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Hospice Funding
22 April 2024
Lead MP
Sally-Ann Hart
Debate Type
General Debate
Tags
NHSSocial CareStandards & Ethics
Other Contributors: 53
At a Glance
Sally-Ann Hart raised concerns about hospice funding in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
Opened the debate
Calls on integrated care boards to urgently address the funding for hospice-provided palliative care. Emphasises the importance of end-of-life care as a legal right, highlights financial pressures faced by hospices due to inflationary costs and increasing demands, and calls for increased Government funding.
Barry Gardiner
Lab
Brent North
Highlights the importance of palliative care for children and the support provided by children's hospices not only to children but also to entire families.
Questions why end-of-life care is not funded similarly to maternity services, using Havens Hospice in Southend as an example of high dependence on donations for funding.
Munira Wilson
Lib Dem
Twickenham
Critiques the variability in ICB spending on palliative care and calls for multi-year contracts to provide financial stability for hospices.
Desmond Swayne
Con
New Forest West
Expresses concern about potential loss of independence if hospices are fully state-funded, suggesting central funding through grants could be better.
Clapham and Brixton Hill
Notes the significant increase in costs for Royal Trinity Hospice while NHS funding decreases in real terms, advocating for maintenance of current funding levels.
Tim Farron
Lib Dem
Westmorland and Lonsdale
Suggests that Government fund hospices directly at NHS pay rates to ensure staff retention and competition with NHS salaries.
Discusses the challenges faced by Mountbatten Isle of Wight Hospice due to underfunding from ICB, emphasising the need for better management and transparency in ICB operations.
Jim Shannon
DUP
Strangford
Stresses the importance of faith-based care provided by hospices like Marie Curie in Belfast, highlighting its role beyond just physical care.
Southgate and Wood Green
Hospices provide essential palliative and end-of-life care, supporting patients and their families. In Enfield, the North London Hospice has been providing care since 1984, offering comprehensive support including physical, emotional, spiritual, wellbeing, and bereavement services. The hon. Member introduced a private Member’s Bill in 2018 to improve palliative care provision for terminally ill patients and their carers. However, hospices face significant funding challenges due to inadequate central government funding, rising costs, and the impact of the cost-of-living crisis on charitable donations. Hospices are struggling to keep up with inflation and demand is increasing by 5% year-on-year. The NHS does not provide sufficient funds for hospice staff to be paid at par with their counterparts in the NHS, leading to a shortfall of £130 million this year alone. Without sustainable long-term funding models, hospices will cut essential services, threatening their existence.
Munira Wilson
Lib Dem
Twickenham
Questions whether the current children's hospice grant model from NHS England is sufficient for long-term planning and proposes a ringfenced funding approach pegged to inflation.
Gen Kitchen
Lab
Wellingborough and Rushden
Emphasises the difficulty of fundraising for pay increases with inflation, noting that ICBs are often not forthcoming in providing necessary funds despite year-long negotiations.
Suggests looking at parity of esteem between voluntary hospice sectors and NHS structures to ensure equitable investment and support.
Peter Gibson
Labour/Democrat
Broadgreen
It is a pleasure to follow the hon. Member for Enfield, Southgate; I congratulate him on completing the London marathon yesterday. The debate focuses on solutions to challenges faced by hospices rather than merely asking for more money from the Government. Hospice care delivers good deaths and ensures proper funding and commissioning for palliative care in appropriate environments such as hospices or homes. Integrated Care Boards (ICBs) now have responsibility for commissioning palliative care, but many hospices face immense challenges with rising costs of energy and staffing. The House must address the mixed patchwork picture across the country to ensure proper funding and support for hospices. Hospice-at-home models and virtual wards can be explored to deliver palliative care more effectively. Children’s hospices also need guaranteed funding and inflation uprating. Specific examples were given from various locations in England, Wales, Scotland, and Northern Ireland to illustrate challenges faced by individual hospices.
Colleen Fletcher
Lab
Coventry North East
Thanked the hon. Members for Hastings and Rye and Darlington, as well as the All-Party Parliamentary Group, for securing the debate on hospices' importance in Coventry. Described Myton Hospice's role in providing critical palliative and end-of-life care, easing pressure on NHS resources while supporting patients' needs. Shared personal experience of her husband receiving care at Myton Hospice, highlighting its tranquility and quality. Highlighted funding challenges faced by hospices due to the pandemic and cost of living crisis, with only 20% of Myton's funding coming from the NHS in real terms, decreasing year on year while costs increase. Emphasised that more people need hospice beds than ever before, and highlighted the urgent need for sustainable funding solutions.
Will Quince
Con
Colchester
Praised Colleen Fletcher's powerful speech and thanked Sally-Ann Hart and Peter Gibson for securing the debate. Described St Helena Hospice's vital role in his constituency since 1985, facing financial challenges due to rising costs and NHS funding cuts. Mentioned East Anglia’s Children’s Hospices (EACH) caring for life-threatened children and generating 85% of its income from non-statutory sources. Urged caution on national solutions for commissioning, advocating for consistent commissioning based on service specifications by Integrated Care Boards (ICBs). Emphasised the need to talk about death openly and support community care alongside hospices for better patient outcomes and value for money.
Birmingham Erdington
I thank the hon. Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing an excellent and important debate... Now more than ever, our hospices and our NHS need a Labour Government.
Sarah Owen
Lab
Luton North
I am listening to my hon. Friend’s impassioned speech, and the experience that she brings to this House is valuable... Does my hon. Friend agree that we need sustainable funding models for hospice care?
Marie Rimmer
Lab
St Helens South and Whiston
I thank my hon. Friend for her wonderful contribution to the debate... Do you find that is the case? That is not decrying hospitals, but hospital is not somewhere to die.
I gently remind the House that when people use the word “you”, they are referring to me, so please try to resist that.
It is a great pleasure to follow the hon. Member for Birmingham, Erdington (Mrs Hamilton), and I congratulate my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) on securing the debate... By fostering a collaborative approach with the hospice sector, we can ensure that hospices in Southport and across the United Kingdom are not just sustained but supported to continue to provide critical services to those who need them.
Andrew Slaughter
Lab
Hammersmith and Chiswick
Welcomed the debate on hospices, highlighting the issues faced by adult and children's palliative care services. He mentioned the Pembridge palliative care unit in North Kensington that closed due to staffing shortages but has a strong desire for reopening. Slaughter also discussed Shooting Star Children’s Hospices in north-west London, which supports over 700 families through community nursing and end-of-life care, with funding primarily coming from charity rather than statutory channels. He emphasised the need for properly funded paediatric palliative care across the UK to ensure stable services.
Paul Holmes
Con
Hamble Valley
Describes his personal experience with Mountbatten hospice, mentions demand rise of 40% in next 18 months and funding shortfall of £750,000 despite ICB giving only a 2.4% uplift compared to the required 8%. Criticises ICB's failure to pass on Government funds intended for frontline services.
Supports the call for fairer funding, citing an example of Sidmouth Hospice at Home in his constituency which receives no public funding from NHS Devon despite being a valuable service.
Rachael Maskell
Lab Co-op
York Central
The NHS is failing to provide equitable care, resulting in a postcode lottery where different areas experience varying levels of healthcare. The reorganisation devolved powers but has not ensured these structures function effectively. Hospices face funding issues, leading to deficits and inequalities in access to palliative care. One in four people die without the required support due to insufficient funding, with demand increasing faster than funds are provided. Funding must rise to match rising costs; currently, hospices like St Leonard’s in York do not know their ICB funding after April 2024. Hospice at home services need integration and full funding to ensure people can die where they choose.
Marie Rimmer
Lab
St Helens South and Whiston
Asked if there should be more equality between care at home and in hospices. Agrees that clinical support at home is often lacking, highlighting issues such as her brother's search for morphine at night.
Hayes and Harlington
Mr McDonnell, who is a trustee of Harlington hospice, discussed the challenges faced by his organisation due to the cost-of-living crisis and economic recession. He advocated for consistent funding over several years to enable hospices to build on their services and meet increasing complexity in care requirements. He also highlighted the need for state-funded staffing support to ease financial burdens and stressed the importance of long-term cross-party commitment to provide a solid financial base for hospices.
Maria Miller
Con
Basingstoke
I add my thanks to the Members who called for this debate, expressing support for hospices like St Michael’s in Basingstoke. Constituents have echoed their support for these vital institutions which provide independent and community-led care, often funded through local fundraising efforts. Hospices need consistent funding from the NHS, multi-year contracts, full cost payments, and a national plan to ensure equitable commissioning decisions by Integrated Care Boards (ICBs). The Health and Care Act 2022 requires ICBs to take on commissioning responsibilities for hospice care, but disparities in funding between hospices persist. My local hospice receives much less than others, which feels unfair with increasing costs and demand. Support is needed to address the disparity and ensure certainty in forward planning through multi-year contracts.
Richard Burgon
Lab
Leeds East
I congratulate Members on securing this debate highlighting the importance of hospices such as St Gemma’s in Leeds. Hospices touch countless lives, yet face major funding challenges—St Gemma’s funds less than 30% from NHS and is budgeting a £500,000 deficit this year. Despite tough circumstances, community support remains strong; in just 48 hours, St Gemma’s exceeded its fundraising target of £200,000 due to public generosity. Fundraising has become more difficult due to the cost-of-living crisis but is crucial for sustaining hospice operations. I reiterate the call for increased and sustainable NHS funding to ensure all hospices can continue their vital work.
Selaine Saxby
Con
North Devon
Ms Saxby highlighted the financial challenges faced by North Devon Hospice, which currently relies on charitable funds to support its hospice to home service. She reported that despite assurances from the Devon Integrated Care Board, there is no clear funding commitment for the service beyond this financial year. She also noted that the ICB is under special measures and called for urgent intervention from the government.
Peter Gibson
Lab
Darlington
Mr Gibson agreed with Ms Saxby, emphasising the unique challenges faced by rural constituencies in providing hospice at home services due to higher transport costs compared to urban areas. He argued that funding models need to address these additional costs.
Jim Shannon
DUP
Strangford
Thanked the hon. Member for Hastings and Rye for setting the scene, emphasised the importance of hospice care in Northern Ireland, highlighted the financial challenges faced by hospices including Northern Ireland Hospice which provides care for more than 4,000 individuals annually but relies on voluntary donations due to lack of government funding. Called for an increased role of the NHS in providing hospice care and urged the Minister to respond positively.
Hayes and Harlington
Intervened to highlight the contributions of shop volunteers who fundraise for hospices, underscoring their critical role in supporting hospice services.
Suggested that legacy giving contributes significantly to hospice funding but can create a postcode lottery due to variations in estate sizes and property values across different regions.
Chris Green
Con
Bolton West
Congratulated the hon. Members for Hastings and Rye and Darlington on securing the debate, emphasised the positive contributions of hospices to communities, discussed the challenges faced by hospices in fundraising during economic difficulties and lockdowns, highlighted the importance of national and local government, NHS, and ICB support for hospices, raised questions about bridging the divide between the NHS and ICB responsibilities.
Robert Buckland
Con
Swindon South
Emphasised the importance of hospices in providing dignified and proper end-of-life care, highlighting the balance between independence, flexibility, and government support. He mentioned specific challenges faced by Prospect Hospice due to inflation and fundraising difficulties, including halving the number of beds from 12 to six and closing the day therapy unit. Buckland praised the Government's recent steps in supporting hospices but called for further action to avoid duplication of services and ensure sustainable funding.
Jane Hunt
Con
Loughborough
Discussed the importance of hospice care, specifically focusing on Rainbows Hospice which provides care for children with life-limiting conditions. She highlighted the lack of 24-hour end-of-life care at home and the significant funding gap faced by Rainbows, currently receiving only 14% of its costs in statutory funding. Hunt urged the Government to review palliative care funding for children's hospices and fill the £295 million annual gap in NHS spending on children’s palliative care.
Bob Seely
Con
Isle of Wight
I thank my hon. Friends for organising this debate and highlight the importance of hospices, particularly Mountbatten hospice on the Isle of Wight, which faces financial pressures due to insufficient NHS funding increases. I emphasise the need for the NHS to pay its way in supporting hospices and raise concerns about Integrated Care Boards (ICBs) being in special measures and potentially cutting funding to hospices.
Chris Loder
Con
West Dorset
I speak on behalf of Weldmar Hospicecare, a well-respected charity providing end-of-life care in Dorchester since 1994. I emphasise the financial challenges faced by hospices and highlight the need for increased funding to sustain their services. I also call for greater priority to be given to palliative and end-of-life care within integrated care partnership strategies.
Richard Drax
Con
South Dorset
I congratulate my hon. Friends on securing this debate and thank those who work in hospices for their remarkable job. I share personal experiences with Julia’s House, highlighting its importance in providing practical and emotional support to families caring for children with life-limiting conditions. The organisation is one of 200 adult and children hospices that care for about 3,000 patients a year. Hospices are mainly funded through charity, with two thirds of the income for adult services raised through fundraising and four fifths for children's services. Despite legal requirements introduced by the Health and Care Act in 2022, funding from ICBs varies significantly across the country. Julia’s House faces significant financial pressure, with over 90% of its annual running costs met by fundraising. The Government’s contribution remains low at only 8%, leading to a budget deficit of £1 million this year. A charity like Lewis-Manning Hospice Care provides free services proactively rather than reactively, saving the NHS money and reducing crisis at end-of-life care.
Peter Aldous
Con
Waveney
I congratulate my hon. Friends on leading this debate and recognise the need for a hospice in the Waveney and Great Yarmouth areas, which desperately needs one due to an ageing population and health inequalities. A local partnership involving the NHS, councils, volunteers, and fundraisers is evolving to build a local hospice led by St Elizabeth Hospice. The Norfolk and Waveney ICB has responded with a review highlighting the need for urgent actions. After merging with East Coast Hospice, feasibility studies have concluded that building a hospice in stages is viable. Expressions of interest are being invited from architects. National Government support is required for ongoing revenue costs and to meet projected demand growth for palliative care.
Steve Double
Con
St Austell and Newquay
The Member acknowledges the importance of hospices through personal experience, highlighting two exceptional examples in his constituency. He emphasises the outstanding care provided by Mount Edgcumbe hospice and Little Harbour, both praised for their personalised support and state-of-the-art facilities. Steve Double calls for fairer NHS funding to address regional disparities, noting Cornwall's high elderly population growth as a pressing need. He argues for multi-year funding settlements to provide stability for planning and stresses the vital role of independent charity status for hospices.
James Sunderland
Con
Worcester
I am humbled to be called in the debate. I commend my hon. Friends for bringing the debate to the House, acknowledging those who have had personal experience of hospices and their speeches which came across with real pathos and depth. I talk about two important hospices for my constituency: Thames Hospice and Sebastian’s Action Trust. Thames Hospice is serving constituents in Berkshire since 1987, and needs a refined funding model from the NHS, with upfront notification of funding. The organisation supports about 2,500 patients annually with high-quality medical and emotional support, aiming for dignified care. With increasing numbers of people over 65 by 2030, there will be an increased demand for hospice services. Costs at Thames Hospice have risen by 9%, with no commensurate increase in Government funding; it has to raise £38,000 every day to subsidise the costs of care. Sebastian’s Action Trust provides palliative care for children aged between zero and 18 and supports their families, but is expected to close its Crowthorne site later this year due to lack of funds. We need more funding, better funding models, not relying on charities and donations; funding must be provided up front.
Jason McCartney
Con
Colne Valley
I highlight the issue of sustainable and surety of funding for children’s hospices in West Yorkshire, supporting the Together for Short Lives campaign ask. Children’s hospices need a multi-year promise and confirmation of funding beyond 2024-25 to plan for the future.
Andrew Rosindell
Con
Romford
Every penny that the Government give to the hospice movement takes pressure off the national health service, as they do the job otherwise done by the NHS. I congratulate the Saint Francis Hospice in my constituency for its long-standing service and its fantastic job for the entire country.
Peter Gibson
Lab
Darlington
Many people have called for multi-year funding settlements for hospices, which is not to make life easy for them but to enable better planning into the future. This will allow them to sign leases, buy equipment, and train, recruit and retain staff.
Patrick Grady
SNP
Glasgow North
Congratulates the hon. Members for Hastings and Rye and Darlington on securing the debate, noting the publication of Hospice UK’s report which estimates a £77 million deficit across the UK hospice sector in 2023-24, with an 11% increase in payroll costs. Emphasises that heating, food, drink and other consumables are not discretionary expenditure for hospices which must run 24 hours a day, seven days a week, highlighting the current challenges faced by hospices due to rising energy costs and increased demand for palliative care.
Sally-Ann Hart
Con
Hastings and Rye
No extracted contribution text available for this contributor yet.
Peter Gibson
Lab
Darlington
No extracted contribution text available for this contributor yet.
Andrew Gwynne
Ind
Gorton and Denton
Emphasises the importance of end of life care, highlighting personal experiences with family members who have passed away due to cancer. Discusses the impact of well-managed versus poorly managed end-of-life care on families. Mentions the critical role of hospices in providing dignified and integrated services, noting challenges such as financial pressures and legal requirements for Integrated Care Boards (ICBs) to commission palliative care according to local need. Raises concerns about potential service reductions due to economic climate and energy costs. Calls for a comprehensive approach to support the hospice sector.
Helen Whately
Con
Faversham and Mid Kent
The Minister thanked hon. Members for securing this debate, emphasising the importance of end-of-life care provided by both NHS and hospice services. She disagreed with centralising funding for hospices but supported localised approaches by ICBs to address inequalities in access to hospice care. She also acknowledged the significance of fundraising efforts for hospices and committed to improving transparency regarding palliative and end-of-life care.
Peter Gibson
Con
Darlington
Mr Gibson supported the Minister's comments on localised approaches by ICBs, suggesting that these boards could use hospice services to address inequalities in certain communities. He also asked for clarification regarding the distinction between NHS-provided care and hospice care when fully commissioned and funded by the NHS.
Caroline Ansell
Con
Eastbourne
Ms Ansell emphasised the community support for local hospices, noting that people in her constituency were willing to undertake challenging activities such as walking over coals to raise funds for St Wilfrid’s Hospice.
Sally-Ann Hart
Con
Hastings and Rye
The concluding remarks thanked the Backbench Business Committee, Members who spoke in the debate, and staff of hospices. She highlighted the need for closer consideration of funding models to ensure parity with NHS funding while preserving hospice independence and flexibility.
Government Response
The Minister thanked hon. Members for their contributions, emphasising the importance of end-of-life care provided by both NHS and hospices. She disagreed with centralising funding but supported localised approaches by ICBs to address inequalities in access to hospice care. She acknowledged the significance of fundraising efforts and committed to improving transparency regarding palliative and end-of-life care.
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