Mark Hunter and Greg Mulholland on the funding of hospices

5.51.40pm GMT Fri 1st Feb 2008

• [Jan 30] Bob Spink (Castle Point, Conservative): You will be deeply saddened to hear, Mr. Williams, that hospice funding is compromised. Unless action is taken, it will need a life support system . .

. . Mark Hunter (Cheadle, Liberal Democrat): It is pleasure to contribute to this debate under your chairmanship, Mr. Williams. I congratulate the hon. Member for Castle Point (Bob Spink) on securing this important debate on hospice funding. I would also like to thank him for being one of the first MPs to sign my early-day motion, tabled last year, on St. Ann's hospice in Heald Green, in my constituency. This issue is very close to my heart and I and other Members feel very strongly about it.

I have visited St. Ann's hospice on many occasions and have seen for myself, in both a public and personal capacity, the truly exceptional work that hospices do and the difference that such provision makes for those in need of palliative care and their families. I continue to be genuinely shocked by the lack of Government support for all the hospices that play such a vital role in the national health service. Despite Government assurances that voluntary organisations that deliver public services should be paid the full cost of providing such services, hospices still only receive, on average, one third of their total costs.

St. Ann's is a case in point. As the hon. Member for Eccles (Ian Stewart) pointed out, it receives only £3 million out of the £9 million that it needs each year, so it has to find the other £6 million itself. That equates to a whopping £16,000 a day. Surely the Government want such hospices to spend more of their time providing the excellent care that the NHS needs, rather than having to spend time and energy raising so much money each and every day of the year.

Charitable hospices provide 80 per cent. of adult in-patient palliative care beds, yet their funding has dropped in real terms over the past few years, leaving 28 per cent. of independent hospices in deficit in 2006. Palliative care is a core service for patients-it is not, and never has been, an optional add-on. If independent hospices cease to exist, the NHS will have no option but to pick up the slack. The Government should be acutely aware of that fact and address the funding shortfall while there is still time. We do not want excellent hospices such as St. Ann's and the others that have been mentioned today to be unable to continue because of short-sighted funding arrangements.

We are all aware that hospices ask only for a level playing field; they want to be treated in the same manner as other NHS service providers. Hospices such as St. Ann's fulfil a necessary function in a society in which debilitating and life-threatening diseases such as cancer are sadly on the rise, and they do so in a manner that is truly laudable. They provide a unique and personal service that improves the quality of thousands of patients' lives. They also support patients' families and carers. When the Minister responds, I hope that he can tell us what action the Government intend to take to put right this desperate situation, and to ensure that hospices get the stable funding regime they so desperately require.

Greg Mulholland MP

Greg Mulholland (Leeds North West, Liberal Democrat): I congratulate the hon. Member for Castle Point (Bob Spink) on securing this debate, and I pay tribute to him for his consistent commitment to hospices. I also pay tribute to all the other Members who have contributed; they have provided powerful accounts of their experiences of the hospice movement in their constituencies. We are all very aware of the wonderful work that hospices do in dealing with those who have a terminal illness. Hospices provide not just palliative care but a whole range of services-a point that often does not come out-including not only skilled nursing care, pain relief and counselling, but activities such as art, music and physiotherapy. Of course, hospices offer services not only for patients but for their families, as other Members have made clear.

The key issue is, and the purpose of the debate is to discuss, the consistency of funding across the hospice sector. Members on both sides of the House have related some very interesting and concrete examples. Each and every hospice faces a struggle month on month, year on year, to secure the funding that it needs to continue doing its vital work. We have heard from Help the Hospices that, on average, just 34 per cent. of funding comes from Government-a little over one third. I think that we heard a slightly lower figure for Wales from my hon. Friend the Member for Ceredigion (Mark Williams). Of the £1.2 million needed by hospices every day, only £360,000 comes from the Government, so every day hospices have to find an extra £840,000 to carry on their work.

Inequality of funding-I am referring to the proportion of money that hospices receive-has been touched on. For some, it is potentially as high as 62 per cent.; for others it is considerably lower. My hon. Friend the Member for Cheadle (Mark Hunter) made the point, which was clearly not acknowledged by the Minister, that funding for hospices has dropped in real terms in recent years. That is putting considerable extra pressure on the hospice movement.

In speaking on behalf of my party from the Front Bench, I point out that I am proud to have a hospice in my constituency-Wheatfields hospice, in Headingley. Like the other examples that we have heard about, it does wonderful work in dealing with patients and their families in the tragic situation of the end of life. Wheatfields needs about £2.25 million every year to keep going, and the Wheatfields fundraising team has to raise approximately £1 million a year for it to continue its work. I have visited Wheatfields and seen the amazing fundraising operation-the remarkable and professional sales that it organises all week, and the twice-weekly public sales. It runs a joint lottery with the equally excellent St. Gemma's hospice, in the constituency of my neighbour, the hon. Member for Leeds, North-East (Mr. Hamilton). Together, they run a lottery and do so much for that area of Leeds.

The key point that has been brought out, particularly by the hon. Member for Castle Point but also by my hon. Friend the Member for Cheadle and others, is that we do not have equity with other areas. My hon. Friend said that there is not a level playing field, and the hon. Member for Castle Point referred to unfair treatment. The message is clear: there simply must be equity for hospices and other partially funded sectors of the health service. The reality is that we are talking about mainstream NHS palliative care. Unfortunately, the hon. Member for North-West Leicestershire (David Taylor) has left his place, but he put it very clearly when he said that fundraising should provide add-ons to core services, not the core funding itself. Many people in this Chamber will feel that that was an astute analysis.

Sue Ryder Care has estimated that the state receives about £200 million-worth of palliative care from the hospice sector at no cost to itself. That is the level of contribution that the sector makes. Sue Ryder, which runs the Wheatfields hospice, estimates that it subsidises primary care trusts and social services up and down the country to the tune of £7 million, and that is one organisation. Clearly, this is a real concern for the hospice movement, which I am sure the Minister will acknowledge. I am conscious that the Government are considering the issue, which is why this debate is particularly timely. I hope that the Minister will accept that there are real concerns, and that several questions are being asked in the hospice movement about funding, equity and the differing proportions of funding for some hospices.

Liberal Democrat Members welcome the grant that was announced to refurbish hospices, but as I am sure the Minister will acknowledge, that is not a long-term answer to the questions being posed. In the new strategy, will he commit to an increase in hospice funding not only overall, but proportionately? Will the Government seriously consider that? Will he address the issue of equality of funding across the hospice sector? Will he comment on the idea of a tariff-based system for hospice care, which has been mentioned by Sue Ryder? Given the Government's commitment to full cost recovery and closer partnership with the voluntary sector, the simple question is: why does that still not apply to hospice care, and when will it?

I again pay tribute to all Members who have taken part in this most important debate; I look forward to the Minister's contribution. One thing that Members on both sides of the House are absolutely committed to and 100 per cent. behind is the view that we must do whatever we can to support the wonderful work done by hospices.

. . Ivan Lewis (Parliamentary Under-Secretary, Department of Health): I congratulate the hon. Member for Castle Point (Bob Spink) on securing this important debate and on the passionate and authentic way in which he goes about championing the cause of hospices. . . The only partisan contributions made during the debate were made by the hon. Members for Cheadle (Mark Hunter) and for Leeds, North-West (Greg Mulholland). They turned it into a party political issue. They talked about a real-terms cut in the amount of funding for hospices based on those figures. That was absolutely opportunistic and disgraceful.

Greg Mulholland : Will the Minister give way?

Ivan Lewis (Parliamentary Under-Secretary, Department of Health): Will the hon. Gentleman be writing a blank cheque to the hospice movement? Is he saying that if the Liberal Democrats ever formed the Government, they would meet all the hospice costs at 100 per cent. recovery? Of course not, but that is the impression that Liberal Democrat Members always give when contributing to debates.

Greg Mulholland : Will the Minister give way?

Ivan Lewis (Parliamentary Under-Secretary, Department of Health): We are all fed up with it. I return to the substantive issues.

Greg Mulholland : Will the Minister give way?

Ivan Lewis: I will not give way.

On regulation costs, I shall consider the question of the consultation that the Healthcare Commission is undertaking-

Greg Mulholland : He's an a*******.

Ivan Lewis: -and the nature of regulation costs. That was not very parliamentary language, Mr Williams.

On the question of-

Mark Hunter (Cheadle, Liberal Democrat): Will the Minister give way?

Ivan Lewis: No, I will not. [http://tinyurl.com/2rfpqc]