Hansard

It is a privilege to lead the final debate in 2023 of Scotland’s Parliament to congratulate Marie Curie on celebrating its 75th anniversary this year.

That we have such a parliamentary debate just before Christmas is fitting. As many of us head off for our Christmas break, the work of Marie Curie staff will continue undiminished. They will provide dignified, respectful, caring and compassionate palliative and end-of-life care in a hospice setting and in people’s homes over the entire holiday period. That will not stop. Marie Curie staff and its army of volunteers and fundraisers deserve our heartfelt thanks and support for all that they do, not just over the festive period but all year round. I will say more on that later.

Our thanks to Marie Curie must reach back some 75 years since its inception in 1948. Across the UK, Marie Curie has provided palliative and end-of-life care and support to millions of people affected by terminal illness and those dealing with dying, death and, importantly, bereavement. Marie Curie serves the communities that I represent with hospice-at-home services across Maryhill and Springburn and beyond, as well as at its inspirational hospice at Stobhill.

I use that word “inspirational” quite deliberately, and I extend the description to the wider hospice movement, including St Margaret of Scotland hospice in Clydebank, which showed great love to my father in the last weeks of his life. Marie Curie is inspirational and unflinching in the love, care, compassion and support that it offers people approaching the end of life, as well as their families.

Marie Curie has come a long way since its first home was opened in 1952 at the Hill of Tarvit in Cupar in Fife. Initially, it provided residential care to cancer patients and ran a home nursing service, with clinical advice provided primarily by general practitioners.

Marie Curie’s willingness to innovate, change and adapt has been crucial over the years, which is another theme that I will return to. It saw significant change in the 1980s, moving away from providing long-term nursing care to cancer patients and becoming increasingly focused on palliative and end-of-life care in communities and hospices. It was caring for more patients, who were more seriously ill, for shorter periods of time. Medical care was and is led by consultants in palliative medicine, and specialised services are provided by allied health professionals. Marie Curie hospices also developed a wide range of day services, reaching out into their communities.

The 2000s witnessed further change and innovation. Marie Curie committed to providing palliative and end-of-life care to all people diagnosed with a terminal illness, irrespective of their diagnosis, and, in 2014, to reflect that, it removed “Cancer Care” from its name.

Marie Curie has two hospices in Scotland: the one in my constituency and another in Edinburgh. However, it is a truly national service and, one way or another, offers hospice-at-home services across 31 of Scotland’s 32 local authorities.

Its report from July entitled “How many people need palliative care?” demonstrates why we need Marie Curie and others more than ever. We need their expertise, dedication and innovation. Palliative care needs are set to increase by more than 25 per cent by 2048, and modelling work suggests that the number of 85-year-olds living in Scotland will increase by 90 per cent to 257,000 by 2048. We should celebrate and welcome that scenario, but we must also address the clear service and funding challenges that will be presented to government at all levels, as well as to the wider public sector and all delivery partners that support palliative and end-of-life care.

The growing challenge of supporting all those with multimorbidities who will be in need of complex person-centred care and pain management at the end of life is daunting, but it should also be cherished. Offering love and ensuring dignity and quality of life to all in such situations is the core business of a humane, caring and compassionate society.

I said earlier that I would return to the issue of the support required. I welcome the Scottish Government’s recently announced strategy steering group to oversee the development and delivery of a new palliative and end-of-life care strategy and associated work programmes. We can all agree with the principles that will underpin the new strategy, including equitable access to general and specialist palliative care services and the development of a fair, transparent and ethical commissioning and funding process. Marie Curie and Scotland’s network of hospices and hospice-at-home services will be key partners in delivering on those ambitions, and they will also be key partners in developing the innovative new models of palliative and end-of-life care that will be required, as Marie Curie has always done since its inception in 1948.

I want to offer some suggestions to support that innovation. The debate on pay pressures and funding gaps in the hospice sector has been well rehearsed in the Scottish Parliament in recent months. The £16 million gap that has been identified has been driven, in large part, by the hospice sector trying to keep pace with the very welcome and significant pay awards that the Scottish Government has made to national health service workers.

Any new sustainable funding model for hospices must have an in-built mechanism by which NHS pay awards in Scotland recognise the clear and obvious knock-on effects on pay pressures in the hospice sector. That should form part of any ethical commissioning and funding process that is developed.

I note that some of the communities that I serve have significant levels of deprivation. Areas of deprivation are more likely to have a higher proportion of people living with multimorbidities, and doing so at an earlier age; have lower levels of healthy life expectancy; have less financial resource; and, often, have more precarious support networks. That must be taken into account when we map out how to deliver the equitable access to general and specialist palliative services that we are all committed to.

Perhaps we need to start being explicit in legislation about a right to palliative and end-of-life care, as that might focus minds and drive the budget decisions of the people who are tasked with designing future provision across Scotland. I ask the minister to consider what opportunities are presented in the proposed human rights bill and the National Care Service (Scotland) Bill, which will progress through this Parliament, to do just that, and I ask her to work with me, Marie Curie and others to achieve that end.

I conclude by congratulating Marie Curie on its 75th anniversary, and I end as I began, by passing on my heartfelt thanks to all those who offer such wonderful palliative and end-of-life care. Of course, I also wish everyone a merry Christmas and very happy new year. [Applause.]