THE funding of hospices shows that “voluntary sector beginnings” are “still very much in evidence”, Lord Farmer said on Thursday as he introduced his debate on how the state funds palliative care.
“A review of funding would find a highly variable model for hospices: some are run by the NHS, with large annual charitable grants, and others are run by a charity that gets some funding from the NHS. A common hallmark is a holistic, bespoke, and patient-centred approach that values their relationships,” he said.
“We should not forget that all receiving hospice care are on the edge of eternity, and dying peacefully also requires spiritual palliative care.”
He spoke of how “many hospices and the essential support they provide to dying people, their families, and the wider health system, are already in funding-famine” as he advocated “a national plan” and a “review of the state’s own role and responsibilities”.
The Bishop of London, the Rt Revd Sarah Mullally, said that she suspected that “there has never been a more important moment in time to discuss the funding. . . According to Hospice UK, the sector is facing the worst financial crisis in more than 20 years.” She explained that she was patron of Hospiscare, in Exeter.
Inequality was an issue, she said, as “the state provides on average only a third of hospice funding. A large proportion is found by fund-raising.”
With reference to the new attempts “to change the law for those who are terminally ill” (News, 25 October), she asked: “How can we consider this if we do not give enough funding to hospices, palliative care, and palliative care research, so that people dying receive the best care — the care that they need to make life worth living, and, in the words of Dame Cicely Saunders, to live life until they die?
“I hope that we are not prioritising the care of those who need it based on their contribution to our economy. This is contrary to how God values each one of us, contrary to the principles on which the NHS is founded, and contrary to human dignity. How the Government choose to prioritise palliative care matters very much.”
The former Archbishop of York Lord Sentamu spoke of his experience of the “amazing work and care offered to many people at the end of their lives”. He suggested that the Government might “apply to the funding of hospices the lesson of the R. A. Butler 1944 Education Act”, which made secondary education free and universal up to the age of 15.
“Before this was enacted, the voluntary schools provided by churches were largely funded from the income of historic trusts, or from the giving of the parishioners. In voluntary aided schools, the Church is responsible for only ten per cent of the cost of the upkeep of the building; the rest is provided for by the State,” he said.
“A mixed funding model could work well, provided that the Government remains the last person standing in terms of funding. Hospices could become voluntary aided hospices.”
Lord Griffiths of Burry Port, a former President of the Methodist Conference, also referred to the imminent debate on assisted dying. “Is it not ironic that we cannot see the two together? We must stiffen our resolve, influence all we can, and stand up for investing in hospices as a responsible way of dealing with people at the end of their lives. We must then let the other debate happen, with that already a commitment on our part.”
In summing up for the Government, Baroness Merron commented that “irrespective of whether the law changes on this matter, we will and must continue to work towards providing high-quality, compassionate palliative and end-of-life care for every person who needs it.”