Terminal Illness: Mental Health Support

Luke Evans Excerpts

Wednesday 3rd December 2025 Westminster Hall

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

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.

[The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)]

It is a pleasure to serve under your chairmanship, Sir Jeremy, and I start by sincerely thanking my hon. Friend the Member for Altrincham and Sale West (Mr Rand) for securing this debate. I also welcome Mike and his family to the Public Gallery, and pay tribute to Mike for all his efforts.

My hon. Friend raises an important issue that can affect so many people—all people perhaps, at some point—about ensuring that when someone is diagnosed with a terminal illness, they can receive the mental and emotional support that they need in the place that they need it. We want to be a society where every person receives high-quality, compassionate and personalised care from diagnosis through to the end of life. The Government are determined to shift more healthcare out of hospitals into the community to ensure that patients receive personalised care in the most appropriate setting.

Palliative care and end-of-life care services, including those provided by hospices, have a big role to play in that shift. Palliative care services are included in the list of services that an integrated care board must commission, promoting a more consistent national approach and supporting commissioners to prioritise palliative care and end-of-life care. To support that process, NHS England has published statutory guidance stating that ICBs must work to ensure that there is sufficient provision of care services to meet the needs of their local population. It also includes references to mental health, wellbeing and support for those with palliative care and end-of-life care needs.

Of course, there are many examples of voluntary initiatives, such as grief or bereavement cafés, or the Good Grief community, which aims to support people at the end of their life and their families through a programme of events and courses, and the provision of resources that often include pre-bereavement advice and support.

I know that my hon. Friend the Member for Altrincham and Sale West feels passionately about mental health support for those with palliative care and end-of-life care needs, and that he has been supporting Mike’s campaign for improved mental health services and support. I offer him my deep appreciation, as well as a meeting with the Minister for Care and end-of-life care officials, so that we can engage him around the palliative care and end-of-life care modern service framework that was recently announced, which we hope to publish in the spring.

The Government are also transforming the current mental health system, ensuring that people get access to the right care at the right time in the right place. That is why we are increasing our investment in mental health support by £688 million in cash terms.

The hon. Member for Hinckley and Bosworth (Dr Evans), who spoke for the official Opposition, talked about impact assessments. I gently say to him, in the context of this convivial and constructive debate, that when we came into office we had an impact assessment by virtue of the Darzi review, which highlighted in stark terms the difficulties that the NHS in its totality is under after 14 years—the difficulties that we inherited. I also point out that our real-terms investment of £26 billion is an increase to the NHS budget that will translate into, among many other things, a new national cancer plan. That will examine not only the process of getting the best treatments to patients, but improving communication, improving pathways, and instilling better and more bespoke mental wellbeing support into some of those pathways.

[Dr Evans]

The Minister is indeed right to say that there was an injection of cash, but the proportion of funding being spent on mental health was actually cut. The written ministerial statement is very clear that that proportion went from 8.78% to 8.71%, which the royal college said was about £300 million of investment. Can he confirm from the Dispatch Box—if he cannot, he can write to me later—whether the Government are still committed to the mental health investment standard, or is that commitment going to change? Currently, it is unclear whether they are still committed.

[Dr Ahmed]

The mental health investment standard is something that we expect ICBs to meet. I will gently push back on what the hon. Gentleman is saying because, as we have been so succinctly reminded in this debate, investing in mental wellbeing is about more than just headline figures. For instance, we need psychology in oncology, in children’s health, and in other forms of cancer care. The provision of such services is not always recorded in the way that the hon. Gentleman would wish it to be recorded, but there are still formats and sub-types of mental health support.

The Government are also keen to press ahead with our 10-year plan, and we are setting out ambitious plans to boost mental health support across the country while delivering the shift from hospital to community. As part of that process, we wish to open around 85 mental health emergency departments, reducing pressure on busy A&E services, which are the last places that people with mental health needs should be, and ensuring that people have the right support they need in a calm, compassionate environment.

We will also use new integrated health organisations to break down barriers between services, which I also think is really important in the context of this debate, and to ensure integrated and holistic care, addressing both physical and mental healthcare needs, with more freedom to determine how best to meet the needs of those local populations. That will build on the work that has already begun to bring down waiting lists. As I said, we are investing an extra £688 million this year to transform mental health services. On staffing, I am pleased to say that almost 7,000 extra mental health workers have been recruited since July 2024, against our target of 8,500 by the end of this Parliament.

We are also expanding talking therapies, and we have committed to continuing that expansion over the coming years. More adults already benefit from better access to those therapies, and the aim is for over 900,000 people to complete a course of treatment with improved effectiveness and quality of services by March 2029. Anyone who develops a common mental health condition, such as anxiety or depression, in any context, including terminal illness, can self-refer to talking therapies. [Interruption.]