Hospices reliant on people’s generosity due to lack of funding, MPs warn

Members on both sides of the House discussed a lack of government funding for hospices in their constituencies that left many with rising budget deficits and created a “postcode lottery” for palliative care.

The Health and Care Act 2022 states a legal duty on integrated care boards (ICBs) to commission palliative care services, with ICB commissioners obligated to ensure access to general medical and nursing services, out of hours services and rapid response to maintain continuity of care, thereby supporting patients’ preferences and choice.

Conservative MP Richard Drax, whose mother worked in a children’s hospice, said the organisations were subject to an “over-reliance on people’s generosity”.

He said: “(Hospices) work hand in hand with local health and care services taking the pressure off the NHS.

“Hospices, as we’ve heard, are mainly funded by charity. On average around two-thirds of the income for adult services is raised through fundraising. For children, alarmingly, that figure is four-fifths.”

The South Dorset MP concluded: “Yes, I hear the Government say it’s another call for money, and there are many other demands, but well-funded hospice care would safeguard this very effective and necessary sector which can not live on charity alone and nor should it.”

Opening the debate, Conservative MP Sally-Ann Hart said the current funding model that is reliant on fundraising is “uncertain and unsustainable” for hospices.

Ms Hart said hospices are “heavily dependent on the generosity of local individuals, companies, groups and trusts – this funding model is uncertain and unsustainable, and places hospices under considerable strain”.

The MP for Hastings and Rye added: “We should all want to see the best support available for those people that are nearing the end of their lives, as well as their families. And excellent palliative care, support for people mentally, physically and spiritually is vital.”

Ms Hart further stated: “The future of end of life care is uncertain, as increasing costs and demands are putting huge demands on hospices and care providers.”

Labour MP Colleen Fletcher (Coventry North East) said: “If we are to ensure that the demand for hospice care, both in their inpatient units and in the community is met and eliminate the inequality and postcode lottery of services, we need hospice funding to be sufficient, resilient and sustainable.”

Conservative MP Peter Gibson (Darlington) said the funding issue is “a matter of life and death” and that hospices faced “immense challenges”.

He said: “What we have seen is a very mixed and patchwork picture across the country.

“During Covid the Government stepped up to the plate, acted decisively and provided much needed financial support to the hospice movement, which not only prevented many hospices from failing and collapsing, but ensured that much needed palliative care could continue to be delivered around the country.

“The picture today however is one of immense challenges for our hospices. Many have failed to receive an increased level of support under their existing contracts with ICBs, to meet rising costs of energy or staffing.”

Conservative former minister Dame Maria Miller (Basingstoke) said it would be the “wrong way forward” for hospices to be overtaken by the NHS, adding that hospices are “fiercely independent charities and they can as a result of their independence do things that the NHS finds difficult to do”.

She added: “There does need to be more certainty in the forward planning for hospices, there needs to be multi-year contracts to provide that certainty especially given the pressures they face.”

Health minister Helen Whately said she stood by the “localised approach” to hospices and ICBS, adding: “We set-up ICBs purposefully to understand the healthcare needs of our local communities and to plan and commission services to meet those needs, and in so doing to reduce health disparities.

“There aren’t easy answers to the questions raised this evening, there rarely are. I don’t have a pot of money otherwise going unspent for hospices, nor do ICBs or NHS England.

“But I will continue what I do, working with NHS England, to make sure palliative and end of life care is given the attention it deserves and needs.”