Comment: The case for hospice funding

Health service provision in the United Kingdom currently finds itself at a critical juncture. The new coalition government has quite rightly taken up the mantle for setting out measures that seek to help the NHS adapt to the many new challenges that will present themselves in the future.

By Dr Daniel Poulter MP

As a hospital doctor, I came into politics to use my firsthand experience of our health system to help make necessary changes in healthcare services, to reduce the administrative red-tape and bureaucracy that envelopes the NHS, and support funding arrangements that best suit the interests of patients.

In my career, I have always found hospices not only an invaluable provider of care for local communities, but also as a significant instrument for social cohesion; their role in helping individuals, and families of individuals, diagnosed with terminal illnesses come to terms with death and dying can never be underestimated.

Since the formation of St. Christopher’s Hospice in London, our attitudes toward death have taken a fundamental shift in embracing the need for providers of palliative care to help patients and their. As the hospice movement has progressed, so too has the empowerment of individuals to make decisions over their end of life care.

That is why it is no surprise to me that the hospices I have encountered have focussed their efforts and resources on taking care and services to people’s homes and out in the wider community. As our population of over-75s is forecasted to increase to 8.7 million people in 2033 (4.8 million as of 2008), the need for well-resourced hospices is one that will be increasingly relevant to all fellow MPs and their constituents.

As the government looks to initiate many reforms of our health services, there can be few that are better able to adapt to changing circumstances. I admire the way in which St Elizabeth’s Hospice in Ipswich, that serves my constituency, has been able to modernise its services. I believe that one current problem that we have in our health system is that services are too reactive to patients’ needs, as opposed to being proactive. Not only is this not in the best interests of individuals in need of care, but it also puts a significant strain on the finances of our health services.

In St Elizabeth’s (and other hospices), methods of modernising its services have come in three key areas:

– Providing holistic therapies that support patients with other aspects of their terminal illnesses, for example anxiety, stress and pain relief.
– Being able to support the family members of individuals with terminal illnesses through the processes of caring and dying.
– Taking more workers out to the community to have in house visits. This is especially frequent in our rural areas, where patients are much less likely to be able to get to hospices.

However to help continue the changing and innovative work in hospices around the country, there needs to be a greater recognition by the government of how reliant their local hospices are on the benevolence of their constituents. On average, only one-third of hospice funding is provided by PCTs under the NHS. The other two-thirds are entirely reliant upon the public; whether it is donations, trusts, fundraising events, or private sector partnerships, it must be recognized how precarious the continued work of such valued institutions find themselves in.

I believe it is a marvellous testament to our local communities that despite the recent economic downturn, these donations were still sustained. However, in order for hospices to continue their expanding services, it is crucial they are brought into the mainstream of health reforms, and are allocated a seat at the table with Commissioning Boards on how we can proactively plan for the challenges set by our ever-ageing population.

I am encouraged by the reforms under the health and social care bill. I believe that the per-patient approach will help equip hospices with the means to bring closer together the patient, their families and their local hospices.

Hospices rely upon their ability to provide a frontline service that can engage in communities, taking the care to the patient. In addition, I welcome the Palliative Care Funding Review that looks to ways in which institutions in palliative care can be initiated, and provisions toward specialised palliative teams that have an in-depth knowledge of the needs of patients and families with terminal illnesses. Finally, I am encouraged that it is becoming more recognized that hospices and palliative care are not synonymous only with cancer sufferers. Motor Neurone Disease, COPD and Heart Disease are all very common terminal illnesses are readily taken up by hospices and their services.

As we all push for the Big Society, I believe that it would be a missed opportunity to overlook the role of hospices. Quite apart from the ageing population forecasts, hospices provide local communities a firm platform of stability through the most painful of times; individuals are helped with chronic pain and anxieties, a semblance of isolation is eroded, and their families are helped to come to terms with the death of a loved one.

The government has made clear its intention to change our health care structure for the better. Well-resourced local hospices will continue to be a keystone through such changes.

Dr Daniel Poulter is the Conservative MP for Central Suffolk and North Ipswich

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