St. Christopher's Hospice, Sydenham

Part of Orders of the Day — Local Government Finance – in the House of Commons at 2:30 pm on 9th November 1990.

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Photo of Mr Philip Goodhart Mr Philip Goodhart , Beckenham 2:30 pm, 9th November 1990

At the beginning of each parliamentary Session, it is customary for the two hon. Members who have been chosen to open the debate on the Address to describe their constituencies in some detail. In a similar position, I should have referred to the benefits that have flowed to the sick from two establishments in my constituency—the Wellcome research laboratory and St. Christopher's hospice. The research workers at the Wellcome laboratory have a remarkable record for producing drugs that combat disease and suffering, while St. Christopher's hospice has become an inspiration and an example to the rapidly growing hospice movement, both in this country and overseas.

I am especially grateful that, so early in the Session, I have been given the opportunity to discuss once again the financial problems facing St. Christopher's, a hospice in which I know that you, Mr. Speaker, take a great interest. For the first 23 years of its life, the driving force behind St. Christopher's has been Dame Cecily Saunders, the only saint I know who was educated at Roedean. For those 23 years, it has been her energy, humour and faith that has inspired St. Christopher's. Like Florence Nightingale, she holds the Order of Merit; and like Florence Nightingale, I expect that her reputation will survive for generations.

When I first raised the subject of St. Christopher's in June 1988, the hospice faced a financial crisis following the last major increase in nurses' pay. Those problems have not gone away; in fact, they have grown. However, I am happy to say that the hospice movement as a whole has grown.

I shall put the matter in perspective. In June 1988, there were 124 hospices in the United Kingdom, with 2,000 beds; by June 1990, there were 145 hospices, with 2,600 beds. They are supported by 277 home care teams and 115 day care units. More than 30 further projects are planned. The National Health Service provides, on average, rather more than one third of the funding. Of course, the demand for hospice care for terminally ill patients is growing rapidly. In St. Christopher's, the work load has grown by 10 per cent. during the past year.

Even greater than the growth of in-patient care has been the demand for home care. In 1986, St. Christopher's looked after 50 patients in their own homes at any one time. In October 1990, the number receiving home care exceeded 100 for the first time, and in January 1991, the hospice will expand its work in south Croydon, bringing a further increase of 25 per cent. in home care work.

The hospice also hopes to open a new day centre by Christmas, which will look after between 15 and 20 patients each day, not only providing essential therapy but giving families at home a much-needed break and an opportunity to recharge their batteries.

Ten years ago, in 1980, St. Christopher's received 50 per cent. support from the National Health Service and needed to raise £250,000 in donations to break even. In 1990, even after the hospice received its share of the extra £8 million for hospices announced by my hon. Friend the Minister for Health on 15 December 1989, National Health Service support will meet only 38 per cent. of St. Christopher's expenditure, and donations of £2·5 million are needed. St. Christopher's is by far our largest local charity—virtually every club, pub and organisation in the community raises funds for it—but the cost of the services provided by St. Christopher's next year will push expenditure close to £5 million.

Looking at hospices other than St. Christopher's, I note that, even with the extra £8 million announced by my hon. Friend the Minister, it seems inevitable that there will be some bed closures and cut in services unless the Government provide further funding. St. Oswald's in Newcastle, St. Michael's in Hastings, and Butterwick hospice in Cleveland face particular problems, while Michael Sobell house in Oxford, in which I also have a personal interest, has closed four beds, with further cuts threatened.

With the introduction of health service reforms, hospices will be required to negotiate contracts with individual authorities. St. Christopher's is notably well administered, but that new arrangement is bound to increase its administrative problems, as it will have to agree contracts with no fewer than 10 separate district health authorities.

In the debate on 23 June 1988, I called for 50 per cent. support from the National Health Service for St. Christopher's and all hospices. I was delighted when, on 7 October 1989, my hon. Friend the Minister with responsibility for health matters in Scotland announced that that would happen in Scotland, and that the Government would match pound for pound public support for Scotland's 13 hospices. He said: Hospices are a splendid example of partnership in health care. The movement is well-established and has been recognised for many years as providing an integral part of the care for cancer patients.I cannot stress strongly enough the importance I attach to supporting hospices and ensuring that they are equipped to face the challenges of the future, confident in the belief that they will be able to maintain and further improve upon the already high standards of patient care that they offer.We must acknowledge the expertise that hospices have in the care of the terminally ill and assist the hospice movement to improve and develop its services and encourage the growth of locally based services.Therefore, I intend making funding available to match, pound for pound the support given by the public. This will result in a substantial increase in the amount of public funding provided to hospices.Working for patients is the watchword. The terminally ill and their families deserve as much care and support as we can possibly give them. The hospice movement has proved its worth, and in this very worthy area of service, and I am very pleased to be able to share in carrying their burden. That was a splendid announcement. In implementing this 50:50 funding scheme, there have been some problems, as one would expect, but in the seven months that the scheme has been in operation, I note that individual donations have increased. As one might expect, the reality of the Government doubling gifts has encouraged benefactors. I was also encouraged by the Minister of Health's statement on 15 December last year, when she said: The Government's objective is to work towards a position in which the contribution from public funds available to voluntary hospices and similar organisations matches that of voluntary giving. This will provide a clear basis on which to plan ahead."—[Official Report, 15 December 1989; Vol. 163, c. 847.] Yesterday, the Chancellor of the Exchequer was able to announce another massive increase in funding for the national health service. As the Secretary of State for Health said yesterday: Next year the NHS in the United Kingdom will get the biggest ever year on year increase in resources. The service will have £3·2 billion more to spend than this year. This is an increase of 11·6 per cent. or 5·3 per cent. after allowing for inflation. Fifty:fifty funding for hospices in the United Kingdom will cost approximately £15 million. Yesterday afternoon we were talking of sums in excess of £3 billion. I hope that today, or in the near future, the Minister will be able to come to the Dispatch Box and say that he can take extra steps towards 50:50 funding, which we are all agreed is a sensible objective.