| Previous Section | Index | Home Page |
12.40 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I am pleased to have the opportunity to respond to my hon. Friend the Member for Lewes (Mr. Rathbone), and I congratulate him on securing time for a debate on the funding of St. Peter and St. James's hospice. I have no doubt that it is an extremely important issue.
I have listened carefully to my hon. Friend. He feels that the hospice provides a valued service for the people of Lewes and Haywards Heath in East Sussex, and I understand any concern that he has for its future.
Before I respond to my hon. Friend's concerns about funding, I should like to express sadness at the untimely although not entirely unexpected death of Julian Wellesley, chairman of the East Sussex, Brighton and Hove health authority. He was a well respected man, with a successful career in finance and commerce. He devoted considerable time and energy to the health service, and was appointed to the position of health authority chairman in 1990. He proved to be an outstanding chairman, leading his authority with great style and skill, and his name will live on in the many improvements to local health services that he pushed through.
Mr. Rathbone:
I should like to add my support for my hon. Friend's words. I knew Julian Wellesley for many years before I came to the House. He started his work in the health service on the board of Eastbourne general hospital. He was then appointed chairman of Eastbourne health authority and most recently he was a marvellous chairman of East Sussex, Brighton and Hove health authority. He engineered the bringing together of the local health authorities and community care providers under one wing. I believe that my hon. Friend's words are justified.
Mr. Horam:
I am grateful to my hon. Friend.
I know something about St. Peter and St. James's home and hospice from my colleague, Lady Cumberlege, who visited the premises on 20 August, as my hon. Friend said. She was very impressed by what she saw. The charity's efforts are obviously much appreciated by patients and the local community.
13 Nov 1996 : Column 316
St. Peter and St. James's home was built 20 years ago to provide residential care for severely disabled people and elderly people. It branched into hospice care in the early 1990s. The hospice comprises six in-patient beds and a new day centre. It also provides home support services for patients in the community.
St. Peter and St. James's is one of a number of hospices in Sussex. Like other voluntary hospices, it is funded from charitable sources, and also by the health authorities. I will have more to say about health authority funding of hospices, which ultimately comes from the taxpayer, of course, but first I should like to pay tribute to the excellent work done by charities up and down the country in raising many millions of pounds every year for hospice care. None of us is under any illusion about how difficult it can be to raise the sums required, and we are extremely grateful for the considerable unpaid time and effort so generously given by so many people.
I should make it absolutely clear that our commitment to palliative care is undiminished. I also remind the House that the United Kingdom is a recognised world leader in the care of the terminally ill. Significant advances have been made in pain and symptom control and in improving the overall quality of life for patients with cancer and other life-threatening illnesses. The aim of our policies is to ensure that the benefits of those improvements in treatment and care are available to all patients, wherever they may live.
The spectrum of palliative care provision and support required to meet patients' and carers' needs continues throughout the patient's illness and into the carer's bereavement. It ranges from the promotion of physical and social well-being to highly specialist palliative care involving physical, psychological, social and spiritual support. It is provided in both community and in-patient settings. It will vary according to the stage of illness, and may be required from the time of diagnosis.
To provide such services, the Government's support for hospice and specialist palliative care services has, as my hon. Friend acknowledged, increased sixfold between 1990 and 1994. In 1994, that funding reached nearly £48 million. As of January this year, there were 171 hospices operating in England, with a total of 2,599 beds, 308 home care teams, 89 hospital support teams and 191 day hospices. Some of those are part of larger national voluntary bodies, but most are locally based individual charities such as the St. Peter and St. James's hospice. As the House will appreciate, the care of the terminally ill nationally is a large undertaking, which has grown enormously in the past 10 years.
As my hon. Friend said, since 1994, funding for specialist palliative care has been built into health authorities' allocations and has not been ring-fenced as it originally was. My hon. Friend is concerned that that practice has diminished support. I can tell him that my Department has a good working relationship with the National Council for Hospice and Specialist Palliative Care Services. We rely on that organisation to identify local problems. The council is co-ordinating a survey of all health authorities and is interviewing those responsible for palliative care. The picture is incomplete because the survey is expected to be published early next year, but the evidence so far is that health authorities are at least maintaining--I emphasise that word--their palliative care funding levels.
13 Nov 1996 : Column 317
The change in the funding approach was designed to ensure that health authorities planned for palliative care in the same way as they planned for other health services. Health authorities are free to negotiate with individual providers the level and form of support required to meet the palliative care needs of their population. That flexibility in the use of funding has enabled the palliative approach to become more widely adopted in all settings, including hospices, hospitals, nursing homes and the patient's own home.
It is, of course, essential that hospices and health authorities work in partnership when drawing up and developing local strategies for palliative care. Agreement between them must be based on the assessed health needs of the resident population and should take into account local priorities, available resources and existing patterns of services. That should allow resources to be used effectively and avoid undue duplication.
It is also important for health authorities to ensure that new developments do not divert resources from established palliative care units if they are delivering high quality care. That fact needs to be emphasised in the context of today's debate as I know that St. Peter and St. James's is a valued as well as an established palliative care unit. I am sure that that point will not be lost on the health authorities. Indeed, if there was any danger of that, we re-emphasised that point as recently as 15 October 1995 in guidance to all health authorities.
East Sussex, Brighton and Hove health authority and West Sussex health authority are responsible for contracting for palliative care services in Sussex and the area served by the St. Peter and St. James's hospice. While I understand the wish of that hospice and those connected with it to secure as much funding as possible from their health authorities, it is for the two Sussex health authorities, as purchasers of health care for their residents, to determine what level of resources to devote to palliative care, and which particular providers to use.
My hon. Friend the Member for Lewes referred to the level of support being provided and mentioned a total contribution of approximately £60,000 from the two health authorities to the more than £400,000 required to maintain the hospice. Those are large sums of money for the authorities, but I readily agree that they are small in relation to the total sum required. My hon. Friend was correct to say that approximately 30 per cent. of the costs of patients from East Sussex are being matched by funds from their health authority, and that the percentage provided by the West Sussex authority to maintain patients from its area is even smaller--perhaps as low as 10 per cent.
Mr. Rathbone:
I remind the Minister that those figures apply only to funding for in-patient services and not for other services.
Mr. Horam:
I accept that, but those are the amounts being provided by the two health authorities.
The matter of what resources are available to the health authorities is a separate issue. As a Member of Parliament representing a Sussex constituency, my hon. Friend the Member for Lewes will be aware of the difficulties faced by the West Sussex and the East Sussex, Brighton and Hove health authorities. This year, the disparity between the target and actual amounts that the East Sussex health
13 Nov 1996 : Column 318
My hon. Friend will also be aware that we are endeavouring to diminish the disparity between the ideal and actual amounts over time. Therefore, this year the two authorities received increases that were very much higher than inflation. They can also expect increases very much above inflation in future years. I am sure that my hon. Friend will be aware of the commitment made by my right hon. Friend the Prime Minister at the Conservative party conference to real-term increases in the health budget, which will be reflected in the amount of money going to health authorities.
At this time of year, health authorities do not know how much money they will receive next year, but they will know fairly soon. I hope that the authorities will appreciate the point made by my hon. Friend the Member for Lewes in this debate and bear in mind the situation facing St. Peter and St. James's hospice when they consider the disposition of their resources, which have been increased in real terms. I hope that they will consider the situation very carefully when they know where they stand.
| Next Section
| Index | Home Page |