Palliative Care (Hansard, 9 March 2004)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, the Government have met their pledge in the NHS Cancer Plan to increase NHS investment in specialist palliative care, including hospices, by an extra £50 million per year by 2004. The £50 million has been allocated to local level by the joint NHS/voluntary sector national partnership group for palliative care, which will undertake a monitoring exercise to ensure the funding is used appropriately.

§ Lord Ashley of Stoke
My Lords, I am grateful to my noble friend for that reply. Is he aware that the recent extra funding is welcome and very commendable? But would he comment on a report that the percentage of funding for National Health Service hospice care is lower now than it was in 1997? Could the Government make the funding of palliative care in hospices, and elsewhere, a higher priority? No one who is terminally ill or suffering from pain should be denied palliative care if he or she needs it. The estimates of those people who need it and do not receive it vary between 300,000 and 1 million. Either figure is shocking.

§ Lord Warner
My Lords, although I gave the answer for NHS increased investment, it is also worth bearing in mind that about £170 million per year is also spent in hospices in the voluntary sector. During the past few years, the New Opportunities Fund has put extra money into palliative care, including into hospices for adults and children.

§ Lord Walton of Detchant
My Lords, the Minister's original Answer was clear. But, does he accept that palliative care is a principle of care which is not devoted totally to the care of patients in hospices, but extends into the community? In that regard, organisations such as Macmillan Cancer Care, Marie Curie and others make a major positive contribution. Within the initiative to which the Minister referred, are the Government giving priority to proposals relating to the work of primary care trusts to ensure that this community programme goes forward?

§ Lord Warner
My Lords, as I said in my Answer, there will be careful monitoring of the £50 million. It is worth bearing in mind that the £50 million will fund an additional 66 consultants in palliative care, 162 clinical nurse specialists and 92 in-patient beds. It will provide additional funding to the voluntary sector, including hospices, and for example, extra Marie Curie nurses to provide practical care to patients.

§ Baroness Pitkeathley
My Lords, to follow on from the question asked by the noble Lord, Lord Walton, does my noble friend agree that a mix of care is really important when it comes to providing care for terminally ill patients and, indeed, for their relatives? In that regard, funding given by the New Opportunities Fund pioneered some of those domiciliary care services that are very valued by patients so that they do not have either hospice care or care in the home but a mix according to their needs at the time.

§ Lord Warner
My Lords, my noble friend is right. I pay tribute to the work that the New Opportunities Fund has contributed in this area under her chairmanship. As I said earlier, about £90 million in total is going into a wide range of care to meet the needs of adults and children in their local communities.

§ Baroness Finlay of Llandaff
My Lords, the £50 million given by the Government is greatly welcomed by all those working in palliative care. Do the Government recognise that there needs to be ongoing funding of services, particularly in those areas where there is poor provision of services for patients who have diseases that fall outside the current service provision? Just funding services for cancer is not enough in the long term to ensure that patients have the choice to access the service wherever they are and when they need it, irrespective of where they live or their diagnosis. That needs long-term ongoing funding to ensure that salaries are paid.

§ Lord Warner
My Lords, of course, the £50 million will continue to meet the service needs of people to whom it is allocated. On top of that, my right honourable friend the Secretary of State for Health has announced another £12 million to improve the quality of care services for people who wish to die at home.

§ Baroness Barker
My Lords, what steps has the department taken to identify those strategic health authorities which, in their criteria for NHS continuing care, have time limits on life expectancy? When it does find them, will there be changes?

§ Lord Warner
My Lords, I shall have to make inquiries into the question posed by the noble Baroness and write to her.

§ Earl Howe
My Lords, following on from the answer given by the Minister a moment ago, is he aware that Marie Curie Cancer Care believes that the NHS could save itself some £200 million a year if more terminally 1115 ill people were given the choice of dying at home? Is he receptive to that message, and to what extent will the Government's money be directed towards that end?

§ Lord Warner
My Lords, we welcome the Marie Curie Cancer Care campaign. Indeed, my right honourable friend the Secretary of State for Health spoke at its launch. We look forward to working in partnership with Marie Curie Cancer Care and other voluntary sector providers to improve the services for people who choose to die at home. Moreover, as I said in response to an earlier question, my right honourable friend has announced an extra £12 million to be put into work in this area.