The government is likely to provide a financial lifeline to the hospice sector amid fears that end-of-life care providers are at risk of closure due to the double whammy of employers’ national insurance increases and higher labor costs, the Guardian understands.
Officials have been looking at the possibility of providing more funding for hospices and other end-of-life care through the NHS, partly to offset the impact of the national insurance increase, which the industry says could save the sector £30 million a year costs.
Hospices were already struggling with higher wage costs to offset the 5.5% pay rise for public medical workers, with the sector estimating an additional shortfall of around £60m in total.
Whitehall sources said it was not yet a done deal, but it is believed three main options had been considered: offsetting some or all of the national insurance rise for non-NHS providers of end-of-life care; funding for staff pay increases to match NHS terms each year; or a direct funding pot for hospices rather than end-of-life care more broadly.
Rachel Reeves, the chancellor, suggested last week that it was a “matter for the NHS to deal with the allocation of money to, for example, hospices and GP practices”. Integrated care boards within the NHS have had a duty to establish palliative and end-of-life care since 2022, but the sector says the extent to which this is happening is patchy – and two-thirds of funding still comes from the voluntary sector.
MPs say West Streeting, the health secretary, has privately told them he will tackle the funding crisis facing the end-of-life care sector. Last week a message circulated in the Labor MPs WhatsApp group suggesting he was working on a solution.
The assisted dying debate, which will take place in parliament at the end of November, is likely to provide an opportunity to rethink hospice financing more fundamentally. The legislation will consider whether assisted death should be allowed for terminally ill patients in the last six months of their lives.
Many ministers have supported the idea in the past, but Streeting is said to have changed his mind and is unlikely to vote for the legislation as he fears the palliative care system is not “where it needs to be to give people real choice”.
Labor MP Rachael Maskell, an opponent of assisted dying, said improvements in the end-of-life care sector are needed so people can have better access to medicines and good care options when facing terminal diagnoses.
“The hospice sector is extremely under-resourced… but there is so much that palliative medicine can provide. In the assisted dying debate we hear many tragic stories of sub-optimal deaths, but if high quality facilities had been put in place it could have been so much better.”
The end-of-life and hospice sector remains neutral regarding the assisted dying debate. However, it has repeatedly warned that more funding would be needed to avoid cuts to end-of-life services after the Budget.
The charity Marie Curie has written to Streeting saying the recently announced increase in employers’ national insurance contributions would cost the charity a further £3 million a year, warning that without further support, reducing services would be the only option.
Ruth Driscoll, the charity’s deputy director of policy, said: “It is really vital that there is immediate funding to tackle the problem (national insurance) but these costs will be repetitive so one-off funding will not be enough. The challenges facing palliative care are truly significant. The new one NHS Long Term Plan and the comprehensive spending review in the spring should set out a very clear approach to transforming these services in the future.”
Toby Porter, the chief executive of Hospice UK, which represents more than 200 hospices, said: “Far too many hospices are already cutting back on their services as NHS funding has failed to keep pace with rapidly rising healthcare costs for years.
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“The increases in employer contributions from April will cost the average hospice several hundred thousand pounds and have made the situation much more serious and urgent. Hospice charities will set their budgets for the next financial year in the next two months.”
Meanwhile, the Labor MP who introduced the proposed assisted dying legislation has said laws would provide the “strongest protection” against coercion anywhere in the world, with the bill potentially running to more than 40 pages.
Kim Leadbeater has warned that existing policies mean people with a firm death wish have to travel abroad to end their lives.
Leadbeater wrote in House magazine that her proposal “offers hope to terminally ill people with a clear, informed and firm desire for a better death, while at the same time protecting anyone nearing the end of their lives from coercion or pressure.” to make a decision that is not good for them; Indeed, my bill will contain the strongest protections and safeguards of any legislation in the world.”
A government spokesperson said: “We want everyone to have access to high-quality end-of-life care and are aware of the financial pressures facing the hospice sector, and the enormous generosity of the British public, whose donations provide a significant proportion of care for take their account. of hospice financing.
“We are committed to shifting more healthcare to the community and ensuring patients and their families receive high-quality, personalized care in the most appropriate setting, and hospices will play a major role in that shift.”