The Guardian View On Hospices: Investment In End-of-life Care Is A National Priority | Editorial

England’s first modern hospice, group up pinch nan purpose of improving nan value of life of terminally sick people, opened arsenic a kindness successful south-east London successful 1967. Its guiding accuracy was movingly summed up by Cicely Saunders, nan caregiver and societal worker behind its foundation: “You matter because you are you, you matter to nan past infinitesimal of your life.”

Since then, done a operation of donations, fundraising efforts and financial assistance from nan NHS, nan independent hospice activity has go a cardinal constituent successful nan UK system of care. Offering affectional arsenic good arsenic aesculapian support to terminally sick group and those pinch life-limiting conditions, and delivering services to those who wish to enactment successful their ain homes, hospices are an invaluable societal asset. On some sides of nan fraught parliamentary statement complete nan assisted dying bill, nan request to ensure that bully palliative attraction is an accessible action for each has been treated arsenic a given.

All of which makes nan National Audit Office report connected nan financial sustainability of England’s big hospice assemblage a disturbing read. A dense reliance connected charitable sources already intends that a postcode lottery applies to hospice provision, advantaging wealthier areas. In its report, published connected Wednesday, nan NAO describes an ominous financial compression crossed nan board.

Almost two-thirds of independent hospices reported a shortage successful 2023-24. A diminution successful donations, nan effect of ostentation and higher employment costs is starring to a simplification successful nan number of beds and unit layoffs. Services providing psychological and bereavement support are being withdrawn, and immoderate hospices are cutting backmost connected at-home provision.

This is, rather simply, dismal news. Significant numbers of group who would wish to person palliative attraction are already incapable to entree it. An ageing population, successful which group are surviving longer pinch much analyzable wellness conditions, intends that request will only grow. As Gareth Davies, nan caput of nan NAO, observed connected Wednesday: “With galore much group expected to want hospice attraction successful nan future, it is important that nan assemblage is financially resilient.”

The Department of Health and Social Care committed this period to a three-year backing settlement for children’s hospices, and has provided a one-off bailout of £100m for superior spending successful nan big sector. But it needs to do overmuch much to buttress and boost institutions that travel retired of nan champion of nan voluntary tradition. Supplementing nan state, hospices play an basal portion successful enhancing corporate wellbeing, reducing suffering and redeeming nan NHS money.

Safeguarding nan early whitethorn mean rethinking existent arrangements, successful which nan bulk of backing for hospices is reliant connected charitable contributions. The imaginable of a state-funded assisted dying work sitting alongside a cash-strapped hospice assemblage is profoundly disquieting. The mounting debts propose it is nevertheless a chopped possibility.

For nan government, and nan state arsenic a whole, nan NAO’s study should beryllium a wake-up call. Current proviso of end-of-life attraction remains patchy and taxable to a postcode lottery, but nan early must beryllium astir description alternatively than retrenchment. Following Saunders’s groundbreaking activity successful nan 1960s, nan worth of hospices to nan NHS was only gradually recognised and acknowledged. Warm words astir nan sector’s value, and nan qualities of nan dedicated unit who activity wrong it, request to beryllium followed up pinch action.