Children’s Hospices: Funding

Wendy Morton Excerpts

Wednesday 30th October 2024 Westminster Hall

[Wendy Morton (Aldridge-Brownhills) (Con)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I pay tribute to the hon. Member for Liverpool West Derby (Ian Byrne) for introducing the debate. We all agree that children’s hospices do absolutely amazing work, including Acorns in Walsall, which is a lifeline to families in my constituency. Much of its work goes unnoticed by many, but not by those who rely on their services—the children, the families and the siblings. With that in mind, I pay tribute to Councillor Kerry Murphy who, at a recent meeting at Walsall council, gave an incredibly moving and emotional speech, touching on her own personal experience as a carer, a mum and a wife who relied on the services of Acorns hospice. Whether it is accessing short breaks for respite, help for accessing the right services or support for the loss of a child, children’s hospices are a crucial source of support for seriously ill children and their families.

It costs around £11 million every year for Acorns to run its care services, and only a small percentage of that is funded by Government. That money currently comes through NHS England. Children’s hospices, as we have heard this morning, are left increasingly reliant on their charitable income and reserves to provide that vital care and support. Thanks to the commitment, determination and ingenuity of the Acorns team, it has increased its fundraising efforts, with a whole programme of activities, including its shop in Aldridge, but it is not sustainable to expect such reliance to continue.

If the Government fail to maintain the existing £25 million NHS England funding for the children’s hospice sector, families and children will suffer. They will miss out on the extraordinary care and support that they need and rely on. Their child will miss out; their siblings will miss out. I really fear that if this funding issue is not addressed properly, as we have heard this morning, our hospices will face some of the toughest decisions, which none of us would like them to have to face. That cannot be right. We have a responsibility to the sector, which needs clarity and commitment from the Minister, and I hope we will get that today. It needs the certainty of sustainable funding, starting with a return to NHS England distributing the grants centrally in ’25-26. With care costs growing rapidly, the £25 million must be maintained and increased.

I will make a further point on the role of the ICBs. We know that ICB funding for children’s hospices is patchy and variable and nowhere near the level that is really needed. Greater accountability and transparency are required, so I urge the Minister to listen to the hospice sector and recognise that its strong preference is for the funding to go through NHS England. I am conscious of time, but I urge the Minister to listen to us and to maintain, ringfence and centrally distribute the budget beyond ’24-25, with increases at least at the rate of inflation.

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank my hon. Friend the Member for Liverpool West Derby (Ian Byrne) for securing this vital debate. I know that this sector—this community—is very close to his heart. I thank him for all his work to support it and raise awareness of the issue generally, and in particular for the heroic work he has been doing for Zoe’s Place. I know Zoe’s Place faces an uncertain future, but I also know that my hon. Friend is spearheading its fundraising campaign and has been part of the discussions with its trustees and builders about securing a new site for the hospice to ensure it has a long-term future. I am very much aware of the work that the Liverpool-based Home Bargains is doing, particularly in pledging an incredible £2.5 million towards the campaign. I wish my hon. Friend and the hospice every success in those vital endeavours, and I pay tribute to Home Bargains for its outstanding community spirit.

I thank the many hon. Members who have attended this important debate and contributed so powerfully to it. We have heard some really excellent contributions. Hon. Members have shown how important this issue is to the House. I thank all the people who work in children’s palliative and end of life care, including in hospices throughout the country, which provide vital care and support to those who need it.

We all recognise the importance of palliative and end of life care services, including hospices, which provide personalised care and support at the most difficult times for children and young people with complex needs, and their families and carers. It is estimated that there are more than 86,000 children and young people with life-limiting conditions in the UK, but it is predicted that, as we continue to make medical advances, that number will increase.

Palliative and end of life care for children with life-limiting conditions is provided by a broad range of organisations and professionals across multiple settings, including primary care, community care, hospitals, hospices, educational settings and children’s own homes. This system-wide approach to providing palliative and end of life care should be sufficient to ensure that the local offer to patients is personalised, of high quality and sustainable. The majority of palliative and end of life care is provided by NHS staff and services, but we recognise the essential part that voluntary sector organisations, including hospices, play in providing support to people at the end of life and their loved ones.

Children’s hospices are a vital part of that system-wide approach, because they provide a wide range of health and care support to meet the physical, emotional, social and, indeed, spiritual needs of children, young people and their loved ones. Care is often provided by a multi-disciplinary team, and often in collaboration with statutory services, to ensure that the entire family is supported.

The support provided by hospices can include practical advice and information; short breaks or respite; specialist therapies such as physiotherapy, art therapy or play therapy; 24/7 end of life care; and bereavement support. Short breaks are a key part of a range of provisions that support disabled children and their families. They can include the provision of day, overnight and weekend activities for children and young people, and can take place in the child or young person’s own home, the home of an approved carer, or a residential or community setting.

Local authorities have a statutory duty to assess the social care needs of disabled children and young people, and to provide respite care where necessary. Where it is appropriate, local authorities can fund respite care provided by hospices, either as a short-term stay or as a service that the hospice team provide to the child or young person in the family home. Local authorities and ICBs regularly liaise to plan and commission the most appropriate package of respite care for children and young people with life-limiting or life-threatening conditions in their area.

The Government do not monitor the use of social care for children with palliative and end of life care needs, but local authorities are required to publish a local short breaks duty statement, which shows what services are available, how they respond to the needs of local carers and how they can be accessed, including any eligibility criteria. Local authorities must consider the needs of local parents and carers when preparing their statements, and they must review them regularly.

Palliative care services are included in the list of services that an integrated care board must commission. That promotes a more consistent national approach and supports commissioners to prioritise palliative and end of life care locally. To support ICBs in that duty, NHS England has published statutory guidance and service specifications, which include specific reference to ensuring that there is sufficient provision of specialist palliative care services and hospice beds, as well as future financial sustainability.

Most hospices are independent charitable organisations that receive some statutory funding from the NHS.

[Wendy Morton]

If funding for children’s hospices is to go through ICBs—I hope the Minister will take account of the sector’s view—what assurance can he give us that it will actually go to the children’s hospices? I fear that if we are not careful, we will pit one healthcare sector or charitable sector against another, and that would not be in anybody’s interest.

[Stephen Kinnock]

The right hon. Lady is absolutely right: funding that is earmarked for palliative care must go to palliative care. There is statutory guidance from the NHS, and it is vital that we continue to liaise with ICBs from the centre, to ensure that the allocated funding goes where it needs to go. If she is aware of cases in which that funding is not going where it should go, she should make representations; I am happy to receive a letter from her on the issue.

The amount of funding that each charitable hospice receives varies both within and between ICB areas. That funding will vary depending on demand in an ICB area, but will also depend on the totality and type of palliative and end of life care provision from both NHS and non-NHS services, including charitable hospices, in each ICB area. There are inequalities in access to hospice services, especially for those living in rural or socio- economically deprived areas. That is why including hospices as part of a system-wide approach is so important.

I understand that charitable hospices value their independence and autonomy, which allow them the freedom to provide services beyond the statutory offer, which is one of the wonderful parts of hospice care. That independence also gives a sense of shared purpose, in which the community cares for the hospice, and in turn the hospice cares for the community and is something to be cherished. That is indicative of the compassion that is found in hospices and communities all over the country.

In addition to ICB funding, at a national level, NHS England has supported palliative and end of life care for children and young people through the children and young people’s hospice grant, totalling £25 million in ’23-24. While ’23-24 marked the final year of the grant in its previous format, in ’24-25 NHS England continued to provide £25 million of funding for children and young people’s hospices. A prevalence-based model is used for that funding, which supports the move away from a traditional model of bed-based funding, better reflecting population needs. In ’24-25, that funding was transacted by ICBs on behalf of NHS England for the first time, rather than being centrally administered. I am aware that the shift to an ICB-transacted model for ’24-25 has not been as smooth a transition as we in the Department certainly would have hoped. We are working closely with NHS England to resolve any remaining issues with the ’24-25 funding, and to learn from what did not work so well this year.

We, alongside NHS England, absolutely recognise the importance of sustainable funding for the palliative and end of life care sector, including hospices, and we will consider the future of children’s hospice funding in the context of Budget discussions. I have absolutely heard the representations by hon. Members on both sides of the Chamber today about the need for the Government to maintain the £25-million grant, and I assure hon. Members that I am working very closely with NHS England to get that confirmed as a matter of urgency.

Hospice Services: Support

Wendy Morton Excerpts

Wednesday 14th June 2023 Westminster Hall

[Paul Holmes]

I suspect that I will be in constant agreement with interventions this morning. My hon. Friend and constituency neighbour makes an astute point, as usual, and she is right to pay tribute to the hospice in her constituency.

Communities such as mine in Eastleigh will suffer as hospices such as Mountbatten have no choice but to reduce their services and the extraordinary high-quality care they offer, and this comes at a time when demand is only growing. As if that were not enough, staffing costs are but one consideration that care providers are having to take into account. As we all know, the soaring price of energy has hit businesses, families and individuals all over the country, and none more so than those in the charity care sector.

[Wendy Morton (Aldridge-Brownhills) (Con)]

Acorns Children’s Hospice in the Walsall borough supports families and children in my constituency. Does my hon. Friend agree that, in these challenging times when energy prices are on the rise, we want any additional help to include the hospice sector?

[Paul Holmes]

I thank my right hon. Friend for her intervention. She tempts me to talk about issues that I will come to later in my speech—it is only a couple of pages away, I assure you, Ms Nokes. She is right that hospices have not been included in the energy support given to other charities, even though their services are energy intensive due to the equipment they use. Her point is well made and will be recognised in her constituency.

The energy bill for Mountbatten has risen by an eye-watering £250,000—a fivefold increase—and there has been no additional financial support. One might think that that is surely as high as prices can go, but a London-based hospice has forecast that its energy costs will increase by almost £300,000 a year due to inflation pressures. A north London hospice told Civil Society Media that it faces an energy bill of £433,000 in 2023-24, based on predicted energy costs.

Adult hospices are not the only ones affected by this issue. As my hon. Friend the Member for Winchester (Steve Brine) said in his letters to the Department of Health and Social Care, there is also uncertainty about the children’s hospice grant—a vital source of funding that represented an average of 15% of children’s hospices’ income in 2021-22.

Oral Answers to Questions

Wendy Morton Excerpts

Tuesday 6th December 2022 Commons Chamber

[Helen Whately]

The hon. Lady makes an important point about people who are receiving social care also having access to the healthcare they need and these systems working together across our health and social care systems. We are training more doctors overall, and we have an increase in medical school places, which is leading to more doctors coming through. I am happy to take away and look at her question about the number of geriatricians.

[Wendy Morton (Aldridge-Brownhills) (Con)]

On delivering social care reform, does the Minister agree that we also need to be looking at how the funding packages work, particularly across borders? I have a constituent whose case falls between two local authorities. Will she agree to meet me as a matter of urgency to make sure that this poor constituent receives the funding she needs for her husband’s care?

[Helen Whately]

As announced in the autumn statement, we have a record funding settlement of £7.5 billion going into the social care system over the next two years, to improve both access and quality of care. I am happy to meet my right hon. Friend to look into the specific challenge that she has outlined, because it is important that local areas are working together across boundaries.

Mental Health Units (Use of Force) Bill

Wendy Morton Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Oliver Dowden]

The hon. Lady makes an important point. The closer to the community the treatment can be given, the better the treatment will be. I see this with my own constituents. If they are having to travel long distances, particularly with younger children, to access mental health care facilities, that can only add to the disruption in their lives. However, I believe that a journey is taking place in all of this, and I am glad that the Government are addressing the need for that journey.

The experience of many of us is that mental health is now delivered at the primary care level. From speaking to GPs in my constituency, I know that they are now on the frontline of the process. What is the answer? The first thing is to ensure that we have parity of treatment between mental and physical health. A broken limb is a serious injury and the patient is patched up and treated properly—no one doubts that they have had an injury. However, it has been the case for too long that if people have a mental health condition, it is not immediately treated with the same seriousness, and there is a sense that the person concerned has to prove that they have a problem in the first place.

[Wendy Morton (Aldridge-Brownhills) (Con)]

My hon. Friend is making an important point. In addition to parity of esteem, we need greater understanding of what it really means to live with a mental health illness, and Bills such as this are important for raising awareness of what can be a sensitive issue.

[Oliver Dowden]

My hon. Friend is absolutely right. This is about not just understanding the experience of the person who is suffering from mental health, but the knock-on effect on the entire family. One thing that my constituents frequently raise is the impact on other siblings when one child in the family has mental health issues and ensuring that the others do not feel neglected or disadvantaged when one sibling necessarily gets more attention.

Not only do we need to change cultural attitudes towards mental health, we need to look at the legislative framework. Most of us would agree that 1983 was the last time we had a serious, large-scale piece of legislation and, in 1983, the old model that I was discussing earlier was the prevalent model. There is a pressing need for a larger piece of legislation that can build upon on the measures in this Bill and ensure that we take a more comprehensive look at things.

Children’s Oral Health

Wendy Morton Excerpts

Tuesday 31st October 2017 Westminster Hall

[Wendy Morton (Aldridge-Brownhills) (Con)]

Teeth Team has visited one of the schools in Brownhills in my constituency. Does the hon. Gentleman agree that we need to further consider such innovative new schemes and other ways to educate children on dental health and tooth-brushing?

[Steve McCabe]

I absolutely agree with the hon. Lady. An education programme for young children and their parents is crucial. I want the Government to play a bigger role, but there are other approaches, too. As I have said, Simplyhealth is supporting the venture in the city of Hull and in East Riding of Yorkshire, as well as in the hon. Lady’s constituency.

A pilot programme called Starting Well is about to commence in 13 areas of England, although none of those pilots will be in Birmingham or the west midlands. I would be grateful for details of the pilot. How long will it run? How will it be evaluated? How were the 13 areas selected? It would also be useful to know exactly how the programme is being funded.

A new initiative by the British Society of Paediatric Dentistry, “Dental Check by One”, is seeking to raise awareness of the importance of getting young children to attend the dentist from an early age. It is supported by organisations across the dental professions. I am pleased to report that it is due to launch in Birmingham tomorrow, despite some torturous negotiations about funding. It seems likely that funding issues will prevent it from being implemented by other regional NHS teams.

What else might be done? Has any consideration been given to proposals from the Faculty of Dental Surgery to use school breakfast clubs to deliver supervised tooth brushing sessions? Analysis by Public Health England has suggested that if public health professionals such as health visitors are involved in supporting oral health improvement programmes, that can lead to significant improvements and long-term savings. Health professionals who have regular contact with children, such as midwives, health visitors, school nurses, pharmacists and early years practitioners, are all ideally placed to help identify children who may be at risk of tooth decay.

Equally, dentists look at all the soft tissues in the mouth and are often able to help identify a number of conditions, from diabetes and Crohn’s disease to oral cancer. According to recent figures on dental attendance, 42% of children aged 0 to 17 did not visit an NHS dentist in the 12 months to 31 March 2017.

Social Care

Wendy Morton Excerpts

Wednesday 25th October 2017 Commons Chamber

[Wendy Morton (Aldridge-Brownhills) (Con)]

As the Minister clearly set out at the start of her speech, it is right and proper that we recognise all those who work in the social care sector. In fact, my own mum was a home carer for many years. She would go out early every morning and late of an evening to look after the people she was supporting. It is right that we support and recognise not only those who work in the sector, but those unpaid carers who quietly get on with looking after those they love and care for at home. That work often goes unrecognised.

There are several care homes in my constituency, including Pelsall Hall and the Hawthorns, which are part of the whole range of homes that provide social care and independent living for those who really need it. There are also many charities and organisations that provide invaluable support—in particular, the Alzheimer’s Society, which was recently kind enough to run a dementia friends session in my constituency.

Aldridge-Brownhills has an ageing demographic, with 27% of the population aged between 45 and 64 and 21.6% aged over 65, so it is part of the challenge that we face as a country. Not just in my constituency but right across the country, the ageing population presents us with probably one of the greatest challenges we face, and it is one that we cannot leave alone.

We have heard how successive Governments have kicked this can down the road, and I have heard a lot of charges against this Government from Labour Members. They may well protest, but they, too, kicked the can down the road. Labour promised a social care solution in its 1997 manifesto, yet despite a royal commission, two Green Papers and a pledge to address the issue in the 2007 comprehensive spending review, it left government without having delivered.

Today, we have had many good contributions. The one thing that has come across loud and clear is the need for us all to engage in this consultation and to work together, because it is a challenge that is facing the whole country. I really hope that we can find a system that not only works today, but is ready and fit for the future.

Oral Answers to Questions

Wendy Morton Excerpts

Tuesday 10th October 2017 Commons Chamber

[Steve Brine]

I am very happy to meet the group, and the hon. Lady should contact my office. The Home Office is the lead Department for cross-governmental drugs policy, and we obviously released the new cross-Government drugs strategy earlier this year. However, this cannot all be about drugs services and picking up the pieces after things have gone wrong; it can also be about prevention. We should, as somebody once said at this Dispatch Box, understand a little more and condemn a little less.

[Wendy Morton (Aldridge-Brownhills) (Con)]

This month is Stoptober, and someone who manages to stop smoking for 28 days is five times more likely to quit for good. Legislation is obviously part of this, but perhaps the Minister could update us on what more could be done.

[Steve Brine]

At the last health oral questions, I committed to publishing the new tobacco control plan. I did that on 18 July. We have had a lot of legislation, from this and the previous Government. It is Stoptober, and there has never been a better time to quit. We now need to take that legislation, work with the control plan the Government have published and work it through local authorities and smoking cessation services, because my hon. Friend is absolutely right that where buddying services are used, we have better outcomes.

Contaminated Blood

Wendy Morton Excerpts

Thursday 20th July 2017 Commons Chamber

[Jackie Doyle-Price]

It is in taking forward the consultation that we are delivering on the commitments made last week. We made it clear then that we wanted to get the inquiry going as soon as possible because, frankly, these people have waited long enough for answers. We have not ignored the concerns expressed by many about the role of the Department of Health in the inquiry. I repeat: no decision has yet been made and the Cabinet Office is closely involved in taking the matter forward.

As for the complaints about the short notice of the meeting organised by the Secretary of State this week, it is because we want to hear directly from the people affected as soon as possible that such a meeting was arranged before the House rises for recess. This is just the start. We want there to be good, effective dialogue because, as the hon. Member for Washington and Sunderland West (Mrs Hodgson) and the rest of the House will appreciate, it is important that we all inspire confidence in this process. Given the cross-party support we had when the inquiry was announced, it is disappointing that we are now getting bogged down in the process.

[Wendy Morton (Aldridge-Brownhills) (Con)]

Like others in the Chamber, I welcomed the Prime Minister’s announcement last week of a public inquiry. I am encouraged by what the Minister is telling us this morning. One of my constituents who was affected has raised the issue of which Department should take the lead in the inquiry. Will my hon. Friend the Minister confirm what role victims, families and campaigners will play? How can they best engage with her and the Department at this stage?

[Jackie Doyle-Price]

We obviously want to hear from as many of the affected people as possible, and we will reflect on their representations. If they want to be very clear and blunt about the role of the Department of Health, we need to hear those representations so that we can make the best decision about who takes forward the inquiry.

Contaminated Blood

Wendy Morton Excerpts

Tuesday 11th July 2017 Commons Chamber

[Wendy Morton (Aldridge-Brownhills) (Con)]

Like other hon. Members, Madam Deputy Speaker, I welcome you to the Chair. I also wish to put on record my thanks to the hon. Member for Kingston upon Hull North (Diana Johnson) for securing this debate. In the short time that I have been a Member of this place, I have been struck by her determination and perseverance with this campaign. Clearly, it is an issue that goes right across the Chamber. I also wish to thank and to recognise all those Members who are not in the Chamber today or who have perhaps moved on following the election for playing a part in this campaign. That includes David Cameron, who, at his last Prime Minister’s questions, said that he wanted more to be done on this very important issue.

This is a very important matter to many of us both inside and outside this House. As we have heard today, so many constituents have been affected by this issue and are still affected today. It was first brought to my attention about a year ago when a constituent came to my surgery, but the issue that she raised was slightly different. We have heard a lot of stories about victims and those who are suffering as a result of the contaminated blood tragedy, but this lady came to raise the issue of support for the spouses of those who have died from contaminated blood. She had a number of questions and concerns, particularly around the discretionary payment fund. In particular, she wanted to know exactly what her position was, saying that she felt as though she was in limbo when it came to her monthly payments.

This is a tragedy that means so much to so many people. Through no fault of their own, they have suddenly found themselves in hardship and really suffering as a result of what has happened. We know that this tragedy goes back to the 1970s and 1980s and that it is an issue that has spanned several Governments. It is a long-running issue, but for those families in my constituency and across the country, it is still a priority for them and rightly so. From what we have heard from the Minister today and from the Prime Minister in her statement, I sense that it is still a priority for the Government as well. We should continue to provide support for those affected by this tragedy.

I am very conscious of time, Madam Deputy Speaker, so I will draw my comments to a close by saying that I hope that this inquiry brings together all the parties, including the families and the victims, because, after all the time that has elapsed, there are still families who want answers, and a sense of conclusion and closure to this tragic issue.

Adult Social Care Funding

Wendy Morton Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

Of course Governments of all colours have delivered us to the place where we are at this very moment, but have this Government put more money into the social care system? Yes. Did we provide more money in the Budget this year? Yes. Are we allowing councils to raise more money? Yes. As I said earlier, we spend more on long-term care as a share of GDP than other industrialised countries, including Germany and Canada and the massive economy of the United States.

[Wendy Morton (Aldridge-Brownhills) (Con)]

As the Minister knows, about 2.8 million adults over the age of 65 are currently in receipt of formal or informal social care. Can he confirm that a recent Care Quality Commission report showed that, despite the pressures, the proportion of care services rated good or outstanding is actually increasing?

[Steve Brine]

Indeed I can. We introduced the new, tougher system of CQC inspections, for the reasons I set out. We introduced a care certificate for support workers and healthcare assistants, and we introduced the new quality standards to clarify what excellence actually looks like in care. We brought in new criminal offences of ill treatment and wilful neglect, and we introduced a fit and proper person test to hold directors to account for care. Those are all things that have happened under this Secretary of State that never happened before.