The Government will provide a financial lifeline to the hospice sector amid fears end-of-life care providers are at risk of closure due to the double blow of employer national insurance increases and rising wages. The Guardian understands that this is likely.
Authorities are considering options to provide more funding for hospice and other end-of-life care through the NHS, in part to offset the impact of the National Insurance hike, which would cost £30m a year in premium increases. The industry believes this is possible.
Hospices are already struggling to raise wages to match the 5.5% pay rise given to civil servant healthcare workers, and estimates they will be short by around £60 million more across hospices.
Whitehall officials said no deal had been finalized, but it is understood that three main options were being considered. One would offset all or part of the National Insurance contribution increase for non-NHS end-of-life care providers. Provide funding for staff pay rises in line with the terms of the NHS contract each year. Or a direct funding line for hospice rather than broader end-of-life care.
Asked about the plight of hospices last week, Chancellor Rachel Reeves suggested it was “a problem for the NHS to allocate funding to, for example, hospices and GP surgeries”. Integrated care boards within the NHS have been given a duty to commission palliative and end-of-life care from 2022, but the sector says the extent to which this happens is patchy and that only a third of its funding 2 said it still comes from the voluntary sector.
MPs said Health Secretary West Street had privately told them he would address the funding crisis facing the end-of-life care sector. Last week, a message was circulated in a WhatsApp group of Labor MPs suggesting he was working on a solution.
The debate on assisted dying, scheduled to take place in Congress in late November, is likely to provide an opportunity for a more fundamental review of hospice funding. The bill will consider whether to allow assisted dying for terminally ill patients within the last six months of life.
A number of ministers previously supported the idea, but Mr Streeting is believed to have changed his mind, saying the palliative care system is not “the place we need to be to give people real choice”. They are concerned and are unlikely to vote in favor of the bill. .
Labor MP Rachel Maskell, who opposes assisted dying, said the end-of-life care sector needed to be improved to give people better access to medicines and appropriate care options when faced with a terminal diagnosis.
“The hospice sector is severely under-resourced… but palliative care has a lot to offer. In the assisted dying debate, we hear many tragic stories of suboptimal deaths, but quality It would have been much better if they had provided better medical care.”
The Department of End-of-Life and Hospice remains neutral on the debate regarding assisted dying. But it has repeatedly warned that more funding will be needed to avoid post-budget cuts to services.
The Marie Curie charity has written to Streeting, saying recently announced increases in employer national insurance contributions will cost the charity an additional £3m a year and will cut services without further support. He warned that he had no choice but to do so.
Ruth Driscoll, the charity’s associate director of policy, said: [the national insurance] However, these costs are recurring, so one-time funding is not sufficient. The challenges facing palliative care are truly significant. new NHS long term planning And the comprehensive spending review in the spring should set out a very clear approach to transforming these services in the future. ”
Toby Porter, chief executive of Hospice UK, which represents more than 200 hospices, said: ‘Too many hospices are already in the red as years of NHS funding have failed to keep up with the rapidly rising costs of providing care. “We’re cutting back on services,” he said.
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“The rise in Employer National Insurance from April will cost the average hospice hundreds of thousands of pounds, making the situation even more serious and urgent. We plan to set a budget for the next fiscal year.
Meanwhile, the Labor MP who tabled the assisted dying bill said the law would feature the “strictest protections” against coercion anywhere in the world and the bill could be more than 40 pages long.
Kim Leadbeater warned that current policies could lead to people with a death wish having to travel abroad to end their lives.
Writing in the House of Commons Journal, Mr Leadbeater said his proposals would “give hope to terminally ill patients who have a clear, informed and calm desire for a better death, while at the same time It protects everyone in the country from coercion and pressure.” Making decisions that are not right for you. In fact, my bill contains the most stringent protections and guarantees of any law in the world. ”
A government spokesperson said: “We want everyone to have access to high-quality end-of-life care, and we recognize the financial pressures facing the hospice sector and the enormous generosity of the British public, of which donations make up a significant portion. I am aware of hospice funding.
“We are determined to move more care into the community and ensure patients and their families receive high-quality, personalized care in the most appropriate setting. Hospice will play a huge role.”
