NEWS

Hospices may have to turn dying people away as running costs crisis grips

14 November 2024
by Graham Martin

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Sector leaders make dire warning after UK Government NI hike

Hospice charities say the cash crisis now engulfing them is so bad they will have to turn people away as they cut services.

They say they face an "insurmountable funding gap" due to a perfect storm of rising costs, not least the UK Government’s recently announced employer National Insurance (NI) hike.

Charities say they cannot match NHS pay awards for consultants and nurses, with these coming against a backdrop of spiking transport, food and heating bills.

In a letter published by The Herald, the heads of 14 hospice charities say their funding model is “grossly unfair” and have called for a new, sustainable model to be included in next month’s Scottish Government budget.

The alternative is that that will have to cut services and turn dying people away.

They write: "Hospice care is always free. There is now a risk that, for the first time ever, hospices will have to turn people away.

"Cutting services is the last thing any of us want to do. It would break our hearts.

"We promise to do everything we can to avoid that, but we also have to balance the books."

TFN has published the letter, including a list of all signatories, in full below.

The alarm being sounded by hospice bosses adds to that coming from the wider charity sector, where there has been dismay over the imposition of employer NI hikes for charities.

Rhona Baillie, chief executive of the Prince and Princess of Wales Hospice in Glasgow, said it had begun the year with a £500,000 deficit which they "worked very hard" to eliminate through cuts to day-to-day running costs, but that the recent combination of national insurance and pay hikes had added another £500,000 to its expenses.

The hospice costs £9 million a year to run, and gets around £2.4m from government - a sum Baillie said had "not significantly changed" despite spiralling overheads.

She said: "I've been in this job 20 years and this is the worst position I've ever known us to be in.

"We've already made efficiencies in every single area we could apart from patient services and staff because we really don't want to do that, but there's nothing else left for us now.

"I can't emphasise enough that we really don't want to cut staff and services - that would be a last resort, but that's where we are headed."

A Scottish Government spokesman said: “We are deeply concerned that many vital frontline services – including hospices – are facing uncertainty due to the impact of the UK Government’s increase to employer National Insurance.

“We are aware that the UK Government has suggested that it will develop support for the hospice sector and we are seeking clarification as to what this might mean in practice.

“Independent hospices are highly valued and we understand the pressures they are facing, which is why health ministers continue to engage with the sector and hold open and honest discussions with hospice leaders, as well as continuing to work with the Integrated Joint board chiefs and independent hospices to support the longer-term sustainability of planning and commissioning.”

UK health secretary Wes Streeting has said that the UK Government will "make sure we're protecting our hospices" by providing extra financial support to help with rising National Insurance contributions for employers.

Details will of what this means will be be announced "before Christmas", he said.

HOSPICE LEADERS' LETTER IN FULL

Hospice funding is in crisis. Hospices in Scotland provide dignified care for around 21,000 patients and their families every year, but are struggling enormously.

Hospices are a key part of the health and care system, but we aren’t part of the NHS.

We are charities that rely on generous donations and fundraising to employ thousands of nurses, doctors, physiotherapists, counsellors, and support staff.

When NHS salaries rise, hospices face the extra costs, but aren’t covered by the government pay awards. This is grossly unfair.

This year alone, salaries have risen by 5.5% for NHS clinical and support staff and 10.5% for consultant doctors.

For hospices, matching this is near impossible.

The cost of heating, transport and supplies has soared. From April, the National Insurance hikes alone will add a further £2.5m to hospices’ wage bill.

And the share of NHS funding for hospices is declining. Scottish hospices face an insurmountable funding gap.

Hospice care is always free. There is now a risk that, for the first time ever, hospices will have to turn people away.

Cutting services is the last thing any of us want to do. It would break our hearts. We promise to do everything we can to avoid that, but we also have to balance the books.

It doesn’t have to be like this. The Scottish budget is an opportunity for our political parties to forge a new course.

Hospices are the core of palliative care, not just a place people go to die.

Our dedicated staff work in hospices, in patients’ homes, NHS hospitals and other care settings. They help people live for whatever time they have remaining.

They provide specialist education and training to NHS colleagues. They prevent many people being admitted to hospital and help others to die with dignity in their home or a hospice.

They support families in grief and help them recover.

Supporting hospices is not only the right thing to do for patients and families; it is the right thing to do for the health care system. Hospice care reduces pressure on our overstretched NHS.

As people live longer, Scotland will need more hospice care.

With sustainable hospice funding, people’s experience of death and dying in Scotland could be transformed. The Scottish Parliament can help us do that.

Ahead of the Scottish Government Budget in December, we are urgently calling for cross-party consensus on sustainable hospice funding, so care at the end of life is as it should be and everyone has access to palliative care where and when they need it.

Decision-makers can’t let this opportunity to support these vital services pass by.