Part of the debate – in the House of Commons at 9:42 pm on 22 April 2024.
I thank my hon. Friends the Members for Hastings and Rye (Sally-Ann Hart) and for Darlington (Peter Gibson) for securing this debate. The number of speeches this evening reflects the strength of feeling, and the support, for hospices across the country. As the Minister with oversight of end of life care, I share the passion of many hon. Members for hospices and for what they do, caring for people towards and at the end of life, providing respite for carers and supporting families both before and after the death of a loved one. Many hon. Members have rightly praised the work of the hospices that serve their constituents and made special mention of the extraordinary work of hospices for children and young people. I also thank the hospices for all they do, and for all they are doing right now, as their staff work around the clock.
Beyond that, I thank everyone who gives palliative and end of life care, as part of hospice teams but also working in the NHS. How you die, how your loved ones die or how you live towards the end of your life, matters. As Mrs Hamilton said so eloquently earlier this evening, and as all of us here this evening know, that is why palliative and end of life care matters. It matters when that care is provided by the NHS, as it is for the majority of people, and when it is provided by hospices. I emphasise that point, because there is sometimes a misunderstanding, which I have heard a few times this evening. The fact is that most palliative and end of life care is provided by the NHS, whether in hospitals, by primary care or through community trusts. Alongside and in addition to that, hospices do the wonderful work that they do. Recognising the importance of palliative and end of life care, we specified in the Health and Care Act 2022 that integrated care boards must commission these services to meet the needs of their populations.
Some hon. Members have argued this evening for hospice funding to be centralised, taken away from integrated care boards and, I assume, allocated by either NHS England or the Department of Health and Social Care. While I understand their motivation in making that call, I do not agree. We purposefully set up ICBs to understand the healthcare needs of our local communities, to plan and commission services to meet those needs and, in so doing, to reduce health disparities. Our communities and their needs, and the services they already have in place, are different, and rarely is a one-size-fits-all decision made in Westminster the right answer. I stand by a more localised approach, in which there is, of course, variation.
Another source of variation is historical. The hospice movement has grown organically, and the location of hospices has not been planned to meet demographic need, for instance. There are, therefore, inequalities in access to hospice services, especially for those living in rural and more deprived areas. This variation in access to hospice care has to be taken into account by ICBs in the decisions they must make to ensure that people have access to end of life care, whether or not they live in an area served by a hospice.