PARLIAMENTARY DEBATE
Hospice Funding - 19 December 2024 (Commons/Commons Chamber)

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on hospice funding.

I am grateful to the hon. Member for Sleaford and North Hykeham (Dr Johnson) for asking that important question. This Government want a society where every person receives high-quality, compassionate care from diagnosis through to the end of life. We will shift care out of hospitals into the community to ensure that patients and their families receive personalised care in the most appropriate settings. Palliative end of life care services, including hospices, will have a big role to play in that shift. 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 integrated care board areas.

On children and young people’s hospice funding, the Minister for Care met representatives from NHS England and Together for Short Lives and one of the chairs of the all-party parliamentary group for children who need palliative care to discuss children’s palliative and end of life care, and that funding stream was discussed at length at that meeting.

This Government recognise the range of cost pressures that the hospice sector has been facing over a number of years, so today I am delighted to announce the biggest investment in hospices and end of life care in a generation. We are supporting the hospice sector with a £100 million boost for adult and children’s hospices, to ensure that those hospices have the best physical environment for care, and with £26 million in revenue to support children and young people’s hospices. The funding will support hospices and deliver much needed funding for improvements, including refurbishment, overhaul of IT systems and improved security for patients and visitors. It will help hospices in this year and next year in providing the best end of life care for patients and their families in a supportive and dignified physical environment.

Hospices for children and young people will receive that further £26 million in funding for 2025-26 through what was, until recently, known as the children’s hospice grant. We will set out the details of the funding allocation and dissemination in the new year.

We completely understand the pressures that people are under. To govern is to choose, and the Chancellor chose to support health and social care in the Budget. The alternative is not to fund. The sector has suffered from 14 years of underfunding, and we are righting that historic wrong. This Government are committed to ensuring that every person has access to high-quality palliative and end of life care as part of our plan for change. We are taking immediate action to make our healthcare fit for the future. I am sure that the hon. Member for Sleaford and North Hykeham and everyone in the House will welcome this announcement. I thank her for giving me the opportunity to give the House an early Christmas present.

Order. I think you might find that I granted the urgent question, but don’t worry, Minister. I call the shadow Minister.

After the confusion of yesterday, I welcome the fact that further details on hospice funding have been announced, albeit by our dragging them out of the Government on the very last day of Parliament before the recess.

On 30 October, the Chancellor decided to break her election promise by increasing employers national insurance contributions and reducing the threshold at which employer contributions are payable. It was later confirmed that hospices would not be exempt from the increase in costs. Now the Government have announced new funding for the sector, which they have the audacity to call

“the biggest investment in a generation”.

Let us be clear about what is going on: the Government are taking millions of pounds off hospices and palliative care charities, and then think those hospices and palliative care charities should be grateful when the Government give them some of that back. That is socialism at its finest.

We will look more closely at the funding announced today, but despite many questions from right hon. and hon. Members, to date the Government have refused to give any clear answers on how much their tax rises will cost hospices. I will try again: will the Minister please tell us how much the Government estimate they will raise from taxing hospices more? Was an impact assessment ever produced on how hospices will be hit, and how that will affect the care that they provide? Do the Government expect the funding that they have announced today to cover the additional costs in their entirety?

At the heart of this discussion are charities that provide compassionate care to terminally ill people in their final days, weeks and months. While hospices were left without information, Hospice UK reported that 300 beds have already closed, with many more closures to come. Does the Minister accept any responsibility for that? Ultimately, it is patients who will pay the price.

While we welcome this update for hospices, when will the Health Secretary come forward with more details on the many other health providers who have been hit by Labour’s tax increases, including GPs, community pharmacies and dentists? Will they be expected to be similarly grateful for getting back some of the money that the Government have taken from them?

To govern is, indeed, to choose. The Conservative party chose neither this sector nor any other health sector and it refused to govern. Within five months, we have not only increased the funding to the health sector to stabilise it but made today’s announcement.

Beneath all that, there might have been a welcome for the announcement—I am not entirely sure—whereas the sector is pleased to have the money. The chief executive of Hospice UK said:

“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”.

The chief executive of Haven House children’s hospice said that it is

“very positive to hear about the government’s plan to invest significantly in the wider hospice sector; we hope that there will be as much flexibility as possible to determine locally how this new money is spent.”

This is an important issue for many hon. Members, and we look forward to working with the sector in the new year on the specifics of the announcement.

This is a very welcome announcement and I am sure the hospices are breathing a sigh of relief after the level of funding they endured for 14 years under the Tories. If we are to move palliative care out of hospitals and into care situations or people’s homes, the money needs to be passported to the hospice sector for it to play its part. Integrated care boards have been charged under the Health and Care Act 2022 to provide that funding. Will the money go through ICBs or will it be passported straight to the hospice sector?

My hon. Friend makes an important point about the need for more people to be treated at home. That is absolutely the direction of travel that we want to see. This money will help, for example, with technology to support more people to be treated at home. ICBs are responsible for commissioning and allocating funding, so that will be done in the normal way.

I call the Liberal Democrat spokesperson.

I wish you and the whole team a very merry Christmas, Mr Speaker.

Last week, I visited Hope House in my constituency, where I met beautiful young Esmay, one of hundreds of children cared for by the hospice every single year. She is nearly three and has a life-threatening heart condition. Esmay’s family do not know what the future holds for her, but they know that Hope House will be there to support them, as it has since before she was born.

There are 300,000 people like Esmay treated in hospices every year, and just one third of their funding comes from the NHS. That leaves institutions such as Hope House and nearby Severn hospice reliant on generosity and unable to plan as they wait for confirmation of the funding they will receive from the NHS. That situation has been made more difficult this year because of the increase to national insurance contributions, which Hope House estimates will cost £177,000.

Funding is welcome, and I welcome the Minister’s commitment today. Will she explain whether the increase that she has announced today will cover the NIC hike for hospices and the increase in the living wage that was announced at the Budget? Will she also commit to providing future settlements in a timely manner so that hospice managers can budget effectively for the coming year?

I thank the hon. Lady for her questions and for welcoming the announcement. She will know that, in the past 14 years, the sector has been neglected, like the rest of the NHS and social care system. As we have repeatedly said, to govern is to choose. We have improved the settlement for the sector this year. Today’s welcome announcement can be used by the sector to manage some of those pressures and deliver the sorts of services it wants for the future.

Does the Minister agree that the amazing staff at Overgate hospice in my constituency should be focused this Christmas on caring for their patients and not on funding? Will she confirm that this funding allows them to do so? Also, in April I will be running the London marathon for the Overgate hospice’s big build appeal. Will the Minister sponsor me?

That is possibly one of the cheekiest questions I have ever heard asked here, and I am obviously going to have to say yes. Frankly, rather him than me, but good luck to my hon. Friend on doing that. I know that many hon. Members raise money for their local constituencies and that the marathon is an important part of that.

We understand how different hospices are funded differently throughout the country. We want to make sure that end of life care, with all the different options that people have in their local systems, is well supported. It is really important for people to have some of that security, and I know that this announcement will be welcomed by my hon. Friend’s local hospice, as it is by the sector today.

Merry Christmas, Mr Speaker.

The St Helena Hospice in Colchester, which serves my constituency and that of the Labour hon. Member for Colchester (Pam Cox), estimates that the national insurance increase will cost it £300,000 in a full year. Can the Minister now give a guarantee that the hospice will be compensated by the Government in full?

It is good to hear the hon. Gentleman supporting his local hospice with his neighbour, my hon. Friend the Member for Colchester (Pam Cox). We will announce allocations for the whole sector and the NHS in the usual way in the new year.

St Giles Hospice in my constituency has funding challenges like any other. One thing that staff mentioned to me was the sustainability of when they are contracted to do things. Is the Department considering the timing and not just the funding, to enable better planning and better staff planning?

Yes, stability and understanding longer-term planning is important for this sector as well as for many others. Certainly, we want to make sure that we work with the sector and the wider NHS, so that we deliver our longer-term 10-year plan, but get to that process in the next few years.

Merry Christmas, Mr Speaker.

St Luke’s Hospice in my constituency covers the whole of Brent and Harrow. I helped to form it back in the 1980s. The staff tell me that the biggest problem they face is that, every time there is an increase in nurses or doctors’ pay, it is never passed on to them, so they have to find the money from charitable giving. The Minister’s announcement of extra money is of course welcome, but she has failed to answer the question: will it cover the national insurance increase, or not?

All hon. Members support their local hospices, which I know is important, but I have to remind the House of the parlous state of the sector that we inherited after 14 years of the previous Government. If Conservative Members, many of whom were part of that Government, had wanted to rectify the way in which hospice funding was allocated, or indeed that end of life care was managed, they had plenty of opportunity to do so. This Government have hit the ground running. We have fast-tracked these measures, and this announcement today is clearly a part of that. I hope that they all welcome it; it is just a shame that they did not do it themselves.

Merry Christmas, Mr Speaker.

May I welcome this record investment in our hospices from the Labour Government? The Conservative Government had 14 years to do that, but they shirked that responsibility. Will the Minister join me in thanking the amazing staff and volunteers at Saint Michael’s Hospice and Demelza hospice in my constituency who do such amazing work all year round to support families and children who need amazing care?

I am delighted to support my hon. Friend in the work that she has been doing with St Michael’s and Demelza hospices. She is absolutely right to highlight that, and I hope that she will be able to meet the staff in the new year and discuss how they can best use some of this funding.

I wish you, Mr Speaker, and all the House staff, a very merry Christmas.

Following on from the hon. Member for Calder Valley (Josh Fenton-Glynn), next year I will be taking part in a strictly dancing competition for my local Rowcroft Hospice. However, I am pretty sure that, even if all the Members in this House sponsored me, I would not be able to raise the £225,000 needed by Rowcroft to cover the additional national insurance contribution payments that it will have to make. Will this extra funding, which is very welcome, be additional funding, or will it be just enough to cover the extra costs that have been imposed on the hospice sector through the increase in national insurance contributions in the recent Budget?

I have to say that dancing is more my style than marathon running, so I wish the hon. Lady luck with that. At least she did not ask me for any money. I refer her to my earlier answer: this is additional money to support the hospice sector. It is a £100 million boost for adult and children’s hospices to ensure that they have the best physical environment for care, and £26 million in revenue to support children and young people’s hospices. We look forward to working with the sector in order to best deploy that in the New Year.

Merry Christmas to you and your team, Mr Speaker.

Our hospices do an amazing job, and I look forward to visiting my local hospice in the next few days, but Scottish hospices have warned that they might have to turn patients away because of the funding crisis that they face under the SNP. Does the Minister agree that the Scottish Government must at least match the level of investment that she has announced today? They must have a similar level of ambition for Scottish hospices, and provide fresh investment for our hospices, which do an amazing job in Scotland.

As my hon. Friend highlights, this is a devolved issue for the Scottish Government. We hope that they match our ambition, as she rightly puts it. I wish her well with her local hospice, and I hope that the Scottish Government take note of what we are doing here in England.

Over 7,000 charities and voluntary groups have written an open letter to the Chancellor warning that the national insurance increase will cost them £1.4 billion and have a devastating impact. At this time of the year, ahead of Christmas, many charities, including hospices, are trying to raise funds. I know that the Chancellor did not go into politics to be the Grinch who stole Christmas for charities, so will the Minister please look at this again, and exempt charities and voluntary groups, including hospices, from this cruel tax increase, which is sucking up good will and donations and really hurting valuable charities?

The hon. Gentleman was a Government Minister, so he had plenty of opportunities to change the system, had he wanted to do so at the time.

I thank the Minister for her announcement of a huge funding boost for the hospice sector. Will she join me in thanking all the brilliant staff at Keech hospice, which serves Luton South and South Bedfordshire, and especially all the volunteers who are out fundraising with Smiley Sam and Santa’s train across the streets of Luton, including Farley Hill tomorrow and Wardown Crescent on Saturday?

I thank my hon. Friend for making that point, and wish the volunteers well in their weekend activities. She is right to highlight not only staff but the hundreds of thousands of volunteers across the country who work to support the hospice sector and others with end of life care. That support is so important for people receiving end of life care and their families. It is something that I have experienced; my father died over the Christmas period a number of years ago. It is a hard time of the year to have a death, and I warmly support what those volunteers are doing this weekend.

The fact that the Minister has come here expecting us to welcome her announcement and congratulate her on giving money that her Government took away in the first place really beggars belief. Mountbatten hospice in my constituency needs an extra £1 million because of the NICs increase that her Government have brought forward. Will she guarantee to Mountbatten and the charitable sector, including hospices—which the last Government increased funding for, before she comes back to me with that answer —that today’s announcement will cover the £1 million that her Government have taken away in NICs?

What beggars belief is that person after person—man after man—on the Opposition Benches still feels able to get up and defend their record in government. Not once have we heard that they agree with Lord Darzi’s diagnosis, or that they welcome the extra investment that the Chancellor found by choosing to support the health sector in the Budget. I am afraid that, until they reach that conclusion, they are destined to be on the Opposition Benches for a very long time.

Merry Christmas to you and your team, Mr Speaker.

Compton Care hospice in my constituency provides specialist palliative and bereavement care, 24 hours a day, 365 days a year. Having previously discussed the lack of funding with the hospice, I am sure that it will welcome the extra funding that has been announced today. Will the Minister please join me in thanking Compton Care hospice and its incredible staff for the care that they will continue to provide throughout the Christmas period?

I welcome my hon. Friend’s comments, and I am very pleased to thank Compton Care hospice for all its work. He is right to highlight that the care is 365 days a year, around the clock.

Hospices such as St Ann’s in Stockport provide really high-quality care to my constituents and others at what is often the toughest point in their lives, but they are struggling in a system that is no longer fit for purpose. It is of course welcome that the Government are providing additional funding for them. One of the challenges that the hospice sector faces is a really high rate of staff vacancies, so I would be grateful if the Minister would confirm whether the 10-year plan for the NHS includes a specific workforce plan for our hospice sector, so that it continues to care for our constituents at the toughest point in their lives.

The hon. Lady makes an excellent point about the stability of the workforce across the piece, from diagnosis to the end of life. We absolutely need to consider support for all parts of that through the 10-year plan. I encourage hon. Members and others to ensure that they keep making those points. We are getting excellent contributions from the public, patients and staff, and we look forward to developing the plan over the next few months and years.

I welcome the largest funding increase for hospices in a generation. If that cannot bring some Christmas cheer to the Conservative Benches, it will in my constituency of Wirral West where Claire House hospice does such important work all year round. I was there just last week for their Christmas carols. Will the Minister take the opportunity to thank them for the important work they do in my constituency of Wirral West?

I thank my hon. Friend for his contribution and, indeed, for his singing. Those events bring joy to people at a particularly difficult point in their life, and they are very welcome.

Any increase in funding for the hospice movement is of course welcome, but let us be honest: it is giving with one hand and taking with the other. The two excellent hospices that serve my constituency—St Andrew’s in Grimsby and Lindsey Lodge in Scunthorpe—tell me they want certainty. The Minister says they will be told early in the new year. Can the Minister give a categorical assurance that in the first half of January hospices will be told how much extra they are getting from the £100 million she mentioned?

I thank the hon. Gentleman for welcoming the announcement. As I said, we will be working with the sector in the new year and then we will make allocations accordingly.

Stoke-on-Trent is wonderfully served by the Dougie Mac and Donna Louise hospices. They are part of a healthcare system in Staffordshire and Stoke-on-Trent that the Minister knows has a £90 million projected deficit. What oversight will there be to ensure that the money that goes to the ICBs reaches the hospices and that the team in Staffordshire and Stoke-on-Trent do not try to use some of this welcome new money to fill holes elsewhere?

My hon. Friend makes an excellent point —one that was raised earlier. It is vital that ICBs work with all providers to understand the needs and how they are best met. I know he will be diligent, as he already has been, in pursuing what is happening with the funding with his local ICB. We will work with Hospice UK to ensure that that happens across the piece.

The hon. Member for Cowdenbeath and Kirkcaldy (Melanie Ward) calls for a fresh approach by the SNP Government in Holyrood, but she clearly expects us to do that with fresh air, because part of the £750 million additional cost from the national insurance contributions will fall on hospices. On Tuesday, she had the opportunity to vote against that cost. Will the Minister confirm that there will be Barnett consequentials for Scotland? How will she address the problems that Marie Curie in Scotland faces?

I admire the hon. Gentleman for keeping on the same wicket. In the Budget, this Government made the greatest allocation to the health sector. What the Scottish Government do with their consequentials and how they manage that is entirely a matter for them, and if they are not doing a good job, the public need to vote for someone else.

I wish you, the team and all the wonderful staff on the parliamentary estate a merry Christmas. I very much welcome this big investment into local hospices, and I know it will be welcomed by my local children’s hospice Forget Me Not and Kirkwood hospice, which do invaluable work in my constituency. What assessment has the Minister carried out on long-term sustainable funding for the sector, particularly in relation to statutory funding and the increasing role that hospices play in the community and in people’s homes?

My hon. Friend is absolutely right to highlight that need. As I said earlier, end of life care and its stability as part of the wider system, which is a commissioning role for ICBs, was not addressed by the last Government over 14 years. As part of our 10-year plan, that will be important to do.

We can all agree that hospices, such as St Barnabas in Lincolnshire, do vital and valued work. I hope we can also all agree that every Government—Labour and Tory—have increased national health spending, for that is simply a matter of fact. I ask the Minister to show a little wisdom in contrition in acknowledging that the national insurance increase that was imposed on charities and hospices has done immense damage. We welcome the funding today—of course we do—but she needs to be straightforward: was she, or any of the Health team, consulted before the Budget about the impact of the NI increase on hospices, health charities, pharmacies and so on? May I advise her to put down the folder and tell us what she really thinks?

I have scribbled my own note—the right hon. Gentleman says that he “agrees”— but the issue is that his Government did nothing over 14 years to support or make a change. That is why the announcement we are making is so important. I reiterate my earlier point, which I will repeat every time I am at the Dispatch Box: the Conservatives have not read the Darzi report; if they do not agree with the diagnosis, they cannot agree with the solution. That is their fundamental problem.

I welcome the announcement of additional funding, as will many families across the country. Although it is not in my constituency, Rowans Hospice is used by people in Pompey. Indeed, my nan Pearl and my very dear friend Fiona spent their last few weeks in the hospice’s care, and what a wonderful place it is. At a city council meeting this week, concerns were raised about the future of that amazing service. Will the Minister confirm that the Government are committed to ensuring that every person has access to high-quality end of life care?

That is absolutely what we want to do, and today’s announcement is a step towards it. As my hon. Friend highlights, hospices are very special places, but most people want to die at home with their loved ones, in the place they know well, and many parts of the sector will be able to use this money to help more people to die peacefully at home.

This additional funding will benefit hospices serving Westmorland communities—St Mary’s, St John’s, Eden Valley and the children’s hospice, Jigsaw—only if two things happen. First, the Government must provide additional funding to match the national insurance increases that those hospices will have to bear, and secondly, the Government must ensure that the integrated care boards in south Cumbria and north Cumbria pass on that money in full and on time. Will the Minister press them to do so? On the Morecambe bay end, will she press them on the closure of the Abbey View ward at Barrow hospital? The trust is planning to close that end of life ward, which will put additional pressure on our local hospices but without any additional funding to support them.

The commissioning of those services is the responsibility of the ICBs, and we expect them to do that. They are responsible from diagnosis to end of life. In the past few months, I have met many hon. Members from across political parties to discuss issues in their ICBs. I know that he will, like others, be assiduous in pursuing the ICB to ensure that funding goes to the right place.

I wish you, Mr Speaker, and the fantastic staff across the estate a happy Christmas.

I thank the Minister for the way in which she and her team have listened to me and colleagues, who arrived in this place with real concern about the state of palliative care after years of under-investment by the previous Government. The funding announced today will be welcomed by Keech hospice and Garden House hospice, which provide fantastic palliative care for constituents in and around my area. Will she join me in thanking them for the fantastic work that their staff and volunteers do all year round to support people in incredibly difficult moments in their lives? Will she also assure them that palliative care will remain at the front and centre of the Government’s mind in the difficult work of getting health services working again?

I am happy to support my hon. Friend, who makes an excellent point, in his work with local providers. He congratulates me, but the work has been done mainly by the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), and by the Secretary of State, who have personally taken on this issue. They are visiting hospices today, so they could not be here even though they wanted to. We are committed to supporting people throughout their life, from diagnosis to end of life.

I have been contacted by vast numbers of families and relatives of those who have been wonderfully cared for by Sue Ryder Manorlands hospice in Oxenhope in the Worth valley. They are all concerned about the impact that the rise in employer national insurance will have on them. Those at Manorlands are deeply concerned that it will cost them hundreds of thousands of pounds. In answering the urgent question, the Minister has announced additional funding, but can she confirm whether it will cover the cost of those rises to Sue Ryder Manorlands hospice in my constituency? Did the Government carry out an impact assessment of the negative impacts that the Budget would have on those in the charitable and hospice sectors?

The hon. Gentleman asks the same question again. Through the Budget, this Government have allocated more money to the health service than the previous Government—a record announcement—and we have announced money again this morning. To govern is to choose. The last Government neither governed well nor chose to support the health sector from diagnosis to end of life; this Government have, and will continue to do so.

Some weeks before the Budget, I visited both St Catherine’s hospice and St Peter and St James hospice, which serve my constituents. I had not expected how quiet and empty those hospices were, because of the empty beds and mothballed wings that had been closed due to a lack of funding. Evidently, the funding crisis in the hospice sector was very deep before the Budget, but the Budget has only made it worse through the NIC increases. As such, I will try again: will the welcome funding announced today cover the cost of those NIC increases?

As Lord Darzi’s report announced, the entire sector has been under pressure and struggling since the disastrous Lansley reforms—they were part of the coalition Government—through to when we took over in July. We will fix the NHS and rebuild it to make it more sustainable and fit for the future. That includes everything from diagnosis to end of life care.

For my sins, I too will be running the London marathon next year. I will be running to raise money for Keech hospice; I know, as do other hon. Members who represent constituencies in Bedfordshire, what fantastic work that hospice does and the care it provides to our county. The Minister has been asked lots of times to comment on the impact of the NIC increases, which are going to hurt hospices in constituencies all around the country, so may I ask the question in a slightly different way? Does the Minister think that Keech hospice, taken in the round, will be financially better off or worse off next year as a result of both the Budget and this announcement that she has been dragged to the House to make?

I have not been dragged—I am very happy to be here. The reality is that the health sector in its entirety, from diagnosis to end of life care, will be better off this year than it was last year or the year before under the hon. Gentleman’s Government.

I place on record my thanks to all those in my constituency who will be caring for others over Christmas, whether they are unpaid family carers or paid care providers. That includes the registered nurses and registered care providers who have written to me to say that there will be an extra cost of £615 per employee as a result of the changes in the Budget. I will not attempt to ask whether the money announced today will cover national insurance contributions, but I will ask what the Government will do to help registered care providers. Where will the money come from to enable them to meet their increased national insurance contributions?

As the hon. Gentleman knows, this Government have allocated an extra £12 billion in this year for the health and care sector. The full allocation to cover the entire area of health and social care will be announced in the new year.

It would be churlish of anybody in this Chamber not to welcome the money that the Government are setting aside. I thank the Minister and the Government for that announcement, but what discussions has the Minister had with Cabinet colleagues to secure exemptions from national insurance contribution hikes for hospice workers? I think of Marie Curie—I spoke about that charity yesterday in Westminster Hall, and the Minister probably has a Marie Curie in her constituency. We know what that charity does. Unlike the mainstream NHS, it will not be exempted, yet it carries out the end of life care that the NHS simply cannot provide. Further, what help will be provided to carers in the community? The withdrawal of their service would leave the care system decimated.

The hon. Member makes an excellent point about carers and their support. We made announcements about that in the Budget, and we will make more general announcements about allocations in the new year.

May I gently say that I know you welcome being here, Minister, but it would have been easier if the announcement had come as a statement rather than through having to grant an urgent question? When Ministers are going out—quite rightly—to visit hospices, we should be told at the same time. It would be nicer and easier for us all to do it that way, but I thank the Minister for coming.

I would also say to all of us that our hospices matter. In the case of those hospices that serve my constituency—the children’s hospice of Derian House and St Catherine’s— I wish them all the best for Christmas. I thank all hospices for the duty they carry out on behalf of our constituents.