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Hospices: Impact of NHS Pay Increases

Volume 791: debated on Monday 18 June 2018


Asked by

To ask Her Majesty’s Government what representations they have received from the hospice movement about the impact of the proposed increases in NHS pay; and whether voluntary hospices will also be able to access any additional funding being set aside to fund the proposed NHS pay increases.

My Lords, the Government received a number of written representations from hospices regarding NHS pay. The majority of NHS trade union members have now voted in favour of the Agenda for Change pay deal. This is welcome news that will help the NHS to reward, recruit and retain the staff it needs. We are now considering the impact of the agreement on non-NHS organisations such as hospices, and will consider carefully the NHS Pay Review Body’s report before making any final decisions.

I thank the Minister for his reply. Would he agree that, if the Government provided direct ring-fenced funding to improve the pay and the terms and conditions of support workers and all who deliver for the NHS, that would help employers to address the significant recruitment and retention problems and, ultimately, deliver a better service, not putting at risk the vital hospice beds that would be at risk in the voluntary and charity sector?

The noble Lord is quite right; the Agenda for Change pay deal obviously applies to NHS staff who are on the Agenda for Change contract. The deal was agreed and happily has been approved by the unions, precisely to reward NHS staff for the fantastic work they do, and to make sure that we can recruit and retain more. Clearly, as we go forward, for non-NHS providers, be they in social care or hospices, it is important that we do not cannibalise one workforce for the other. That is why we will look carefully at the conclusion of the pay review body’s report with regard to hospices.

My Lords, I declare my interest as chair of Hospice UK. Would my noble friend agree that the greater the extent to which hospices can discharge their functions, the greater the extent to which the pressure on NHS beds will be relieved? Is that not therefore a compelling reason for ensuring that a pay increase is met with regard to hospices?

My noble friend gives a compelling reason. It is salutary to note that while around half of deaths occur in hospital, most people—about 70% to 80%—would prefer to die at home or in a hospice, which means that we need to have a thriving hospice sector. That is why it is important to make sure that it can compete on a level playing field for staff.

My Lords, I declare an interest as the chair of Helen & Douglas House, the first ever hospice in the world for children. When I last spoke about this subject, the Minister invited me for a meeting. I am afraid that that meeting has never been proffered since, but I am delighted to tell the House that the threat of a meeting with a Minister was enough to get the clinical commissioning group to start paying towards our hospice. However, I echo the point made by the noble Lord, Lord Howard: that a hospice that is struggling for staff, which is then presented with a pay deal only for the NHS, will struggle more. Can the Minister really consider the effect of this on hospices?

I am sorry that that meeting has not taken place, and of course I am always glad to meet the noble Lord to discuss this issue. I am glad that the threat of a meeting has had the desired result, and clearly, I agree with him that we have to make sure that hospices are equally attractive places to work as is the NHS more broadly.

My Lords, I declare an interest as a vice-president of Hospice at Home in west Cumbria, where I live. This Question is very important. Does the Minister not agree that hospices work best when they work very closely with the health service? That is certainly the case in west Cumbria. We have become part of the co-operative provision of services and care to the community as a whole, but raising the necessary funds is a tremendous task. I hope that the Government will look very seriously at how hospices can be supported in ensuring that the nurses working for them with so much devotion are able to enjoy any improvements in the remuneration of nurses across the country.

I can reassure the noble Lord that we are looking at that. Hospices work closely with local CCGs, which provide around 30% of their funding. We estimate that around 9,000 nurses work in hospices, and clearly we want to make sure that that number not only stays level but increases so that we can start to deliver the choice that we have committed to in palliative care for people.

My Lords, the hospice movement helps over 200,000 patients every year, and they help not only the patients who are at that point in their lives but their relatives, leaving them with fantastic and positive experiences rather than the alternative which is available. The hospice movement is largely funded by the private sector—

I will quickly get to that—I have a very important question. The hospice movement is largely funded by the private sector—by public subscription, not by central government. Can my noble friend use his great skills, of which we are all admirers, to make sure that nothing that the Government do undermines the hospice sector and that we find ever more imaginative and successful ways to support such a vital role?

I will certainly do everything that I can. I agree that hospices are a fantastic example of the kind of mixed economy that this country does so well, with philanthropic and public contributions, and we must make sure that both those continue.

My Lords, I am sure that the Minister will be aware that this affects not just hospices, which of course are an integral and very important part of the health service, but the pay of those who work in all the charities and social enterprises which contract with the NHS. I would like to broaden the Question slightly from hospices and ask what the Minister’s reaction is to the Royal College of Nursing, which has called on the Secretary of State to establish a non-NHS national staff council to facilitate a more integrated way of looking at the pay of all nurses and healthcare staff in health and social care settings across the piece.

I was not aware of that proposal but I will certainly look at it and write to the noble Baroness with our response.

My Lords, it is not just hospices and social enterprises that are affected by the differential in the proposed NHS scales; the existing framework in Her Majesty’s Prison and Probation Service demands formal nursing qualifications but there is no contractual obligation on private operators such as G4S, Serco and Sodexo to follow those grading scales and there is already wide disparity. What will the Government do to ensure that HMPPS follows both the pay scales and the NHS scales?

It is important to reiterate that, in looking at one of the consequences of the Agenda for Change pay deal, the Government have committed to look at the impact not just on hospices but on staff who are not employed on Agenda for Change NHS contracts and to make sure that they are properly rewarded for the work they do.

Does my noble friend not think that the £20 billion offered by the Prime Minister for the health service is good news for the health service and for the hospice movement overall, and the first signs of a proper Brexit dividend?

This is indeed an important day in the history of the NHS, and I am delighted that it is a Conservative Government who are making this financial commitment. I look forward to having an opportunity to repeat my right honourable friend’s Statement tomorrow, when we will have more time to discuss its benefits.