backslide in their rehabilitation.

[Stephen Kinnock]

I can say a word about our national service model for an integrated community stroke service, which involves a number of specific projects aimed at improving delivery of psychological rehabilitation. The ICSS model is vital to support psychological recovery, return to work and improved quality of life, and I would be more than happy to discuss it further with my hon. Friend.

Before I close, I want to recognise the remarkable work of the charities that help people across the country to rebuild their lives after a stroke. Once again, I thank the hon. Member for Glastonbury and Somerton for this important debate, and I encourage every Member of the House to go to change.nhs.uk and to get involved in the biggest conversation about our health and care service since its foundation in 1948.

Question put and agreed to.

Oral Answers to Questions

Debate between Stephen Kinnock and Rachael Maskell

Tuesday 23rd July 2024 Commons Chamber

[Stephen Kinnock]

The hon. Gentleman was doing so well at the start, and then he kind of blew it a bit towards the end. It is absolutely right that we put country before party, and we will work with whoever has the best interests of rebuilding our public services at heart. The issue that he raises specifically sounds interesting. What I would say is that unless we get the bigger picture sorted, and unless we make NHS work pay for dentists, we will not be able to rebuild the NHS dentistry system that we should be cherishing and seeking to reform. I am of course always open to conversations with him.

[Rachael Maskell (York Central) (Lab/Co-op)]

Just 39.2% of my constituents were able to access an NHS dentist over the past two years. That is an absolute disgrace, but the Health and Social Care Committee put together a report into NHS dentistry, setting out a blueprint for how to resolve the challenges, including access, looking at tie-ins and ensuring that we get more dentists registered. Will the Minister look at that report and follow its recommendations?

[Stephen Kinnock]

I congratulate my hon. Friend on her re-election; it is wonderful to see her back in her place. She is absolutely right that the tie-in consultation deadline was 18 July. We are considering those responses with an open mind. On the broader issues that she mentions, our rescue plan is 700,000 more appointments, incentives for new graduates to go to under-served areas, reform of the dental contract and making work pay for dentists. That plan is at the heart of the reforms that she mentioned and that is what we will be doing.

Illegal Migration Bill

Debate between Stephen Kinnock and Rachael Maskell

Consideration of Lords message
Monday 17th July 2023 Commons Chamber

[Stephen Kinnock]

The Minister is talking absolute nonsense. I am proud of the fact we have many Syrians in our constituency. We have Ukrainians in our welcome centre. Discussions are ongoing between the Home Office and the Welsh Government. The incompetence of his Government means that they are not managing to house them. Wales is ready to have that dialogue with the Home Office.

[Rachael Maskell]

I find it a shocking admission from the Minister—we are fighting for the relatives of people in Afghanistan whose lives are at risk—that these Afghans are being blocked by him because he is not making available those safe routes to bring them to constituencies such as York, where we welcome refugees.

[Stephen Kinnock]

I completely agree with my hon. Friend. There are real concerns about the safety and security of those Afghans now in Pakistan. It is possible that they will be sent back. It is up to the Home Office to facilitate their transfer to the United Kingdom under ARAP and the Afghan citizens resettlement scheme, but like so many things with this Home Office, it is just a catastrophic failure of management.

In trotting out the lines about the schemes that I mentioned, the Minister conveniently ignores the fact that none of those schemes help those coming from other high grant-rate countries in the middle east and sub-Saharan Africa. Neither he nor the Home Secretary have been able to answer questions from their own Back Benchers on that precise point.

The final point of our plan is to tackle migration flows close to the conflict zones where they arise through targeting our aid spending. That is a longer-term mission, but it is no less important than any of the other steps we need to take to meet these migration challenges. I therefore see no reason for the Government not to support Lords amendment 107B in the name of the Archbishop of Canterbury, which would instruct the Government to develop a 10-year plan to manage migration.

I have lost count of the number of times we have come to the Chamber to debate the Government’s latest madcap Bill or hare-brained scheme. Not one of those Bills has helped to stop a single boat, and the Government have sent more Home Secretaries to Rwanda than they have asylum seekers. They are wasting their own time and the time of the House, and they really are trying the patience of the British people. It really is desperate stuff, and it has to stop.

In stark contrast to the hopeless, aimless and utterly self-defeating thrashing around that has come to define the Government’s approach to the asylum crisis, Labour recognises that there is a way through: a route based on hard graft, common sense and quiet diplomacy. It comes in the form of the Labour party’s comprehensive plan, based on core principles, with a commitment to returning asylum processing to the well managed, efficient, smooth-running system we had prior to the catastrophic changes brought in by Conservative Ministers in 2013, which downgraded decision makers and caseworkers, leading to poorer results. With that, we have a commitment to go further in fast-tracking applications from low grant-rate countries so that we can return those with no right to be here, and fast-tracking applications from high grant-rate countries so that genuine refugees can get on with their lives and start contributing to our economy, enriching our society and culture. A third, key principle is the need for international co-operation, as I have set out.

This is not rocket science; it is just sensible, pragmatic, serious governance. It is working in the United States, where the Biden Administration are winning the battle. They have introduced a combination of swift consequences for those who cross the border illegally; orderly paths and controls on which migrants can apply for asylum and where they do so; sensible, legal pathways for high grant-rate nations; and strong co-operation with Mexico. The result is that they are bringing numbers down significantly and quickly. The challenge is not over yet, and we would not see President Biden being foolish enough to go boasting at the border, but that shows that progress can be made.

The Labour party is not interested in performative cruelty, chasing headlines or government by gimmick. We have a plan that will stop the boats, fix our broken asylum system and deliver for the British people. In contrast, the Conservative party has run out of ideas and run out of road. It should get out of the way so that we can get to work.

Illegal Migration Bill

Debate between Stephen Kinnock and Rachael Maskell

Committee stage
Monday 27th March 2023 Commons Chamber

[Stephen Kinnock]

My hon. Friend makes an absolutely valid point about the lack of an impact assessment for children, but there is a broader point about the lack of impact assessment full stop. It is completely and utterly unacceptable that we in this House should now be debating a Bill with no impact assessment having been published in advance. That shows a sort of disrespect to the House that really needs to be put on the record.

I am having to limit my time to discussion of the Opposition Front Benchers’ amendments, so I will not be able to raise my many questions and concerns about some of the provisions on legal proceedings in clauses 37 to 49. Some clearly appear to pose a real threat to due process and to our respect as a country that upholds the rule of law. The entire Bill is shot through with inconsistencies, unresolved questions and bizarre contortions of logic that can only have the effect of worsening the very problems the Government say they are trying to solve.

Just one example of that is highlighted by amendment 41, which I tabled as a means of probing the Government’s thinking on a measure that simply does not appear to have been properly thought through. Clause 45 states that where an appeal against a removal notice is upheld, the duty to remove that person no longer applies—so far, so sensible. The problem is that nothing in the Bill says that any asylum claim made by a person in such a situation would then be considered: those claims would continue to be inadmissible. That means we will end up with situations where there are people who cannot be removed, because a court has ruled that doing so would pose unacceptable risks to their safety, but who also cannot lawfully remain in the UK because of the Government’s refusal to accept their claim for asylum. The law would effectively be saying that a person can neither leave nor remain in this country. If the Minister has an answer to the question of what then happens to a person in that situation, I would love to hear it.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to my hon. Friend for the points he is making. I want to return to the point about detaining children, however, because we know that under this Government, hundreds of children have gone missing, and for some of them—hundreds, in fact—we still do not know where they are. Is it not right for children who come to this country to be placed immediately under the care of local authorities, which can then put proper safeguarding in place to protect those most vulnerable people?

[Stephen Kinnock]

My hon. Friend is absolutely right. She points to a broader failing, and to a clear indication of the shambles and chaos that we have within the broader asylum system. The backlog in the system is out of control, there are massive safeguarding issues, and really it is just more grist to the mill for the people smugglers and the traffickers. That is why this issue has to be addressed.

To sum up, this is a dog’s breakfast of a Bill, and this debate feels like something of a charade, because everyone knows that not only is the Bill unworkable, but it is not even intended to work. Nevertheless, we hope that colleagues across the House will support our amendments and new clauses in the Division Lobby this evening, because let us be clear, Madam Deputy Speaker: Ministers know full well that this Bill is an entirely counterproductive piece of legislation, but they do not really care. In fact, they will be more than happy to see it failing, because then they can blame our civil servants, the EU, the lawyers, the judges, the Labour party, the football pundits, or whoever they can think of.

Why are the Government doing this? Well, the answer is staring us in the face: they know that come the general election, they cannot stand on their record of 13 years of failure, so instead they will whip up division, stoke anxiety and fire up the culture wars. Our constituents know where the buck stops, though. They want solutions, not soundbites; they want the Labour party’s common sense, hard graft and quiet diplomacy, not government by gimmick; and when this Bill fails, they will know that only a Labour Government’s five-point plan for asylum will stop the dangerous crossings, fix our broken asylum system, and get our country back on track after 13 years of Tory failure.