Hospice Funding

Commons Urgent Question

The following Answer to an Urgent Question was given in the House of Commons on Thursday 19 December 2024.

“I am grateful to the honourable 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 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 honourable 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”.

15:37:00

My Lords, I begin by wishing the Minister and all noble Lords a happy new year. The Minister will know that most hospices are charitable, independent organisations, which the Government have recently thumped with increased costs through the rise in employer national insurance and the increase in the minimum wage, which, while welcome, also adds to costs. Will the announced increase in funding fully cover the costs that hospices will face from the rise in employer national insurance contributions and the increase in the national minimum wage? Instead of imposing extra taxes on hospices then giving them back some of the money that they will have paid due to the increase in national insurance, would it not have been better to exempt hospices and other health-related charities from the national insurance increases in the first place? Can the Minister also confirm that increasing the costs imposed on hospices and other health-related charities is not a deliberate attempt to drive out non-state providers?

I thank the noble Lord for his good wishes and extend my new year wishes to everybody in your Lordships’ House. To clarify the situation, this is the biggest boost for hospice funding in a generation. It is £100 million in capital, and there is no intention, as the noble Lord asked, to have any less engagement with the third sector—in this case, the hospice sector. The £100 million in capital is for adult and children’s hospices, and £26 million is confirmed for children and young people’s hospices. This has been widely welcomed. The decision in respect of national insurance perhaps would not have had to be made had the financial situation inherited by this Government been somewhat different.

My Lords, I am grateful to the noble Baroness for explaining about the capital grant, but can she get the Government to commit to a long-term revenue funding formula for hospices for those services that are equivalent to those provided in the NHS, so that they are rewarded financially on the same basis as the NHS fairer funding formula?

I understand the point the noble Baroness is making, because planning ahead and certainty are key. I can confirm that my ministerial colleague, Minister Kinnock, will soon meet all major stakeholders to discuss long-term sustainability of funding. We are very aware of the difficulties that have been caused thus far and seeking a way forward.

My Lords, I commend to the Minister a scheme that I introduced when I was Secretary of State for Scotland, at the suggestion of the broadcaster Martyn Lewis, who wrote a book on the hospice movement in tribute to Dame Cicely Saunders. That scheme introduced pound-for-pound funding: every pound raised was matched by the Government, which had the effect of greatly increasing funding and the incentive for people to support the hospice movement. Will she consider introducing such a scheme, which, alas, did not survive the introduction of the Scottish Parliament?

The noble Lord makes a very interesting point. Of course, the introduction of gift aid supported charitable funding, including to hospices, and I know was very warmly welcomed. These are all important ways of looking at funding and we will consider the best way forward, but I note from discussions with the hospice movement that hospices very much value their autonomy in terms of funding; the more linked it is to government funding, the less autonomy they have. We want dignified and appropriate care for patients and families, and to find the best way to deliver that.

My Lords, I pay tribute to Lady Randerson, who was a great supporter of hospice and palliative care services in Wales, as well as a dear friend. I declare that I am vice-president of Hospice UK and have been involved in setting up the palliative care commission, which will be chaired by Professor Sir Mike Richards and will start to take evidence this week. Can the Minister inform us of the department’s work to look at different funding formulae, such as the one we developed in Wales, which respects the individual autonomy of the voluntary sector while ensuring that some of the black holes of provision can be filled? Will the Government collaborate with the commission by providing as much evidence as possible so that Professor Sir Mike can come up with some really firm recommendations for the future?

I associate myself with the tributes paid to the great contribution that the late Lady Randerson made to this House. She will be sorely missed. In addition to Minister Kinnock meeting major stakeholders, including Macmillan, Together for Short Lives and a number of other organisations and charities to discuss sustainability of funding, Ministers will continue to have discussions with NHS England, because the other area is about getting the money promptly, which has not happened to date. Again, that has caused huge difficulties. We very much look forward to seeing the commission’s findings and recommendations and will look at how we can work to support it.

My Lords, I add my tributes to Lady Randerson and wish the Minister a happy new year. As welcome as the £100 million in capital is, it will not pay for staff, drugs, heating, lighting, meals or day-to-day services. What are the Minister and the Government going to do to add extra revenue funding to deal with the costs that the hospices are dealing with now?

As I mentioned, it has been confirmed that there will be funding for children and young people’s hospices for the forthcoming year, which I know had been hoped for but not actually delivered. I am very glad that the Secretary of State was able to confirm that. On long-term sustainability, Minister Kinnock is very much looking forward to meeting major stakeholders and is working with NHS England to find the best funding mechanism, in respect of the £100 million capital grant and more generally.

My Lords, it is very good news that the commission is in the safe hands of Sir Mike Richards, who I worked very closely with when I was a Health Minister. Could my noble friend set out the ways in which the Government might assist the hospice sector with training, because there must be a crossover in the different tasks undertaken? In particular, could some of the changes announced for social care workers be transferred to the hospice movement?

My noble friend makes a very helpful point that I will certainly follow up. The fact that the majority of hospice care is provided through the NHS suggests that there is room for further co-operation between the independent hospice sector and the NHS. I am grateful for her comments and will follow that up.

My Lords, I remind the House that I am joint chair of Together for Short Lives, the hospice movement for babies and young persons. We greatly welcome the decision and announcement by the Government. Our only hope, as has been alluded to, is that there will be a development to get some forward perspective. One of the problems I addressed in my meeting with Minister Kinnock was the short-termism there has been. Can we use this gap to try to get a longer-term perspective for funding?

We would certainly like to do that. As I mentioned, we will talk with Together for Short Lives and others to achieve that. It is very important to make sure that there are no delays to funding and that it promptly gets to where it needs to be. That is the other area we will attend to.