Terminal Illness: Mental Health Support
Debate between Zubir Ahmed and Luke Evans(2 weeks, 1 day ago)
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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.]
Ageing and End-of-life Care
Debate between Zubir Ahmed and Luke Evans(1 month, 2 weeks ago)
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Dr Ahmed
I am very concerned to hear what my hon. Friend has reported to the House. Clearly, coercion is unacceptable in all forms. Safeguarding is taken very seriously by the national health service and by the Department of Health and Social Care, and as the Minister with responsibility for patient safety, I am very happy to look into that further and to take it up with him after the debate.
As set out in the 10-year health plan, we are going to shift more care out of hospitals and into communities, and make care more personalised. If there is anywhere where that is most important it is palliative care and end-of-life care. Palliative care and end-of-life care, including hospices, have a big role to play in that shift, and they were highlighted in the 10-year plan as an integral component of neighbourhood health teams.
In England, integrated care boards are responsible for the commissioning of palliative care and end-of-life care to meet the needs of the local population. To support ICBs in this duty, NHS England has produced statutory guidance. That includes the need for 24/7 access to palliative care and advice, and a palliative care and end-of-life care dashboard that brings together all relevant data in one place. The dashboard helps commissioners understand the palliative care needs of the local population. Of course, the majority of palliative care and end-of-life care is provided by NHS staff and NHS services, and that has benefited from the record funding in the NHS that the Chancellor delivered in the last Budget.
I will not be able to address all the points made by the hon. Member for Hinckley and Bosworth (Dr Evans), as he was in a typically verbose mood, but if he wills the ends, he must will the means, and if he does not agree with the means, he must present his thesis as to the alternative model of funding that he wishes to see. Otherwise, it is a case of cutting services.
However, we recognise the vital part that voluntary sector organisations, including hospices, play in providing support to people at the end of their lives and to their loved ones. In recognition of that, £100 million of capital funding has been made available to hospices in England to ensure that they have the best physical environment for caring. That includes helping hospices to provide the best end-of-life care to patients and their families in a supportive and dignified environment. It includes funding to deliver IT systems and provide refurbishments and facilities for patients and visitors, so that they can see their family members at the end of their lives in a dignified environment—much more than just a lick of paint.
Dr Evans
Given the recent National Audit Office report and the fact that the tax increase to national insurance contributions has had the biggest impact on the voluntary sector, has an impact assessment been carried out into how much the cost has gone up for hospices in England to provide their services? If not, will the Minister consider it?
Dr Ahmed
The hon. Gentleman knows that the NAO report covers a period both when his party was in government and beyond. I go back to the point about NICs. If he wills the end, he must understand the means. I am very happy to have that conversation with him at length after the debate, respecting the confines of the time that I have—I do not want to test your patience, Madam Deputy Speaker.
I am delighted that the first £25 million of the £100 million fund has been passed to Hospice UK and has been spent on capital projects already. The Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), visited Katharine House hospice earlier this year, Wigan and Leigh hospice in July, and Noah’s Ark children’s hospice earlier this month to see directly for himself how that record investment is making a meaningful impact on the ground. We can confirm that the Department of Health and Social Care has now transferred the rest of the £75 million to Hospice UK for onward spending in 2025-26. We are also providing £26 million of revenue funding to support children and young people’s hospices. This is a continuation of the funding that, up until recently, was known as the children’s hospice grant. That funding will see circa £26 million allocated to children and young people’s hospices in England each year via local integrated care boards on behalf of NHS England. This amounts in total to £80 million of hospice funding over the next three years.
For many of us who are in good health, managing complexity and ageing seems a distant idea. The Government recognise that the number of people with palliative care and ageing needs is projected to rise significantly over the next quarter of a century. That is why we are shifting more healthcare out of hospital and into communities through our plan for change. That is why we are investing, through the National Institute for Health and Care Research, over £3 million in a policy research unit in palliative and end-of-life care. The unit launched in January 2024 and is building the evidence base on palliative care and end-of-life care.
Earlier this year the Minister of State for Care and, more recently, the Secretary of State met key palliative care and end-of-life care and hospice stakeholders at dedicated roundtables, and focused that discussion on long-term sector sustainability within the context of the 10-year plan. Following the recent publication of the plan, the Minister of State for Care tasked officials to work at speed to generate proposals to improve the access, quality and sustainability of all-age palliative care and end-of-life care as we start to implement the plan.
In closing, I hope that those measures assure the hon. Member for Strangford of the Government’s seriousness to build a sustainable palliative care and end-of-life care sector for the long term.
Dr Ahmed
I will not, in the interests of time.
I reiterate my thanks to the hon. Member for Strangford for bringing forward this vital issue, and I thank all hon. Members who have spoken today. He can be assured that he has raised the voice of those who deserve dignity at the end of their lives, and that his call has been well and truly heard by the Government.