It is a pleasure to follow Colleen Fletcher and her powerful speech. I also thank my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing such an important debate, and I pay tribute to my hon. Friend the Minister, who is an excellent Minister. I enjoyed working closely with her at the Department, and I know she will listen carefully and act where she can on the issues raised during the debate.

Hospices play a vital role in local communities and within the wider health and care system, providing care to those at the end of their lives, and support and comfort to their loved ones. St Helena hospice in my constituency is no different, and since its opening on 20 May 1985 it has supported countless families in and around Colchester and north Essex during their most difficult times. However, over the last two years it has been more challenging for it to carry out its vital work. St Helena has averaged a deficit of £l million per year over the past two years due to rising demand, increasing costs, and real-terms cuts to its NHS funding. Similar to cases raised by other colleagues, only 27% of St Helena hospice’s income comes from our NHS, which means that 73% of the income needed to run it is raised through the local community. As is unfortunately common across the country, that income stream has faced its own difficulties due to the increased cost of living.

East Anglia’s Children’s Hospices also plays a hugely important role in caring for families and children in my local area. During 2022-2023 it cared for 532 life-threatened babies, children and young people, and delivered more than 72,000 hours of care and wellbeing support for families. However, every year EACH faces the ongoing challenge of generating 85% of its income from non-statutory sources. It receives only 15% of its income—about £2.7 million—from the NHS and local authorities, mainly on a year-by-year basis via grants and zero-based contracts. Having seen at first hand the impact that hospices have on local communities, and the fondness with which St Helena and EACH are thought of in Colchester and more widely in our region, I can see that it is essential that hospices all over our country are not allowed to fail. That is not only because outcomes for patients will be arguably worse, but because, as a recent Sue Ryder report shows, adequate funding for hospices is more cost-effective than replacing services with the NHS.

As a former Health Minister I want to urge some caution in calling for national solutions for commissioning. Of course we should look at addressing postcode lotteries wherever they exist, but in doing so we must remember that every area is different. The needs of our populations are different, and hospice provision in and of itself is different in every one of our constituencies. ICBs were set up to make local, holistic, system-wide decisions based on their populations’ needs and priorities, always putting at their heart the needs and outcomes of patients, but also looking at system costs, so that there is not that silo mentality in working, and ultimately at what is in the best interests—in terms of outcomes and value for money—for our NHS and the taxpayer. Having said that, I think there needs to be more consistent commissioning. ICBs should commission against service specification.

To conclude, I will make a more general observation: we are not very good at talking about death. Notwithstanding what I said about ICBs, there is a national role here. I would like to see the Government support a population approach to end of life care, involving more people in their care planning, promoting choice and dignity, and supporting community care alongside that. Many people would rather spend their last days at home around their loved ones, their pets and their families, if possible, than die in hospital. Supporting hospices and community services is a way of helping to keep people at home if that is their preference, with not just better outcomes for patients but ultimately better value for our NHS and the taxpayer. I close by thanking all those at St Helena Hospice and EACH for the amazing work they do.