Hospices: Government Support (Hansard, 31 October 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, initially the proposal is to add central funding to that provided by the health authorities to build towards matched giving. Ultimately it may be done also through contract arrangements.

§ Baroness Cox
My Lords, I thank my noble friend for her reply with its sympathetic ambience. Is she aware that hospices were encouraged by the Government's Statement in December 1989 to plan their strategies on the basis of 50 per cent. funding? There is a real urgency for the situation to be addressed, otherwise hospices already face problems of redundancies and bed closures. That is a great tragedy given the enormously important services that hospices provide and the great dedication of staff who work in them.

§ Baroness Hooper
My Lords, I can assure my noble friend that the Government are still working towards that aim. This year we have made additional allocations of over £11 million to enable the health service to increase its support for voluntary hospices. In Scotland hospices are already eligible for public funding of at least 50 per cent. of their running costs. In England and Northern Ireland the health service has been asked to work towards a position in which its contribution matches that from voluntary giving.

§ The Earl of Longford
My Lords, I strongly support the noble Baroness on this issue as occurs so often these days except where Party issues are involved where that becomes more difficult. I shall open a debate on the subject on 15th November. Perhaps I 1845 may ask the Minister whether the Government still stand by the reply given to me on 13th July of this year. We were told: The health authorities and boards in England and Northern Ireland have been asked to work towards a position in which their contribution to the revenue costs of agreed services matches that from voluntary giving".—[Official Report, 13/7/90; col. 551.] Do the Government still stand by that reply or have they ratted on it?

§ Baroness Hooper
My Lords, no. I had sought to give that reassurance in answer to my noble friend's Question. We are still working towards that commitment. I do not wish to pre-empt the debate scheduled for 15th November. Much depends on the outcome of the current expenditure round and until that is known no final decision will be made on future funding arrangements.

§ Lord Nugent of Guildford
My Lords, in view of the urgency which now exists in some of the hospices, whose emergency services are immensely valuable, when can we expect a decision by Her Majesty's Government to grant the sums of money which we are expecting?

§ Baroness Hooper
My Lords, I appreciate the difficulties which can arise when the various health authorities are working at a different pace. However, some authorities have already achieved the 50 per cent. level and some are over and above that. At this point all I can say is that we are working towards a situation in which all local health authorities will have reached the 50 per cent. level.

§ Baroness Seear
My Lords, does the Minister appreciate the extraordinary difficulty into which she places voluntary organisations and others which have been encouraged to expect reliable statutory funding only to find that they do not know when it is coming nor how much it will be? Does she appreciate that when one is trying to run an organisation, uncertainty about one's cash flow is jolly nearly death?

§ Baroness Hooper
My Lords, yes. I reiterate that we have supplied an additional £11 million this year and have given assurances that that level of funding will continue. It is the achievement of the across-the-board level of 50 per cent. in all health authorities that is requiring a little more time.

§ Lord Blease
My Lords, does the Minister agree that, unfortunately, throughout the United Kingdom there is a growing demand for specialised terminal care and family services provided by the modern hospice movement? Does the Minister agree that in human terms those modern specialised hospital services cannot be priced by market values nor meet the acceptable criteria of human need by contracting out to commercially-run nursing home operators? As a possible means of getting out of the dilemma and meeting the present and future hospice financing and funding arrangements, will the Minister use her good offices to ensure the co-operation of the Department of Health with the United Kingdom Hospice Movement Working Party which has been established to report on hospice service standards criteria?

§ Baroness Hooper
My Lords, I am happy to respond to the noble Lord, Lord Blease, in acknowledging the important role played by the hospice movement and the valuable contribution that it makes to the difficulties experienced by people who are terminally ill. Our whole thrust in the health service is towards improving the quality and standards of care. To that extent, I am sure that the Department of Health will be delighted to hear what the working party has to suggest regarding this important issue.

§ Lord Ennals
My Lords, the Minister's sympathy is appreciated; but the problem is financial. Is she aware that health authorities are now telling the hospices that they cannot meet the Government's commitment to 50 per cent. funding unless they receive increased central funds or are expected to cut local services? Secondly, since staff costs represent 80 per cent. of hospice expenditure, does the Minister agree that the members of staff who are constantly working with loss and bereavement should be free of the fears of financial crisis and redundancy which are now seriously affecting the hospice movement?

§ Baroness Hooper
My Lords, as I have said on many occasions, as with other funding issues, the funding of hospices is the responsibility of local health authorities. We must leave that responsibility at a decentralised level. The precise arrangements for supporting individual projects are therefore a matter of discussion between the authorities and the organisations concerned. In general terms, we expect the authorities to use the considerable additional funds that we have made available to support voluntary projects and to top up rather than to replace the contribution that they already make.

Baroness Ryder of Warsaw
My Lords, is the Minister aware that in the hospices and the Sue Ryder Homes the lack of financial assistance adds greatly to the existing worries of the staff, and even more to thousands of supporters who are bewildered and dismayed by the Government's attitude and lack of help?

§ Baroness Hooper
My Lords, the Department of Health has good and regular contact with those in the voluntary sector who are involved in the hospice movement. Indeed, if the Government have not been made aware at that level they are left in no doubt by your Lordships.

§ Lord Williams of Elvel
My Lords, I wish to redirect the Minister's attention to the supplementary question which was asked by my noble friend Lord Longford. There is a great difference between standing by an undertaking and, in the Minister's words, working towards meeting an undertaking subject to the public expenditure round. Will the Minister now repeat her undertaking to this House that the Government will stand by the undertaking that they gave?

§ Baroness Hooper
My Lords, without implicating myself in any undertaking regarding a timescale, I am only too happy to stand by that undertaking.

§ The Duke of Norfolk
My Lords, is the Minister aware that originally the hospice movement asked for £23 million this year and received £8 million? She 1847 spoke of £11 million for next year. Is the Minister aware that to match giving pound for pound £30 million is now required and I see noble Lords opposite agreeing? We do not want any talk of £11 million for next year.

§ Baroness Hooper
My Lords, the overall funding in England and Wales was £11 million for the current year. Until we have the results of the public expenditure round, I cannot say finally what will be available next year.

§ Lord Ennals
My Lords, in view of the great anxiety expressed by Members on all sides of the House, will the Minister undertake to discuss the matter with the Secretary of State in order to ascertain whether a more satisfactory and rapid solution can be found?

§ Baroness Hooper
My Lords, as always, I am happy to relay the opinions expressed in your Lordships' House to my right honourable friend the Secretary of State.

§ Lord Molloy
My Lords—

Noble Lords
Next Question!

§ Lord Molloy
My Lords, in view of the importance of the subject, would it not be possible to refer the matter back to the House after the Minister's discussions with her right honourable friend in order that we can examine the result?

§ Baroness Hooper
My Lords, if the noble Lord, Lord Molloy, had listened to his noble friend Lord Longford, he would know that the House is due to discuss the subject on 15th November.