Contribution
The old adage we often hear is that there are two certainties in life—taxes and death. We spend a lot of time in this House talking about the former and very little time speaking about the latter, even though we know it will affect us; I have argued that both as a doctor and in this House since I was elected.
I take my hat off to the hon. Member for Altrincham and Sale West (Mr Rand) for securing this debate. It is so important and it will affect all of us. We are informed by the work of our constituents, so I also put on record my thanks to Mike for his incredible story and for the memory of Sarah that he has brought to this place, at the highest level, so that we can have this debate about how we can improve the condition of those in their time of greatest need.
In the few minutes I have, I will distil this debate into three areas: first, the location of mental health care, secondly, the workforce and, thirdly, the plan. On the first point—I have raised this with the Minister before—hospices often provide a lot of mental health support, but they are struggling. Many are closing beds and many are in deficit. Together for Short Lives estimates that the national insurance contributions increase costs an average hospice at least £130,000. After a previous debate on hospices, I asked the Government in a letter of 10 November, to which I have not yet had a response, whether they will consider an impact assessment on the state of hospices.
The National Audit Office’s report into hospices states:
“DHSC and NHS England do not know what proportion of the total amount of palliative and end-of-life care provided in England is delivered by the independent adult hospice sector, and therefore how reliant they are on the sector.”
That is an important point in understanding the fabric and make-up of provision, as well as the postcode lottery in provision, which the hon. Member for Dewsbury and Batley (Iqbal Mohamed) pointed out. If we want to improve provision, we need to understand what is there in the first place.
To do so, we need to provide a workforce, as I also said in the letter. A letter I received from the Government on the topic of hospices stated:
“This summer, we will publish a refreshed NHS long-term workforce plan to deliver the transformed health service we will build over the next decade so that patients can be treated on time again.”
I raised this issue in the November debate. We are now into December, and winter, and we still do not know when the NHS workforce plan will come forward. I would be grateful if the Minister could respond to that point. It is especially important given that, in the last Budget, the Government cut the proportion of spending on mental health care. At the time, the president of the Royal College of Psychiatrists said:
“It is illogical that the share of NHS funding for mental health services is being reduced at a time of soaring need and significant staff shortages.”
The previous Government brought in the mental health investment standard, but it is not clear whether this Government are adhering to it or keeping it in place. It will be important in ensuring that we have the investment to provide both the places and the workforce.
I welcome the bringing forward of the palliative care framework, which Opposition Members and many others on both sides of the House have asked for. I am pleased that the Government have set that out, because it will be the framework that provides the care we need across the country. It is also timely, given that the Terminally Ill Adults (End of Life) Bill is going through Parliament. An amendment to the Bill, which was nodded through with support from both sides of the House, will ensure that there is a financial plan for what palliative care should look like. It will be imperative that considerations about mental health care for the terminally ill are involved in that framework.
In his November debate, the hon. Member for Strangford (Jim Shannon) raised the issue of a 24/7 palliative care helpline, which many across the House and many charities have asked for. In the debate—before we had heard about the framework—I asked whether that would be looked at as part of the framework, because that 24/7 point of contact could form part of the mental health support that families get when they are struggling and in their time of need. I would be grateful if the Government would consider that.
I appreciate that this is not in the Minister’s brief, but I would also be grateful if he could set out how the palliative care framework will be put together. Who are the stakeholders? How can people like Mike and interested Members contribute to ensuring that we get it right? We want this House to do it only once; we want to get the framework right for England, and hopefully across the home nations as well, so it will be incredibly important that all stakeholders are involved.
We in this House need to ensure that others can hold what those who are struggling find too heavy to hold. That is the essence of what we are trying to do, whichever side of the House we are on or whether, like Mike, we are outside this House. We are trying to make sure that when someone is in their time of need, and when they feel the burden is too heavy, they can hand it on to someone else, who will help to carry that load.