Meeting of the Parliament 06 December 2023
I am delighted to be able to speak in this important debate in the name of my colleague Sue Webber.
Scotland’s ageing population means that more people will need palliative care in the years to come, and it is therefore vital that we ensure the financial viability of hospices and the third sector delivery of that care. To put that into context, it is estimated that, by 2040, 60,000 people will die with a palliative care need, representing a 20 per cent increase in demand; the number of people dying with more than one terminal condition will have increased by more than 80 per cent; and two thirds of all deaths in Scotland will be in a community setting such as people’s own homes, care homes and hospices.
We know that people in the final year of their lives are significant users of unscheduled care, with nearly 500,000 service contracts across Scotland. Thus, services must be available 24 hours a day. That is why hospices and third sector partners are so important. They reduce pressure on unscheduled care services, which cost the NHS a staggering £190 million a year for those in the final year of their life.
I note the financial constraints that are placed on charitable hospices with regard to matching NHS pay awards, making it impossible to operate in a financially secure way, which has forced the sector into a £16 million deficit for this current year. I also note the need for a new national funding framework for hospice care to ensure the financial stability of the sector. However, I would like to focus my remarks on CHAS.
I am privileged to have the Rachel House children’s hospice in Kinross in my region, and I know that everyone will be aware of the fantastic work that CHAS does to support families and patients. For more than 30 years, CHAS has been Scotland’s only children’s hospice service, and it works diligently to ensure that no one should face the death of their child alone. It provides world-class emotional, practical and medical support from the point at which the child’s condition is diagnosed right through to bereavement or transition to adult services. I have visited Rachel House and can say that the whole surroundings are perfectly arranged to make what is a very difficult time as comforting as possible. We need only look at some of the testimonials to truly see how amazing the service is. One parent said:
“The death of a child is indescribably devastating and we will always be grateful to the entire CHAS team. I cannot imagine getting through those days, weeks and months without their support”.
Unfortunately, the need for the service that is provided by CHAS has never been higher. According to the latest available figures, in the coming years, the number of children in Scotland who die young might rise by more than 40 per cent, and there is no evidence that that number is dropping. However, CHAS is facing undue pressures, with a budget deficit of £2.3 million this year. That is largely due to the unavoidable cost burden of trying to match NHS pay awards in an organisation where staffing costs represent 75 per cent of its expenditure. Having to ensure that the charity remains competitive within the specialist care market leaves it with little option but to do all that it can to match the comparative grade levels in the NHS. However, CHAS does not receive any additional statutory funding when NHS awards are made, which leaves it at a massive disadvantage. That is even more significant when we realise that 70 per cent of the charity’s income is raised through the amazing generosity of the Scottish public.
The stark reality is that the Scottish Government’s funding for CHAS is declining. In 2016, the then Cabinet Secretary for Health, Wellbeing and Sport committed to public funding for pay parity between children and adult hospices at 50 per cent of agreed costs. Unfortunately, that actually came to 30 per cent.
As another parent told the Scottish Government, investment is needed and
“this service is a vital service for those who will lose a child due to chronic illness … put the needs of our precious children as a priority, Please.”
I urge the Scottish Government to meet its programme for government commitment to sustainable funding to ensure that CHAS continues the excellent work that it provides to Scotland’s terminally ill children and their families. Again, I thank my colleague Sue Webber for bringing the topic to the chamber.
17:50