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Palliative Care

My Lords, I am grateful to the House for its indulgence in allowing me to speak during the gap. I am also grateful to the noble Baroness, Lady Finlay, for initiating this valuable debate. I declare an interest as chairman of St John’s Hospice in north London, which is one of the relatively few hospices that offers palliative care for three of the main life-threatening complaints—cancer, HIV/AIDS and, I am happy to reassure the noble Lord, Lord MacKenzie, and the noble Baroness, Lady Masham, motor neurone disease. I am also happy to reassure the noble Baroness that today the hospice has made available six emergency beds for St Mary’s in the light of today’s events. My message is simple; it has been the theme of the debate. Governments—this applies to this Administration and the previous one—have underfunded the hospice movement by at least 50 per cent. The figure of 35 per cent was mentioned by my noble and learned friend Lord Lyell in his excellent and informative maiden speech, and by the noble Lord, Lord Hayhoe. It means that the balance has to be funded through the good will of the public. I do not like to use the word ““cynically””, but the Government have cynically traded on that in the assurance that the shortfall will be made up. Furthermore, while other branches of the National Health Service have been given a 5 per cent uplift this year, the independent hospice movement has had to be content with 3 per cent. Why? In our case, we feel sensitive about that, because all our clientele come from the National Health Service through contracts with 11 primary care trusts across London. Our hospice is fortunate, in that it is part of the same charity and on the same site as the Hospital of St John and St Elizabeth, for which the hospice is its charitable objective. A large part of the hospice’s establishment cost is picked up by the hospital. Other hospices that stand alone are less fortunate. If that underfunding continues, there is a continuing danger that the viability of some of them will be called into question. The hospice movement in London is overwhelmingly independent. I venture to suggest that hospices give huge support to the National Health Service in releasing acute hospital beds, providing high-quality palliative care and, as I have said, giving the National Health Service a service on the cheap, frankly. We are grateful for the money that the Government have made available to the hospice movement in recent years, but I urge the Minister and his right honourable friend the Secretary of State to revisit the problem.