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The voice of Scotland’s vibrant voluntary sector

Published by Scottish Council for Voluntary Organisations

TFN is published by the Scottish Council for Voluntary Organisations, Mansfield Traquair Centre, 15 Mansfield Place, Edinburgh, EH3 6BB. The Scottish Council for Voluntary Organisations (SCVO) is a Scottish Charitable Incorporated Organisation. Registration number SC003558.

Programme for Government: has palliative and end of life care been forgotten? 

This opinion piece is 7 months old

Scottish Government's commitments should have gone further

The recent Programme for Government (PfG) set out by First Minister Humza Yousaf is a welcome assurance of the Scottish Government’s commitments for 2023-24 and it’s promising to see how equality, opportunity, and community will be prioritised in the coming year.  

Ambitious strategies to tackle child poverty and support economic growth are encouraging for Scotland as a whole. While the recovery of the NHS and supporting the health and social care workforce is a priority in the PfG, the care provided to dying people was overlooked. 

Disappointingly, the PfG makes no mention of palliative and end of life care especially at a time when demand for palliative care in Scotland is rising rapidly and the care people need is becoming increasingly complex.

Two years ago Scottish Government promised a new palliative care strategy within the year. Numerous delays and false starts later, work on the new strategy has only just begun and we do not know when it will be delivered. Yet the PfG has made no commitment to when the strategy will be published. 

The PfG is a key opportunity to recognise and support the contribution of all sectors across health and social care, including, critically, the unique role of the voluntary sector such as charitable hospices. While the PfG makes passing reference to the third sector it’s disappointing that this falls far short of the much greater priority placed on the role of business. To address the challenges facing Scotland we all need to work together, with the third sector recognised and valued as equal partners. 

Charitable hospices deliver vital end of life care and often hold special places in people's hearts, yet, in common with other third sector partners, they’re frequently forgotten when it comes to long-term health and care planning.  

Hospices are key partners to the wider health and care system. They provide essential public services that keep people out of hospital, support them to stay at home and provide significant value for money by reducing demand on health services. 

But their statutory funding is limited, relying on charitable fundraising to pay for the majority of their care. And right now is an incredibly challenging time for hospices. The cost of paying their dedicated staff a fair wage has risen by £15.5 million for 2022-24, all whilst the cost of living crisis affects the ability of their local communities to give as generously as they have before. 

Hospices are facing rising costs year on year but their statutory funding fails to keep up. There’s an urgent need for a new national funding framework for hospice care – which the first minister promised to hospices when he met them in his previous role as health secretary back in March, but there was no corresponding commitment within the PfG. 

The PfG would have been a great opportunity to integrate palliative and end of life care into wider health strategy. 

Plans to improve workforce planning would do well to include hospice staff. Promising a practice and culture with a focus on collaborative, compassionate leadership, wellbeing and equality to deliver a more sustainable and skilled workforce is something that should be extended to include the whole health and social care sector, including hospice staff.  

Similarly, ambitions to significantly reduce delayed discharge and hospital occupancy could be improved by working in partnership with palliative and end of life care providers. 

The PfG promised to continue work on the National Care Service legislation, working in partnership with people who access and deliver services as well as trade unions. It is vital that this includes working in partnership with providers of palliative and end of life care, to recognise and respond to the growing need for palliative care, and ensure the contribution of the third sector is recognised, valued and given an equal voice. 

The PfG’s focus on equality, opportunity and community is welcome, but the exclusion of palliative care – which intersects all three – is shortsighted. Hospices, in common with the rest of the third sector, are ready and willing to help, but they must be given a seat at the table to ensure health strategy looks after people from their first days, to their last. 

Helen Malo is policy manager for Scotland at Hospice UK.