Palliative Care: North Derbyshire

Jim Shannon Excerpts

Wednesday 17th December 2025 Westminster Hall

[Mr Perkins]

I absolutely agree with my hon. Friend. It is important to say that a half-hour debate is primarily an opportunity for a single Member to raise something with the Minister, and to get a ministerial response, but as my hon. Friends the Members for Derbyshire Dales (John Whitby) and for Bolsover (Natalie Fleet) made clear, it is an issue that is felt incredibly passionately right across the north Derbyshire community. My hon. Friend the Member for North East Derbyshire (Louise Sandher-Jones) would also have been here if she was not on Ministry of Defence duty in Gibraltar. It is an issue that many of us feel passionately about.

It is important to get across that, in those meetings, we wanted to establish what exactly the ICB’s current funding was paying for and how that benchmarked against the overall level of funding that hospices were receiving in other areas, and to get an agreement on an interim level of funding to enable the hospice to continue providing the current level of care while a more detailed investigation into the current cost of care was commissioned.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Gentleman for securing this debate. I spoke to him beforehand to suggest a helpful intervention. He rightly said that fundraising is important for the hospice, but NHS funding never covers more than a fraction of the cost. There are four distinct hospices in Northern Ireland that provide instrumental support in terms of end-of-life care for those who require it. Does the hon. Gentleman agree that there must be a national minimum NHS funding level for hospice care to ensure that services across this whole nation are not depleting as a result of lack of funding?

[Mr Perkins]

I absolutely agree. One of the frustrations that many of us in Derbyshire have felt is that there is no clarity on what a reasonable level of funding is and what the expectation is. There are rumours flying left, right and centre. In the middle of all this, the staff, the patients and the fundraisers are left wondering who to believe and what the situation is. I hope that, when we hear from the Minister, we will learn more about that.

In the summer, the ICB produced a comparison with NHS-funded care in the south of the county in an effort to show MPs that Ashgate hospice was too expensive, but has now disowned that comparison. After several months of pretty unsatisfactory discussions at which the two sides never reached a settled position even on what was currently being spent, the move from Derbyshire to a three-county ICB model saw a sudden withdrawal by the ICB of any suggestion of interim funding, forcing the hospice to go ahead with plans to make redundancies.

Our hospices receive an average of just a third of their funding from Government via the NHS and are reliant on fundraising for the rest. The Government contribution fell dramatically under the 14 years of the previous Government, leaving the gap for charitable hospices to make up even larger. Year on year, hospices such as Ashgate have expended any fat in reserve and are now faced with intolerable financial pressures. In today’s debate, I am seeking to make the case for a more equitable funding settlement for all hospices to gain greater clarity about the particular situation in Derbyshire and see whether anything can be done to stave off these terrible service closures and nurse redundancies in an institution that provides outstanding palliative care.

Let me touch on the national context. Hospice UK published research last month showing that 57% of hospices ended the last financial year in deficit, with 20% recording a deficit of over £1 million. That is actually a slight improvement on the staggering 62% of hospices that recorded a deficit a year before, thanks to the emergency £100 million of additional funding provided by this Government. A health system that relies on a sector so chronically underfunded that 57% of hospices are in deficit to provide care is simply not functioning. The Government are right to make it a priority to assist hospices such as Ashgate to get back on their feet.

Although it is true that this crisis evolved under the previous Government and sat there on the ballooning list of things to do when this Government came to power, many hospices like Ashgate had spent year after year dipping into their reserves and had no fat left to cut when the Government’s welcome increase in funding was accompanied by the rising employer’s national insurance, the minimum wage increases and the NHS pay increase, which is obviously relevant to the wider health community. Many hospices are on the brink. I join the call of many other MPs from across the country for a more generous funding settlement that recognises the crucial role that hospices play in our health system.

Turning to the local situation, it is immensely frustrating to all the Derbyshire MPs, to staff, to unions and to local fundraisers that even at this stage there seems to be a lack of clarity about the current cost of care and how that benchmarks against hospices nationally. A letter I received yesterday from the ICB repeats the suggestion that it has offered to commission an independent review and provide some financial mitigation linked to specific and agreed service mitigations, funded up to £100,000. Indeed, the ICB repeats its view that those financial investigations will be necessary if sustainable solutions are to be found to funding palliative care. Ashgate’s view is that there is no lack of clarity about what money is being spent on, and that it demonstrated that to the ICB’s director of finance at a recent visit.

The situation seems largely unchanged since late October, but many staff face the threat of redundancy, and in the run-up to Christmas some have reluctantly and heartbreakingly chosen to leave the hospice. For any member of staff in any profession, a job being under threat before Christmas would be deeply worrying, but it is important to stress that nurses in the in-patient wards at Ashgate hospice are not just any members of staff. As we have heard from my hon. Friends the Members for Bolsover and for Derbyshire Dales, they provide support for patients and families at their very darkest hour, when all else is lost and all that remains is the comfort provided by the knowledge that a dying loved one is comfortable and cared for in a beautiful, high-quality and caring environment. The emotional strain on those nurses is huge, and the public empathy and affection for them is widely felt. Their professionalism and compassion is renowned, and the effect of the threatened job cuts on them has been devastating.

Although in-patient wards deal with far fewer patients than out-patient and at-home services, many see them as the front door of Ashgate hospice, but they face the biggest cuts: there is a plan to reduce palliative care beds from 15 to six. In response, there has been an outpouring of support for Ashgate hospice from the community. Nearly £250,000 was raised in just two weeks, including an incredible £50,000 from the owner of a Chesterfield-based business, Peter Kelsey. Those funds will allow the hospice to keep open two additional beds for another six months, and care for perhaps another 25 patients near the end of their lives.

Hundreds of my constituents have contacted me and my colleagues to voice their concerns about the situation at Ashgate hospice, and many have also written directly to the ICB to make the case. Despite the claims and counter-claims, there is now widespread distrust that urgently needs clearing up. The ICB continues to imply that Ashgate services are too expensive, although there has been no formal update following the director of finance’s visit to the hospice on 1 December. Staff and unions have been left confused and concerned about the implication that the finances are not straightforward, and remain frustrated about the process. They have questions about whether every step has been taken to reduce costs.

Staff at Ashgate have been alarmed at communications coming out of the ICB, which they believe undermine their reputation for professionalism and financial prudence. If trust in Ashgate’s ability to run its operations is diminished, it will have grave consequences for future fundraising.

What is not in question is that the care that Ashgate provides is outstanding and that, as of this new year, dozens of north Derbyshire’s most gravely ill patients, who would previously have been able to obtain a bed at Ashgate, will die either at home in less comfort, with family members put in intolerable situations, or in an acute bed in the local hospital sector, possibly at greater cost and in less comfort than was the case last year. I want all my constituents to receive the best end-of-life care possible, so it is hugely disappointing that palliative care patients in north Derbyshire will lose access to those beds, and that nurses at the hospices will be worrying about whether they still have a job.

I want to shed light on the distressing and unacceptable situation of service cuts and redundancies at Ashgate hospice, and I seek further clarity and transparency about the funding situation for palliative care in Derbyshire to see whether anything can be done to hold at bay cuts to services at Ashgate.

Although charitable income will always play a vital role in hospice care, allowing hospices to deliver holistic care that goes way beyond NHS provision, hospices need fair and consistent Government funding, which needs to be transparent and clearly linked to contracts. Crucially, it must reflect local need. Whether a person lives in Chesterfield, across wider north Derbyshire or elsewhere in the country, they and their family should have access to quality palliative care when they need it most. I would therefore appreciate hearing the Minister’s response on several points.

First, will he join me in lamenting the devastating cuts at Ashgate hospice? Does he agree that this situation, whereby in-patient palliative care services in north Derbyshire are being reduced, is unacceptable? Will he or his office intervene to ensure that Ashgate hospice and the local ICB reach a transparent and agreed position on the current funding situation, and examine how that position compares with national expectations about funding of palliative care?

More broadly, will the Minister set out the Government’s plans to ensure sufficient and sustainable funding for hospices in the future? Can he confirm whether he has any concerns about the cost of care at Ashgate hospice? If he cannot, will he get this matter on the public record, so that people across north Derbyshire can be confident that the money they have raised through fundraising—hard-earned money—is being prudently spent?

Does the Minister agree that, six months after the beginning of discussions locally, it is completely unacceptable that there is still a lack of agreement about exactly how much is being spent on care by the ICB and how much commissioned care the ICB is funding? Can he do anything to provide clarity about this situation?

Since 1988, Ashgate hospice has provided exemplary care to thousands of dying patients in north Derbyshire. It must go on. Its nurses deserve better than to lose their jobs and to worry about whether something else could have been done. I implore the Minister to ensure that the hospice sector is given the support it needs to play its crucial role, and that locally in north Derbyshire every avenue is explored to save jobs and beds at this wonderful institution.