Hospices: Financial Support (Hansard, 23 March 2004)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, as I informed my noble friend Lord Ashley of Stoke on 9 March, the Government have met their pledge to increase NHS investment in specialist palliative care, including hospices, by £50 million a year by 2004. The additional funding has been allocated by the joint NHS/voluntary sector National Partnership Group for Specialist Palliative Care, which will undertake a monitoring exercise to see how the funding has been used, including the level of support for hospices.

§ Lord Laming
My Lords, I am grateful to the Minister for that reply. Does he agree that the work of hospices deserves the support of us all, because of the pioneering work that they have done on the management of pain for young and old and on encouraging dignity in death, both in hospitals and in the home?
Does the Minister share with me and, I suspect, others the concern about the time that the good people who work in hospices must devote to fund raising? There is constant anxiety about the continuation of this valuable service. Will the Government consider a national formula that would guarantee core funding for hospices?

§ Lord Warner
My Lords, of course I join the noble Lord in paying tribute to the splendid work done day in, day out, in hospices across the country. As he may know, about three-quarters of all in-patient hospice services in England are provided in the voluntary sector. We have allocated this extra £50 million on a co-operative basis between the voluntary sector and the NHS, so the voluntary sector has played a major part in this allocation and will benefit considerably from the £50 million.

§ Lord Clement-Jones
My Lords, all of us will welcome the additional £50 million and, indeed, the additional £12 million for training that has also been allocated. However, the Minister is no doubt aware of considerable concern about the funding of children's hospices in particular. On average, only 7 per cent of their funding is received directly through the NHS, whereas adult hospices receive more than 35 per cent. Is the department considering this issue?

§ Lord Warner
My Lords, I draw the noble Lord's attention to the fact that the New Opportunities Fund, 597 chaired by my noble friend Lady Pitkeathley, has given £45 million since 2003 to palliative care for children, of which about £15 million has gone to children's hospices.

§ Lord Glenarthur
My Lords, can the Minister say how many hospices there are in the public sector and how he expects that figure to grow over the next five or 10 years?

§ Lord Warner
My Lords, as I said earlier to the noble Lord, Lord Laming, about three-quarters of the in-patient services in hospices are provided in the voluntary sector. That amounts to approximately 2,630 beds. A third of that, give or take, is provided also in the public sector.

§ Lord Ashley of Stoke
My Lords, is my noble friend aware that although the Government have done well as far as hospices are concerned, it is far from good enough? Although the £50 million he mentioned has been helpful and welcome, the Government are relying far too heavily on the voluntary sector. Hospices should have greater responsibility to the Government, and the Government, in my view, should be primarily responsible for funding them. We are nowhere near that, so how about approaching the issue in that way?

§ Lord Warner
My Lords, of course we would all like to do better, and we accept that there is a need to continue to improve the funding of hospices. However, the voluntary sector has done a splendid job in hospices and is held in a great deal of public affection by those who use such services. I do not think we would want to, in effect, give a vote of no confidence to that work by implying that we were not satisfied in any way with the work done in voluntary hospices.

§ Lord Walton of Detchant
My Lords, while welcoming the extra funding to which the Minister has referred, will the long-term support for the hospice movement fall within the remit of the Select Committee's consideration of the Assisted Dying for the Terminally Ill Bill of the noble Lord, Lord Joffe, which is, I understand, not to meet until July?

§ Lord Warner
My Lords, I do not think it is for me to suggest in any way whatever how that Select Committee should do its work. I draw the noble Lord's attention to the fact that the Select Committee on Health will be making an inquiry into hospices and palliative care.

§ The Lord Bishop of Oxford
My Lords, does the Minister agree that although hospice care is sometimes said to be expensive, it represents very good value for money? Not only does it represent superb care for patients but, as the noble Lord, Lord Laming, implied, it has pioneered palliative care for the country as a whole and raised standards.

§ Lord Warner
My Lords, the right reverend Prelate is absolutely right. Great pioneering work has been done 598 by hospices, much of it in developing services outside hospices as well as in relation to in-patient beds. For example, there are 264 specialist palliative homecare teams, 81 hospice at home services and 200-odd daycare services. Some pioneering services have been developed by the voluntary hospice movement.

§ Lord Hunt of Kings Heath
My Lords, given that the health service now knows its allocations three years in advance, will my noble friend encourage primary care trusts to enter into longer term agreements with hospices so that they have much more stability and certainty about the funding they receive from the NHS?

§ Lord Warner
My Lords, as my noble friend knows, primary care trusts will, from April 2004, be responsible for controlling 75 per cent of the NHS budget. Very substantial increases in that budget mean that there will be opportunities for them to respond to local needs, which is the purpose of many of these increases. Much of the £50 million that I mentioned was to improve inequalities in different parts of the country. My noble friend will be aware that in the cross-cutting review by the Treasury and the voluntary sector, strong emphasis was placed on government departments and the public services entering into more secure funding for the voluntary sector.